Medical school. Residency. Active duty versus civilian sponsored versus civilian deferred. Transitional year, GMO tours…what the heck am I getting myself into?! These are all questions that consumed our life for years. When my husband came to me and said he wanted to go to medical school, my first thought was how would we do that with myself working full time as a nurse and pregnant with our first child. It seemed nearly impossible. Medical school is expensive. Residency is notorious for incredibly long hours with little pay. How would we make this doable for our family??
Being that he was an enlisted Marine for 6 years prior to this, and used his GI bill for his undergraduate degree, we began researching ways to commission as an officer in the US Air Force. There were practically zero resources out there for us to reference to determine our best route through the entire process ( which let me tell you, it’s a PROCESS ). So I felt it 100% necessary to do my best to spread all the knowledge we have gained now that we are on the other side. My husband is about to graduate from his Emergency Medicine Residency at Brooke Army Medical Center in San Antonio, Texas and I could not be more proud of what he has accomplished but also what WE have accomplished together.
MEDICAL SCHOOL
So the first step in the process is to get accepted into to a Medical School. This can be a MD program or a DO program. Once you have been accepted, you can start talking to an Air Force recruiter. They will help guide you through the process of applying for the HPSP scholarship, or the “Health Professions Scholarship Program”. This is a year for year scholarship which pays the tuition in full for each year of medical school, as well as a monthly stipend, in return for years of service working in the Air Force after residency is complete. So basically a 1:1 trade. For example, we utilized the HPSP scholarship for all 4 years of school, so we owe 4 years back now that residency is complete. Some key things to note here are that you do NOT qualify for Tricare during medical school. This was a huge expense for us during those years of school because we had all 3 of our children during this time. We paid out of pocket for health coverage because I ended up changing to part-time at my job. You do get a living stipend each month, but it is minimal. I think we received about $2000/month. Obviously this was not enough for us to live on, so we did take out some federal student loans to cover the rest of our expenses. We lived on a tight budget and were always broke. It was very humbling! Typically they will complete an aerospace medicine course as well as commissioned officer training ( COT ) which will either be completed prior to starting medical school or in between 1st and 2nd year. At the end of 3rd year is when you start setting up “away rotations” at active duty residency programs in your specialty of choice. These are 1 month long rotations where they will go ‘show their stuff’ to try to earn a spot in the military match.
MATCHING INTO RESIDENCY
There are several options to completing residency. If you want to do a military residency you will apply to the military match which occurs before the civilian match. Some specialties are more competitive than others due to number of spots, how many people are interested in that specialty, and the caliber of people who typically apply for that specialty. For example, Emergency Medicine (EM) only had 18 active duty spots, with hundreds of applicants, the year we were applying. This changes year to year based on the needs of the Air Force. With that said, there are other ways to complete a EM residency, they just are not active duty. If you do not match into one of the military active duty residencies, then you will go onto the civilian match. There are 2 types of civilian residencies: Civilian Sponsored and Civilian Deferred. I will outline each of them below.
Active Duty Residency
If you match into the military match, you will begin your career on active duty as a captain in the Air Force, working at a military healthcare facility. Your time working during residency does not count towards your payback time, but DOES count towards promotion, time in service, and longevity. You qualify for full Tricare benefits during residency as well.
Civilian Sponsored
Civilian sponsored is a route where you can match into a civilian residency program if there are not enough spots on active duty, but the Air Force still needs physicians in that specialty. You qualify for full Tricare benefits and get paid as a Captain during residency, but your years during residency get added on to your payback time. So for example, if you complete a civilian sponsored EM residency that is 3 years long, you will owe 7 years AFTER residency is over: 4 for medical school + 3 for residency = 7 total. This can be the best of both worlds is you are planning to stay in for a career.
Civilian Deferred
Civilian deferred is another route that is through the civilian residency programs. You can choose where you want to try to match, but you do not receive any Tricare benefits and you get paid as a civilian resident would…which is about $50,000/year. This is a lot lower than the other two options. This time will not count towards retirement and you will owe more time after residency is over just like the civilian sponsored folks.
Transitional Year
If you do not match, you can complete a 1 year internship. After this year, you can reapply for residency or complete a GMO tour.
GMO Tour
GMO stands for general medical officer. This is an important job in the Air Force because they provide primary care medicine to active duty personnel. They are called “flight surgeons” and are attached to an air wing. These are usually 3 years long and can serve as your active duty payback time from medical school. Once your term is up you can reapply to your residency of choice.
*Check out this post to see how to thrive in residency, not just survive, now that you have made it to this point!
LIFE AFTER RESIDENCY
Life after residency seems like just a flicker of light in the vast ocean of medical school training. As each year passes, that light gets brighter and brighter, just like a tiny boat making its way to shore. As you approach the end of training, some people decide they want to go on to complete a fellowship. Others will continue onto another duty station to work as an attending in a military hospital somewhere in the world. These locations all depend on what specialty you choose. The next step of this crazy ride involves deployments, moonlighting, and typical military life. But it also includes the title of being a physician and all that comes with that including more money and a higher rank. Sit back and enjoy the fruits of your labor. Congratulations, you did it!
MEET KRISTINE
