HPSP Medical Waiver?

[jkh389]

Hello,

I am currently applying for the Health Professional Scholarship Program through the Navy to get my medical school paid for so I can practice as a physician without the worry of loan repayment. Last week, I went to MEPS and received a waiver at the discretion of the waiver authority for excessive refractive error. My vision in both eyes are 20/200 and corrected to 20/20. Now my recruiter says that he'll upload the medical record to BUMED and then we'll have to see from there. My question is that are there different waiver authorities that will look at my waiver recommendation? For instance, are there different authorities that grant waivers for pilots versus physicians, which would be my profession. Also, how likely is it that I get my waiver approved granted I had no other outstanding defects. Lastly, how soon could I expect a waiver so that I can submit my kit for the HPSP board?

Thanks for your guys' help!

 

[exNavyOffRec]

N3M looks at diopters, so those would be helpful for the Doctors on here.

also, MEPS can't waive anything for officers, only N3M can approve waivers for officers.

 

[jkh389]

My apologies, what I meant is that I received a waiver recommendation from MEPS. I understand I have to get a waiver granted by BUMED and that is what I was asking mainly about.

I'm unsure of my exact diopters since I do not have my medical record from them.

Also, do you know if there are exceptions for excessive refractory error ( > -/+8.00 diopters) for certain occupations like physicians or will my waiver get automatically denied?

 

[TimeBomb]

JKH,
MEPS simply documented you don't meet standards, but have deferred the actual waiver of standards to the relevant waiver authority for the HPSP program. BUMED will make a recommendation pro or con for that program. MEPS doesn't have waiver authority.

As a physician, you will most likely get a waiver for defective visual acuity, both for general commissioning and any operational medicine field. The waiver authorities are the same across the Navy, but the physical standards differ depending on the community. For example, aviation has different requirements for vision than SWO. Waiver recommendations are made by medical, with final waiver authority being the line.

Not wanting to call your motivation into question, but if the only reason you're going down this road is to avoid debt, please do some more research into military medicine. Military medicine isn't simply a civilian facility where everyone happens to wear the same clothes to work every day.

R/

 

[jkh389]

Thanks for your informed response, TimeBomb. I will hold tight through this process and I appreciate your concern, skepticism, or whichever about myself and the military. I am not calling out your doubts or attacking you but as someone who came to this board seeking information I think I owe you an explanation and whether you read it or not is it up to.





I think for many aspiring physicians medical loans are prohibitive. I would be lying to you if it wasn't a concern of mine because after four years of medical school you can be looking at a staggering sum of debt. It has also been well documented(http://publications.amsus.org/doi/abs/10.7205/MILMED-D-12-00244) that the cost of education has forced many physicians to specialize and pursue practices that pay more such as orthopaedics, surgery, and etc; This is one of many reasons why we see far fewer primary care practitioners in the United States and the specifics could go in a post of its own. The military is not immune to national trends and they too are seeing low numbers of primary care practitioners. This is one of many aspect where the military and my goals align in that they need family practice and I would like to practice family medicine without having the student loan debt push me to another specialty. Could I make more money as a civilian? Absolutely, ROI for HPSP diminishes quite substantially after ~14 years (http://www.ncbi.nlm.nih.gov/pubmed/21441836) for a specialty. So for someone who is thinking solely about financial stability then the military is clearly not as attractive and fortunately for me that is not the case. Secondly, I recognize military medicine is not necessarily for everyone and there are many caveats to being able to "practice". If you ever step foot in a civilian hospital, say the VA, one thing becomes evident quite quickly is that it can seem chaotic. That's because in many cases information is passed along haphazardly. Rarely do you have one point of contact that sees you through an entire episode of care and that's part of the reason why anesthesiologists have started perioperative surgical homes to reduce complications and many more deficiencies. From my Navy physician friends, one of their chief endorsements about the military is the structure and order with which medicine is practiced. Does that mean there's more paperwork and administrative duties? Yes, but that is a footnote to a very appealing method of practice. Also, when considering opportunities in medicine it is hard to deny that you will be gainfully employed for how many years you are deemed fit and able. Having job security and opportunities to pursue more education is something very few institutions or organizations can offer. Lastly, it is also important to point out patriotism and willingness to serve is important. Although I mention it last it is not a representation of its importance or level of priority. I would just like to mention that yes it is important to have a passion to serve those who serve our country but it would be misguided to say that it is the only reason or that it is the biggest factor. Even if I only do my mandatory payback of year for year, I think one should not be disillusioned regarding my commitment or patriotism because I will still be serving those who serve and practicing to my best abilities.

TL;DR debt is important but not the only reason

 

[TimeBomb]

JKH,
I came into the Navy on an HPSP scholarship and spent 23 years in uniform as an internist mostly outside of the hospital, but did a couple tours in an FP teaching hospital. When I came in, I had no intentions to remain past my obligated service date. I am currently a hospitalist in a civilian facility, so I feel I can speak with some credibility on military medicine as well as civilian medicine.

I too entered the program with a reasonably good understanding of the financials of the program and how I could reap both immediate and long-term benefits, but I had an incomplete understanding of the nuts and bolts of military medicine.

I am not questioning your motivation, but practicing in the military involves so much more than most of us appreciated when we raised our hand in the recruiter's office. There are the inevitable deployments, frequent moves that often lead to the destruction or loss of personal property, family separations and missed life events, and the random indignation of having someone watch you pee in a cup a few times a year that make the job so much different than civilian medicine. The financial compensation between military and civilian for non-specialists is close to a wash, I think, based on my experience and current pay and bonus structures. I make a lot more money as a civilian, but I pay a ton more taxes, so my standard of living and actual take home pay hasn't changed all that much, and may be even a little less that I made while on AD. If you want to do FP, realize that you will be preferentially assigned to more remote locations like small clinics, both in CONUS and overseas, and will be first in line for any operational requirements.

Your motivations are yours and yours alone. I honestly don't care if you are in it for the money, for a patriotic sense of duty, to practice in a particular working environment, or any combination of factors. However, knowing what you're getting into can save you and your loved ones a lot of ass pain over the next few years. At some point you're going to question your decision to sign up (everyone does), and you need to have the confidence that you made your choices with your eyes wide open.
R/

 

[jkh389]

Thanks for your thorough response. I do enjoy reading your response as you are someone who has been through it all. I value your insight and I would greatly appreciate if you'd allow me to PM you any questions I may have in the future regarding specifics of military med?

 

[TimeBomb]

JKH,
Please feel free to PM me at any time. I tried to do that with the reply above, but was unable to do so for some reason.
R/