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Exploring Military Physician Careers

September 2002

By Bonnie Darves, a Seattle-based freelance health care writer.

Career Resources Editor’s Note: A medical career in the U.S. military offers a wide variety of training, compensation, financial assistance, and time-obligation options for medical students, interns, and residents. While military service is an honorable and financially attractive approach, personal compatibility with the military lifestyle must be considered.

— John A. Fromson, M.D., Chairman of the Department of Psychiatry at MetroWest Medical Center

The U.S. military offers diverse, financially attractive, and lifestyle-friendly career opportunities in medicine.

Medical students or residents interested in serving their country and receiving substantial funding for their education and training might consider a short- or long-term career in the U.S. military. Major branches of the military — including the Army, Navy and Air Force — offer options ranging from full funding of medical school, graduate education, and even fellowships to well-compensated post-graduate training and loan repayment through service in the reserves.

In exchange, medical students and physicians must serve for two to eight years, depending on the branch of service and the specialty track they choose. When the obligatory service period has passed, physicians may either remain in the military or enter civilian practice.

For Capt. Ramey Wilson, M.D., a member of the Army Medical Corps who is doing his residency in internal medicine at Walter Reed Army Medical Center, the Army’s program was an excellent fit. After graduating from West Point in 1994, Dr. Wilson applied to the Uniformed Services University of the Health Sciences (USUHS) F. Edward Hébert School of Medicine, in Bethesda, Maryland, the country’s only federal medical school.”

“Instead of having $95,000 in debt at the end of medical school, I have no debt and was even able to buy a house,” says Dr. Wilson, 30. At the end of his residency, Dr. Wilson will have a seven-year obligatory “hitch” in the Army — in essence, one year for each year of education and residency.

How Military Programs Work

There are two primary routes to pursuing medical education and training through the military: the reserves and the Armed Forces Health Professionals Scholarship Program (HPSP). Medical students and physicians in residency must formally apply to enter either the HPSP or the reserves. The HPSP provides up to $175,000 for four years of medical training at an accredited medical school, plus a monthly stipend of about $1,100. A separate Financial Assistance Program provides an additional payment of about $22,000, plus the monthly stipend for physicians in certain specialties, including family practice, orthopedic surgery, internal medicine, and general surgery. Whether students attend the USUHS or a “mainstream” medical school, the curriculum has to include components that ensure physicians are prepared to practice in nontraditional settings such as war zones.

In the reserves, physicians or residents receive a salary or education-loan paybacks or both, and resident compensation is often slightly higher than in the civilian sector. In some programs, up to $50,000 in loan repayment is available. Nearly 65 percent of the Army’s medical forces are in the reserve component, where commitments and opportunities for service range from full-time positions to very part-time gigs — two days a month and two weeks during the summer.

For medical students or medical school applicants, requirements for HPSP are much the same as they are for nonmilitary scholarship programs — a solid GPA and good scores on the Medical College Admission Test (MCAT), along with recommendations from faculty and others. In addition, students or physicians entering military training programs or service must pass a required physical fitness exam and undergo security clearance. For some specialties, physicians may be required to be board-certified rather than simply board-eligible. Though paperwork-intensive, the application process usually takes no more than three months from start to finish.

Array of Options, Good Pay

The specialties and practice opportunities for physicians who pursue their careers through the military are virtually limitless. Training and practice opportunities in the Army, for instance, span 41 specialties, according to Maj. Tanya Beecher, a Health Services Operations officer at the U.S. Army Recruiting Command in Fort Knox, Kentucky. “Many people don’t realize that the variety in military medical practice is much like that found in civilian practice,” she says. What’s more, compensation is generally good for military physicians, with the added bonuses of excellent benefits and vacation time, reasonable call duty, and freedom from practice-management headaches. And, as a testament to the quality of military-sponsored medical education, the medical board pass rate across all military programs exceeds 90 percent.

In addition to internships and residencies, the military offers ample fellowship and research opportunities, as well as teaching and public health positions. The military-sponsored resident-match program is similar to the civilian version — and if one of a physician’s first five choices isn’t available in a military facility or residency program, he or she may request a civilian residency program and begin active duty after residency.

According to Kristen Raines, M.D., an Army Medical Corps Colonel and Director of Graduate Education for the Army Medical Command at the Surgeon General’s office, one of the key benefits of the military education path is the range of opportunities after residency, when most physicians enter active service. In the military, physicians are not only guaranteed a job after residency, they also have an opportunity to sample different practice environments. “You never do just one job,” Dr. Raines says. “You get a little flavor of administration, research, academic medicine — and if you want to get your boots muddy, you can do that, too. It’s a great way to figure out what you like to do.”

Nevertheless, while military physicians may put in specific requests for active duty and can practice in just about any kind of geographical setting (including overseas), the typical opportunities are on bases, in the field, in established military medical facilities, and in urban civilian settings. Also, where military physicians are stationed may depend on prevailing geopolitical conditions. In peace time, it’s usually easier to secure a post of choice than it is in war time. Military physicians must accept that our country’s needs will often dictate where they go.

When working at a military installation, physicians may live either on- or off-base, but many facilities have waiting lists for military housing, and on-base living environments vary considerably from one installation to the next. Waiting lists notwithstanding, some military physicians prefer the myriad support services that on-base living affords, while others seek the greater privacy, neighborhood diversity, and access to civilian schools that off-base living offers.

See the World

Physicians working in the military have an opportunity to practice in top-notch facilities, including Walter Reed or the National Naval Medical Center, or in VA centers and scores of other facilities in the United States and throughout the world. Those who seek adventure, special challenges, or unusual missions will have opportunities to practice in foreign countries, often in remote locations where care must be given under difficult conditions. Both military-specific and civilian-setting positions are available. Concludes Dr. Wilson, "What’s exciting for me is that I really don’t know what Uncle Sam will have me doing in a couple of years.”

For physicians with families, however, deployment for periods ranging from a few weeks to several months may be difficult. Remember also that hazardous duty is always a possibility in the military. Physicians like Dr. Wilson may find it exhilarating to practice medicine in a Third World country, in a war zone, or in a locale where potentially fatal infectious diseases pose a threat to patients and physicians alike. Others may find this “excitement” a bit more than they want in their daily practice.

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