Just want to make some clarifications so people who find this in the future don't get some bad gouge
the dean of the med school got up and told the students, that while it's attractive to have their tuition paid for, that the services will control where they go to their residencies.
This is absolutely 100% correct. They will also potentially control what specialties are available. For example, for many years the Navy did not train anyone in Physical Medicine & Rehabilitation (PM&R). If someone wanted to do that specialty they were out of luck if they were in the Navy.
In addition, the dean has to include in his recommendations to residency programs that the med student is a member of the military and may be yanked out of the residency program, if the service branch decides that they need them for something.
This is incorrect. Yes, there is a letter that is included with residency applications called, get ready for it... The Dean's Letter
It would include that the person is on a military scholarship; however, it would not include that the member "may be yanked out of the residency program" as that isn't true. Sure, if World War 3 broke out, then all bets are off, but members in residency are essentially in a protected class.
the prospects of that possibility freaks out the residency programs and often they will not accept the military med school grad
Personally I have only seen positives from residency program directors in regards to military members. For those who come with funding the programs love us as we are essentially free labor. For those who come without funding the programs "know" a bit more about the person they are taking on given the usually positives associated with people who sign up for the military.
(assuming that the grad is not going to the few military hospitals, which have very few residency spots.)
The military hospitals actually have quite a number of spots available. Yes, they aren't as numerous as the number around the country, but there also aren't as many people competing for those spots. The Air Force is the most egregious in having more medical students than intern/residency spots, but that number isn't higher than maybe a few dozen.
This has recently happened to someone I know and it was devastating to a very capable and talented med student.
I won't rain on anyone's parade, but the best applicants don't go unselected....not to be harsh but residency selection is a crazy competitive selection process except for some of the less competitive specialties, but even then it can vary by year & location.
Their choices are then to do a transition year and hope 1. that they get a residency at a military hospital the next year, 2. switch to another speciality that has more spots for residency (but is maybe something you don't want to do) or take a chance reapplying to civilian programs next year with the same language in the dean's letter to the programs.
Residency selection amongst HPSP folks is a little backwards at times. The explanation you have is close. First, the person is obviously a 4th year medical student who went through the military match in December. Sounds like they did not match their desired specialty and instead was given a 1 year deferment. I'm going to assume this person is Air Force as they are essentially the only Service that does it this way. Now, since the military match happens in December the person then had to go interview around the country to find an intern year program for the upcoming "regular (ie civilian)" residency match which just occurred in March. The Dean's Letter is the same for every match and every year. It doesn't change depending on where one applies as it is very "cold" and objective. So the same letter will be what this person gets for the rest of his life. (except after 4th year ends they will add the info from 4th year). So now this person is stuck re-applying next year for the same two matches. Since they only got a 1 year deferment from the military come next December another Board result will come out identifying if that person has been selected for one of the military residencies or has possibly, unlikely, been granted a deferment to complete the remainder of residency as a civilian. (I say unlikely as normally if the Service wants someone to complete a residency as a civilian they will be given a full deferment the first time around) OR if not selected for either of those options the person will end up serving as a General Medical Officer for a handful of years. (This is AF specific, GMO's work a little different in Army/Navy Land).
So, there is no "take a chance on" applying to civilian programs again next year. The military either will or will not allow that come December. If the military gives him a deferment then the Dean's Letter is not going to be the hold up on getting into residency. Reality is that he will very likely be a GMO after next year is over. If he is Air Force his destiny has almost certainly already been decided in that regard if he only got a 1 year deferment.
Wow, okay, that became way longer than I meant. Essentially, yes, the military owns you once you sign the dotted line. They will tell you if you can apply to civilian residency programs or not (I have done both in my training pipeline). They can also send you to a civilian program for a year and then have you complete the rest within the military system. The Dean's Letter will not be a Scarlet Letter if you are in one of the military programs.