Jesse Shaw, DO, is a debt-free second-year resident with four years of military medical experience behind him. Dr. Shaw joined the Health Professions Scholarship Program (HPSP) before entering medical school, and the U.S. military paid for 100 percent of his medical education. In exchange, he served in the Navy for four years of active duty after graduating from Lake Erie College of Osteopathic Medicine.
Thinking of joining the military to pay for medical school? Dr. Shaw explains the process, what he gained from serving in the military beyond a free education, and the key differences he’s noticed between military and civilian medicine.
Choosing a military or civilian residency
HPSP scholars who received support for all four years, like Dr. Shaw did, then owe the military four years of active-duty service after they finish medical school. Residency training, whether completed inside or outside the military, does not count toward the service requirement.
HPSP scholars must enter the military match, in which they’re considered for military residency slots. However, when submitting their rank list, they can include a request for deferment to pursue a civilian residency program. When scholars get deferment, they then participate in one of the civilian matches.
Dr. Shaw chose to finish his military commitment before residency. When he entered the military match, he requested and got a one-year traditional rotating internship with the Navy, which allowed him to obtain an unrestricted medical license to practice in the military. Military physicians with one year of training and a medical license typically practice as a general medical officer, the military version of a primary care physician. In that role, they have their own patients, can write prescriptions and make autonomous treatment decisions.
For his four years of service, Dr. Shaw focused on undersea medicine and worked as a dive medical officer, undersea medical officer and submarine medical officer—comparable to a general medical officer, but with added responsibilities based on the specialized training he received.
Why Dr. Shaw chose a civilian residency
When he was finishing his military service, Dr. Shaw participated in both the military and AOA matches, landing family medicine residency positions in both. Dr. Shaw ultimately chose a civilian residency through the AOA in part because it was less of a time commitment.
The military considers its residency training to be free education that must be paid back with more active duty service. Because Dr. Shaw had already completed his required service for med school, he would have owed the military additional years of service after finishing a military residency.
Dr. Shaw entered the osteopathic family medicine residency at St. Petersburg (Florida) General Hospital as a second-year resident because he’d already completed an internship year with the Navy. He also joined the Navy Reserves and currently serves as a Lieutenant.
Being a military-trained physician
Military physicians who transition to the civilian world often take maturity, decisiveness and confidence with them, Dr. Shaw says.
“If you don’t go straight through your residency and you practice as a general medical officer, you’re stepping out into the fleet and have to learn on your feet,” he says. “That can be very scary for people. You don’t really have the controlled environment that you do as a civilian.”
For instance, while working as a submarine medical officer, Dr. Shaw treated Navy SEALs on submarines where there was a very limited supply of medication and imaging was limited to ultrasound.
“Our triage skills often grow very quickly, because we have to do more with less,” he says.
Military vs. civilian medicine
After practicing medicine for four years in the Navy, Dr. Shaw noticed a few striking differences when he transitioned to a civilian residency.
“On a typical day in a Navy clinic, you’d see mainly 18-to-30-year-old patients who are healthy and physically fit, without any comorbid conditions,” he says. “In the military, we have standards for physical fitness.”
Conversely, as a family medicine resident, Dr. Shaw now treats patients of all ages, many of whom have multiple chronic illnesses.
“Managing so many different conditions and medications was something I had to learn,” he says.
The other major difference? Dr. Shaw says he’s navigating a health care system that’s exponentially more complicated than the military’s.
“In the military, everyone has TRICARE, the military health insurance,” he says. “If I wanted a study done, I could just order it. I could give any medicine I wanted. And the major Naval hospitals have staff who assist physicians with billing and coding.”
Now, Dr. Shaw is primarily responsible for managing his own billing and coding. He also finds himself dealing with different insurance companies and prior authorizations. He has to consider what his patients’ out-of-pocket costs for treatment might be.
“It’s not better or worse, but there’s a lot more to think about,” he says. “You have more moving pieces to consider to get a full treatment plan.”
Dr. Shaw says what sticks with him most from his time in the military is his patients’ stories.
“I worked with members of SEAL teams who had had missions in Afghanistan and Iraq,” he says. “I talked to people who came back when we caught Bin Laden. I heard submarine stories of people being on deployment and having to go on high alert when a Russian sub was in the area.”
For Dr. Shaw, connecting with patients through their stories reinforced the notion that caring for military personnel is an honor.
“When you join the military, you get a paid-for education, but it isn’t free,” he says. “You’re obligated to serve. But once you become active duty, you realize that the obligation is a privilege as well.”
Jesse Shaw, DO
School: Lake Erie College of Osteopathic Medicine
Residency: AOA: Family medicine, St. Petersburg (Florida) General Hospital↩