Navy HPSP / GMO Query

I got a nice email form someone who stumbled across this Humble Blog, and had the following questions; my replies follow. Those who have something constructive to add, please do so in the comments.

1. I’m most interested in EM. Given that I have no prior military service/experience, am I basically going to have to do a GMO tour to get this specialty?

Well, it depends on a lot of factors. Your branch of service is probably the biggest determinant (AF is best, Navy is historically worst at going from Internship straight to residency without a GMO tour), but there are several reasons you might not want to go straight to residency.

Honestly, residency is easy compared with being a GMO, at least the first year of a GMO tour. I finished a Basic Surgery Internship, and went to the fleet as a Battalion Surgeon (honorary doc title). I could spit out the Ddx of hypersplenism but had no idea how to treat musculoskeletal back pain, an ankle sprain, or PFPS. I’ll get into the rest of this later.

2. Did you do a GMO tour? If so, how was it?

Yes, GMO for 4 years. Fortunately for me it was between conflicts. To plagarize some guy, it was the best of times, it was the worst of times. Seriously, if I could have my GMO job 1/2 time and my real job 1/2 time I’d be a very happy person, and a happy doc.

3. What made you ultimately decide to stay in military post-active duty or leave for private practice?

I wasn’t a career type, and I knew I wanted to work in the real world. At the time new EM grads were going to boats, and while they’d be very useful there were there a shooting war, it would be a punishment tour otherwise.

4. What kind of leadership opportunities did you have in military medicine that you feel would have been impossible/unlikely in civilian medicine?

I got to lead, really lead, some excellent Navy Corpsmen, I got to advocate for some Marines and Sailors who needed it, and I got to go places nobody gets to these days. (2 trips to Iwo Jima, try booking that on Kayak).

5. Would you have decided to still do HPSP if the scholarship amount was significantly smaller? (ie, <50% what it is).

It was that then, I did it because I wanted to serve and it served by desires and interests. In general, if you’re considering HPSP just to pay the bills you won’t be a happy camper, and you’re signing on the line for a lot of years.

6. Is it possible to find out how many GMOs the Navy needs? (Currently, there are rumors that the Navy is going to change the GMO program).

No idea. But, don’t consider GMO time punishment, or time lost, it’s just something different, and I still think of (parts of it) fondly. The bonus of being a GMO and re-applying to a military residency? Time in Service is weighted on your app. So, if you want to be a brain surgeon but were bottom of your class, after a few GMO tours you’d most likely be in (YMMV).

Best of luck with your decision, and please let me know how it goes!


  1. Similar experience here, from a former Army Doc.
    Big mistake to look at GMO as anything other than a wonderful, interesting, educational and satisfying experience. Again YMMV. I went from being a surgical intern, then the lowest life form on earth, to a clinic director of an isolated but busy clinic, with 30 people looking to me for leadership and supervision, in the space of a couple of weeks. Was I ready for this? Heck, no. Did I do a good job? My bosses and patients thought I did. Did I learn anything? Absolutely. Much of what I learned in formal post-graduate training before and after that (5 years total) has turned out to be wrong. Everything I learned during my 2 years of GMO has turned out to be useful/valuable and something that I have built on in my subsequent military and civilian practices. Also, as our host points out, you get to have fun, meet some of the best folks in the world, and do stuff and see things that your civilian counterparts can only read about on blogs.

    Again, echoing our host, don’t do it for the money. Do it for the troops, for your country , and for yourself.

  2. Hello GruntDoc,

    I have a question for you, sir: it seems that a GMO tour would be useful if one would like an adventure and plans on going into certain areas like EM, surgery, or FP (“hands-on” areas). But what about those more “theoretical” specialties like radiology or path?

    I’m a slightly non-traditional student and will be starting med school at 27. I’ve probably had enough “adventure” that I can professionaly get away with, so I’d like to be more practical and focused in my choices when deciding which branch to serve with as an HPSP candidate.

    If I were absolutely convinced that I absolutely will be a radiologist, what practical benefit would you see (if any) in me serving as a GMO? In other words, how could taking care of healthy, indestructible young soldiers directly benefit my skill as a radiologist?

    I thank you in advance for your reply, sir!