Money Matters: Is HPSP worth it?

What is HPSP?

The Health Professions Scholarships Program is a program for those seeking advance degrees in medicine who wish to serve in the U.S. Military. For more information about the scholarship and who is eligible check out some of my previous posts here.

What is Covered?

  • Full tuition (up to 4 years, depending on specialty)
  • Mandatory Books & medical equipment
  • Monthly stipend of about $2,200 (Not including taxes)
  • $20,000 sign-on bonus (Not including taxes)

What is Not Covered?

As a medical student you will find that some of the most effective study materials are not those required by your school (meaning HPSP will not reimburse for these items). During my first two years that meant the review books I bought to break down the idiosyncrasies of physiology, biochemistry and pathology were not covered. There are supplemental costs that you don’t anticipate when preparing for boards including subscriptions to some of the most helpful online reference which can quickly add up. To demonstrate this, I compiled a list of the resources I used over the course of my first 3 years of medical school:

Pre-Clinical Year’s Expenses (1st & 2nd Year)

Resource Item

Cost

Online Lectures Sketchy Medical  $315
Pathoma  $85
Question Banks UWorld (1 year access) $400
Combank (1 year access) $390
Practice Tests Comsae $60
NBME $60

Total Non-Reimbursable Expenses

$1310

 

Clinical Year’s Expenses (3rd Year)

Internal Medicine Step Up to Medicine $50.00
Pocket Medicine $25.00
Maxwell Quick Medical Reference $8.00
OBGYN Blueprints for OBGYN $28.00
Pregnancy Due Date Wheel $13.00
Pediatrics Case Files – Pediatrics $24.00
Family Medicine Case Files – Family Medicine $24.00
Family Medicine Shelf Exam $55.00
Psychiatry First Aid for the Psychiatry Clerkship $32.00
General Surgery Pestana $19.00
Surgical Recall $38.00
Step 2 CK/COMLEX CE UWorld Step 2 CK Question Bank (1 Year) $399.00
Step Up to USMLE Step 2 CK $38.00
First Aid for the USMLE Step 2 CK $44.00
Step 2 CS/COMLEX PE COMLEX Level 2 Review Guide $63.00
Airfare to Chicago* $120.00

Total Non-Reimbursable Expenses

$925

Additionally I had some expenses my school or clinical rotation sites charged me that were not reimbursable such as annual TB tests, drug tests, application fees, graduation fees, etc.

Applying to Residency – 4th year expenses

The decision to apply for a military or civilian residency is dependent on the branch of service you are in and can vary depending on which speciality you are applying for. For those of you in Air Force or Navy HPSP, you are encouraged to apply to civilian residency programs as there aren’t enough training spots at military facilities meaning a portion of each class is required to train at a civilian institution for residency (ie they need 20 OBGYNs but only have the capacity to train 15 at a military facility so 5 students would be deferred to a civilian residency). Since the Army is so large, they typically have enough residency spots for the Army HPSP members so many of these students choose not to apply for a civilian residency program. For the students applying for a highly specialized field (ophthalmology, neurosurgery, radiation oncology, etc), there may not be training opportunities at a military facility so these students may also have to apply for a civilian residency program.

Civilian residency applications are now submitted via the Electronic Residency Application Service (ERAS) which is a division of the Association of the American Medical Colleges (AAMC). How many residency programs a student applies to is dependent on which specialty they are pursuing, how competitive they are and geographically where they would like to live.  Most of my classmates applied to 15-30 programs, but it’s certainly not unheard of to apply to 50+ programs depending on an applicant’s circumstances. Rather than try to break down the cost of each residency application myself, I think the ERAS website does a fantastic job of summing up the associated fees. This information was taken directly from AAMC ERAS Frequently Asked Questions:

ERAS application fees are based on the number of programs applied to per specialty and there may be additional fees if you are applying to both AOA & ACGME programs.

Programs Per Specialty Application Fees
Up to 10 $99
11 – 20 $13 each
21 – 30 $17 each
31 or more $26 each

Example 1:

Applying to 30 Emergency Medicine programs:

[$99.00 + (10 x $13.00) + (10 x $17.00)] = $399.00

Example 2:

Applying to 20 OB/GYN programs & 10 Family Medicine programs:

[$99.00 + (10 X $13.00)] + [$99.00] = $328.00

Fortunately the HPSP scholarship does reimburse some of the costs when applying to a civilian residency but these are dependent on the branch. As of the 2018 application season, the US Air Force reimbursed their scholarship recipients for up to $350 of their ERAS application fees. While you are encouraged to apply for civilian residencies, unfortunately the expenses accrued while interviewing for civilian programs (airfare, rental cars, room & board) are not reimbursable and can quickly add up to hundreds, if not thousands of dollars depending on how many programs you choose to interview with.  

One of the perks for HPSP members is that during your 4th year of medical school you have the opportunity for two 1-month long audition rotations at a military residency program that are included in your scholarship. Airfare, rental car, room and board are all covered, however the applicant pays for the rental car and hotel up front and waits to be reimbursed at the completion of the rotation. While you are guaranteed reimbursement, it can often take 6-12 weeks to receive reimbursement which means that you begin accruing interest if you put the charges on a credit card. Also word to the wise, the closer it gets to the end of the fiscal year (October), the longer it takes for you to receive your reimbursement.

Is HPSP Worth It?

It depends!

If you are looking for a way to save a lot of $$$ and get a “free” ride to medical school  –> No

If you are looking for a way to serve your country, work with our active duty military and veterans, make life long friends, and take on a leadership role –> Yes!

Time and time again I have people offer me their two cents on HPSP. I have had classmates tell me that HPSP “wasn’t a good deal” or it makes more sense to enroll in a loan forgiveness type residency program. I would agree with them if my main reason for joining was strictly financial. While I do love that HPSP allowed me to avoid taking out hundreds of thousands of dollars in loans, provided me a little bit of money each month to live on and covered the costs of my expensive medical equipment I joined because I want to be a military physician. 

There are certain scenarios that make the HPSP financial benefits that much more appealing:

  1. You are attending an expensive medical school
  2. You are going into a primary care specialty

For those of you who are attending a fairly cheap medical school (like myself) and are going into a non-primary care specialty (ditto) then you likely will lose money compared to your classmates who are going into the same specialty. As a military physician you will not be making $500,000-$600,000 that civilian anesthesiologists, neurosurgeons, invasive cardiologists, etc have the potential to earn.

That being said working for the military you are entitled to certain financial benefits. While your income is subject to taxes, certain parts of your income are tax exempt such as your basic allowance for housing and for subsistence. You will be reimbursed for any moving expenses to residency and for each subsequent duty station while in the military and for expenses accrued for mandatory training or away rotations. There are also other benefits that aren’t directly provided by the military. For instance you may have certain fees waived for housing applications, credit card application, home loans etc just for serving in the military.


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