Is it typical to stay on after the commitment is completed?
There is some very interesting data that has just come out of NHSC, and I cannot recall all of it, but the majority of NSCH loan repayers and scholars stay at underserved clinics. They don’t always stay at their original site, but they tend to transfer to other underserved sites with high HPSA scores.
I understand NSHC loan repayment program is in exchange for a 2 year commitment, but i also read that additional funds could be used for a third year of service if additional funding is available. Do you know how the funds are prioritized and if current members would get preference for funding?
It would primarily have to do with the [HPSA] scoring of the site, and the available funding for that particular year. The funding for the NHSC can vary year to year based on what is passed by Congress.
Of the students that I had go to work at a NHSC loan repayment sites, most of them have stayed within the system and they have been able to continue to get loan repayment money even after 2 year commitment. I’ve had a few students who decided it wasn’t for them and they left after 1-2 years, but most have stayed beyond their 2 year commitment.
What do you see or hear from your students that you think keeps them in the program?
For some students, it’s a calling. I have other students that just need to get out of debt because they financed all of PA school. It is a great program and is a great way to gain a lot of great skills.
You are taking care of people that have a lot of medical problems and they access issues, so you learn a lot about the health care system, a lot of primary care, and a lot of procedures. A lot of patients couldn’t or wouldn’t go to an emergency room, so you gain a lot of experience with a good base of skills that you probably would not get in your standard primary care practice that can transfer to any specialty.
Could you speak to what types of backgrounds you see for the students awarded a scholarship?
The scholarships are divided up amongst the different professions supported by NHSC, and that is mandated by Congress. So, MD students may get X dollars, dentists, PAs, nursing, mental health all have a set dollar amount that is given as a percentage of the overall budget. The scholar process is very competitive.
They look at the applicant, their demographics, their background and it is much harder to get those scholarships than it is to get loan repayment. The scholarships are more expensive because the NHSC will pay for a more expensive school if that is where the student is going.
Transitioning from Training to Practice
Welcome to the next phase of your NHSC journey!
Before you graduate, we will send you timely information and helpful resources to help you identify an NHSC-approved site where you will complete your service commitment.
Download and read the NHSC Scholar Orientation and Employment Search Guide. It highlights key deadlines, HPSA requirements, and travel and relocation costs that are covered by NHSC.
Review the Postgraduate Training Bulletin (PDF - 298 KB).
NHSC- Approved Sites & HPSA Requirements
You must work at an NHSC-approved site that fulfills the minimum Health Professional Shortage Area (HPSA) score for your class year. Please refer to the chart below.
HPSA Score Requirements by Class Year*
|NHSC Scholarship Program|
(all disciplines – MD/DO, PA, NP, DDS/DMD, CNM)
*A class year runs October 1 – September 30 and is based on your ‘Available for Service’ date.
Additional information on selecting a site can be found in these helpful resources:
Identifying Job Opportunities
You will have the opportunity to identify open positions located at NHSC-approved sites in high-need areas that are right for you and your family. It is your responsibility to select sites that appeal to you and interview with them. Check out these helpful tools during your site search:
- Health Workforce Connector – includes open positions and information on NHSC-approved sites. You can narrow your search based on location, discipline, specialty, HPSA score, or site name. You should also contact NHSC-approved sites directly to inquire about open positions that might not be listed in the NHSC Jobs Center.
- NHSC Virtual Job Fairs – allow you to experience an interactive recruitment event from the comfort of your own home. Learn about the exciting job opportunities that are available at NHSC-approved sites across the country and interact with NHSC site administrators to gain key insights about populations served, employment benefits, advantages of working with interdisciplinary teams, and the unique communities.
Visiting and Interviewing at NHSC Sites
Once you have identified current NHSC-eligible jobs of interest, contact those sites and work your Regional Advisor to verify the HPSA score. If you are selected for an interview, the NHSC will coordinate and cover up to $1,200 in allowable site visit interview travel costs. Before you interview, check out some of these tip sheets to help you determine what site works for you.
Once you have received a job offer from an NHSC-approved site where you want to fulfill your service commitment, you must upload the following documents to your Customer Service Portal account:
- Results of Your Final Professional Exam (e.g. USMLE or COMLEX Step/Level 3, PANCE)
- Unrestricted State License in the State that You will Practice (unless it is a Federal Prison, Indian Health Service Site, or an Immigration and Customs Enforcement Site)
- Copy of Your Job Offer Letter
- Copy of Your Acceptance Letter
If you live within 50 miles of your new job location, you are NOT eligible for NHSC-supported relocation services. Once you have accepted a job and submitted all four NHSC required documents, you are ready to actively plan a move to your new location. The NHSC provides assistance for your initial relocation; it does not provide any relocation support for additional transfers, or moves, beyond your first NHSC-approved site.
Residency/Postgraduate Training, Deferments & Licensure
In the spring of the year of graduation, and each subsequent year of residency training, all physicians and dentists pursuing approved postgraduate training must request deferments to postpone their required NHSC service commitment until they have completed their specialized training. Review the Postgraduate Training Bulletin (PDF - 298 KB) for additional details.
To request a deferment of service in order to attend a residency program or fellowship, you must submit a deferment request through the Customer Service Portal each year. Those eligible to defer the service obligation (MD, DO, DDS, and DMD students) will receive information on deferment during the last year of medical or dental school and will be notified when the deferment request must be submitted. If you do not submit a Deferment Request each year of residency training or fellowship, you may be considered to be in default of the NHSC service obligation and subject to penalties.
Physicians (MD or DO) must complete a residency training program in one of the primary care specialties:
• Family Practice (3 years )
• Internal Medicine (3 years)
• Pediatrics (3 years)
• Obstetrics-Gynecology (4 years)
• Psychiatry (4 years )
• Internal Medicine/Family Practice (4 years)
• Internal Medicine/Pediatrics (4 years)
New deferments will not be granted for dual residencies other than internal medicine/family practice and internal medicine/pediatrics.
One-year osteopathic internships may be approved for deferment. If you plan to pursue this internship year, please provide a letter from your training program stating that the internship is for one year and is prior to entering residency training. Upon completion of the year internship, osteopathic physicians are required to enter and complete a residency program in one of the approved specialties.
Fellowships may be approved for deferment:
• Child Psychiatry following Psychiatry (2 years)
• Obstetrics/Gynecology following Family Practice (1 year)
• Geriatrics following Family Practice or Internal Medicine (1 year)
The NHSC does not provide financial support (e.g., stipend, training expenses, etc.) while you are in postgraduate training. Physicians will be in default of the NHSC contract and liable to pay penalties if they:
• Do not enter an approved postgraduate training program
• Enter an unapproved postgraduate training program
• Do not complete the approved postgraduate training
NHSC requires all physicians to pass all three parts of the medical licensing examination (USMLE or COMLEX) prior to completing their last year of training, so that service can commence immediately upon completion of approved postgraduate training. It is your responsibility to select a residency program that will adequately prepare you to sit for the USMLE or COMLEX and obtain the appropriate license to practice in the United States. You must notify the NHSC when you have successfully completed all three parts of the medical training examinations.
Dentists are not required to, but may elect to participate in, postgraduate training in:
• General Practice Dentistry (1 year)
• Advanced Education in General Dentistry (1 year)
• General Pediatric Dentistry (2 years)
• Public Health Dentistry (2 years)
If you decide not to participate in postgraduate training, you must begin service as a general practice dentist within 6 months of your graduation from dental school. If you do pursue postgraduate training, you must notify the NHSC in the spring of your final year of dental school and then also submit a Deferment Request.
NHSC will not provide financial support (e.g., stipend, training expenses, board exam fees) while you are in an approved postgraduate dental training program.
Dentists will be in default of the NHSC contract and liable to penalties, if they fail to either begin service as a general dentist at an NHSC-approved site within 6 months of graduation or do not receive an approved deferment for postgraduate training after graduation from dental school.
You are expected to take the appropriate exams at the earliest possible date. The NHSC requires all dentists to pass both parts of the National Board Dental Examination (NBDE Parts 1 and 2) prior to completing their last year of dental school or approved postgraduate training so that service can commence immediately upon completion.
To assure that dentists will have licensure in states with the greatest dental needs, NHSC reserves the right to determine which Regional or State clinical licensing exam you should take and pass prior to your service start date.
When to Notify the NHSC
After the NHSC has approved your deferment request, please notify us via the Customer Service Portal if you:
- Do not obtain a position in the postgraduate training program that the NHSC has approved
- Change your address
- Plan to switch residency programs
- Plan to suspend training for maternity leave or other medical or personal reason