Navy Medicine Force’s Focus
BLUF – The Office of the Navy Medicine Force Master Chief has released a new, bi-monthly publication designed specifically for active duty and reserve Hospital Corpsmen across the fleet and operating forces.
Developed directly from fleet feedback, the two-page newsletter serves as a direct line of communication from the Force Master Chief to provide actionable career management tools and highlight operational excellence within the Hospital Corps rating.
You Made CDR! Now What?
If you are one of the lucky people who made CDR, I have some things for you to consider:
- The next 2-3 years of FITREPs may mean very little to your overall career. First, you are soon going to be in the most competitive group in Navy Medicine, Commanders scratching and clawing to make Captain. If you are at a medium to large command, no matter what you do as a junior Commander, you are likely to get a P (promotable) on your FITREPs. That is just how it works for most commands.
- This first bullet means that now is the PERFECT time to do something “alternative” (off the usual career path) or take a position that you know will get you 1/1 FITREPs or be part of a very small competitive group. Go to the War College. Take a senior operational job where you’ll get a 1/1 FITREP. Become a Detailer. Apply for fellowship or additional training because the NOB FITREPs won’t hurt you as a junior Commander or Commander Select. Now is the time to do these type of things. You don’t want to wait until you are a few years below zone for Captain. When you reach this stage you’ll need competitive EP FITREPs.
- After you are selected for your next rank is also a great time to move/PCS. Have you ever been OCONUS? If not, now would be a great time to go. You can PCS somewhere for 2-3 years and then PCS to the command where you are going to set up shop and try to make Captain. At OCONUS commands there is more turnover of staff, so major leadership jobs like Department Head and Director positions open up more frequently, setting you up to get a senior position when you return to CONUS.
- You may think I’m crazy, but it is time to start thinking about how you are going to make Captain. As I mentioned in the first bullet, getting a job that will make you a Captain is tough and competitive. Now is the time to do the things that will make you an excellent candidate for one of those jobs. Want to be a Residency Director? Maybe you should get a degree in adult or medical education. Want to be a Director? Maybe you should get a management degree like a Masters in Medical Management or an MBA. Want to be a senior operational leader? Now is the time to do Joint Professional Military Education I and/or II. Applying for an official Milestone Position is probably the easiest way to make O6 if you get one and are successful.
- Here is a list of the jobs that I think will likely make you a Captain in the Medical Corps. Other Corps will have similar lists you can likely build by getting info from your Corps Chief’s office or Detailer or by closely examining your Corps’ career pathway. Read the list…figure out which of these jobs you are going to use to make Captain…and get busy preparing yourself to get them:
- Residency Director
- Department Head in a large MTF
- Director
- Chief Medical Officer
- Officer-in-Charge
- Major committee chair
- Medical Executive Committee President
- BUMED staff
- Specialty Leader
- Deployment requiring an O-5 or O-6
- Detailer
- Senior operational leader
- Division/Group/Wing Surgeon
- CATF Surgeon
- Amphib or CVN Senior Medical Officer
Optimally you’ll have the time when you are an O5 to do multiple jobs on the preceding list. For example, as an O5 I had been a Detailer, a Specialty Leader, Department Head, Associate Director, and CO of a deployed unit. My next step was to become a Director at a major MTF, and while I was a senior LCDR and CDR I obtained a Naval Postgraduate School MBA as well as achieved certification as a Certified Physician Executive to try and make myself a competitive candidate for a Director position. Ultimately, I became the Director for Healthcare Business at NMC Portsmouth.
Congratulations on making Commander…take a deep breath…and start thinking about some of the things I mentioned in this post. Before you know it you’ll be in zone for Captain.
What Should You Do If You Didn’t Promote?
If you are particularly interested in this post, I’m sorry. You or someone you care about probably failed to promote. In reality, nowadays it is common to fail to promote, so you have company. Here are my suggestions for those that fail to promote.
Try to Figure Out Why You Didn’t Promote
First, try to figure out why you didn’t promote. Because the promotion board members are not allowed to speak about your board, you’ll never actually find out why you failed to promote, but you can usually take a pretty educated guess if you talk to the right people.
If any of these things happened to you, they are likely a main reason you didn’t promote:
- Any PFA/BCA failures in the last 5 years, especially if you have not passed since your last failure.
- Legal issues, such as a DUI or any other legal trouble.
- Failure to become board certified.
There are other things that could happen to you that make it difficult but not impossible to promote. They include:
- You have not been operational or deployed at all, or you have done so much less than your peers.
- Having non-observed (NOB) fitreps before the board, such as those in full-time outservice training.
- Spending too much time in the fleet as a GMO, Flight Surgeon, or UMO. This is mostly because it causes you to come into zone for O5 while you are still in GME, and is more of a problem if your residency is long.
- Never getting a competitive early promote (EP) fitrep. Many officers who fail to select have never had a competitive EP fitrep in their current rank. This can be because they were stationed places without competitive groups and they get 1/1 fitreps, or it can be because they were in a competitive group and did not break out and get an EP. To me this is the #1 ingredient to promote…competitive EP fitreps. If you don’t have them, you are really up against it unless you are in a senior operational position that carries a lot of weight.
- Receiving potentially adverse fitreps. This most commonly happens when you are at an operational command and your reporting senior is not someone who is used to ranking Medical Corps officers, although it could happen for other reasons (like your reporting senior felt you deserved this type of fitrep). The most common situation would be if there is a competitive group of 2 officers but both are given must promote (MP) fitreps instead of 1 getting an EP and the other the MP. When both get an MP, it reflects poorly on both officers unless the reason for this is CLEARLY explained in the fitrep narrative, which it often is not. The other thing that happens is that a reporting senior gives you a 1/1 MP instead of a 1/1 EP. If you are ever getting a 1/1 fitrep, make sure you get an EP. You should consider getting a 1/1 MP an adverse fitrep. If there is no way around this, often because the reporting senior has a policy that they don’t give newly promoted officers an EP, make sure that this policy is clear in the fitrep narrative.
- Having a declining fitrep. Mostly this happens when you go from getting an EP to an MP on your fitrep under the same reporting senior. If it is because you changed competitive groups, like you went from being a resident to a staff physician, that is understandable and not a negative. If you didn’t change competitive groups, though, make sure the reason you declined is explained.
- Making it obvious to the promotion board that you didn’t update your record. The most obvious ways a promotion board will know you didn’t update your record is if your Officer Summary Record (OSR) is missing degrees that you obviously have (like your MD or DO) or if many of the sections of your OSR are either completely blank or required updating by the board recorders. Remember that although promotion board recorders will correct your record for you, anything they do and any corrections they make are annotated to the board. While a few corrections are OK, you don’t want a blank record that the recorders had to fill in. It demonstrates that you didn’t update your record.
Who Actually Promotes?
So who actually promotes? In general, the officer who promotes has:
- Achieved board certification.
- Spent time in both a military treatment facility and in the operational or headquarters setting.
- A demonstrated history of excellence as an officer. In other words, whenever they are in a competitive group, they successfully break out and get an EP fitrep. Being average is just not good enough anymore.
- No PFA failures, legal problems, declining fitreps, or potentially adverse fitreps.
- Updated their record, and if they previously failed to select they reviewed their record with their Detailer and actively worked to improve it.
What Do You Do If You Failed to Promote?
Realize that it is not the end of the world. Based on the recent promotion board statistics, many officers were passed, but a large number of the officers selected were from the above zone group.
If you do nothing, you will continue to get looked at by promotion boards until you retire, resign, or are forced out of the Navy. There is no limit to the number of chances you get to promote and your record will be evaluated for promotion every year. That said…
You need to try to promote. Consider sending a letter to the promotion board. What do you say in this letter? First, briefly state that you want to be promoted and to continue your career in the Navy. Second, explain what a promotion would allow you to do that you can’t do at your current rank. Answer the question, “Why should they promote you?”
For example, if you want to be a Department Head at a large military treatment facility (MTF), a senior operational leader, or a Residency Director (or whatever you want to do), tell them that you need to be promoted to be competitive for these jobs. The Navy wants to promote leaders. Make it clear to them that you are a motivated future leader.
Try and get letters of support to attach to your letter. These letters should be from the most senior officers who can personally attest to your value to the Navy. In other words, it is probably better to get a letter from an O6 who knows you well than a 2 star who doesn’t. If you are not sure who to ask for letters, ask those more senior to you or your Detailer for advice. Your Specialty Leader is always someone to consider if he/she knows you well and can speak to your contributions to the specialty and Navy.
Have your record reviewed by your Detailer, Specialty Leader, or other trusted senior advisor (like me). Because of promotion board confidentiality, you will never know the reason(s) you did not promote, but most of the time experienced reviewers can come up with an educated guess. They’ll often find things that you were not even aware of, like potentially adverse fitreps, or information missing from your record.
Do everything you can to get “early promote” or “EP” fitreps. This is largely accomplished by continually striving for positions of increased leadership. You need to get a job that has historically led to a promotion while keeping in mind that the MC career path emphasizes that all need to be operational.
As a LCDR who got passed over for CDR, try to get one of these jobs and excel at it (this list is not exhaustive and these positions are not the only path to CDR, but they are a good start):
- Assistant Program Director
- Division/Department Head
- Fleet Surgical Team (FST) Specialty Staff
- Global Health Engagement (GHE) Staff Officer
- Group/Senior Flight Surgeon (FS)
- Medical Battalion Specialty Staff
- Medical Executive Committee (MEC) Member
- Regimental Surgeon
- Senior Undersea Medical Officer (UMO)
- Ship or Group Senior Medical Officer (SMO)
- SMO/Medical Director
If you are a CDR who got passed over for CAPT, try to get one of these jobs and excel at it:
- Assistant Specialty Leader or Specialty Leader
- Chief Medical Officer (CMO)
- Director/Large Department Head at a NMRTC/MTF
- Division/Group/Wing Surgeon
- FST Officer-in-Charge (OIC) / CATF Surgeon
- GHE, Headquarters, or Navy Personnel Command (PERS) Staff
- Group UMO
- LHA/LHD/CVN SMO
- MEC Chair
- OIC
- Program Director
- Senior GHE Billet
Meet with your chain-of-command. After you’ve been passed over is not the time to be passive. You need to sit down with your leadership and get an honest assessment from them of how you’re doing and what they would recommend continuing to advance your career. You may not like what you hear, but it is better to find out early if they don’t think you’re doing a good job or that you are unlikely to break out on your fitreps. That way you can try and put yourself in a better situation by changing commands.
Things You Should Not Do
In addition to the above list of things you should do, there are a few things you should not do:
- Do not lie in your letter to the board. In other words, don’t tell them you want to do Executive Medicine if you don’t really want to. Your record reads like a book, and if it tells a story that is contrary to what your letter says, this is unlikely to help you and may hurt you.
- Do not send long correspondence. Promotion boards have to read everything sent to them, and a long letter may not be appreciated. Keep it brief and to the point.
- Do not ask your current CO to write you a letter to the board if they’ve done an observed fitrep on you. His or her opinion about you should be reflected on that fitrep, so they don’t need to write you a letter. If they’ve never given you an observed fitrep or there is some new information not reflected on prior fitreps, they could write you a letter. Ultimately it is up to them whether they write the letter, though.
- Do not discuss anything adverse unless you want the board to notice and discuss it. This issue comes up frequently and people will ask me for advice, but ultimately it is up to the individual officer. The one thing I can guarantee is that if you send a letter to the board and discuss something adverse, they will notice it because they will read your letter! If you think there is a chance the adverse matter will get overlooked, it is probably better not to mention it and keep your fingers crossed.
Never Stop Trying
Those are my tips for those who find themselves above zone. Most importantly, if you want to promote, NEVER STOP TRYING. I personally know of people who got promoted their 9th look!
After Epic Fury, Navy may need an extra $8 billion to be solvent, CNO says
BLUF – Chief of Naval Operations Adm. Daryl Caudle says the Navy needs an additional $6–8 billion in FY26 to cover the costs of combat operations against Iran, personnel expenses and replenishing depleted munitions while avoiding cuts to priorities such as barracks, housing and other readiness investments. For Navy Medicine, the broader funding pressure could affect facilities and other readiness resources while reinforcing the need to ensure medical capabilities are adequately funded for sustained, high-tempo combat operations.
From The Vault: Vice Adm. Alexander G. Lyle, Navy Dental Corps
BLUF – Michael Rhode, the archivist for Navy Medicine, highlights the distinguished service of Vice Adm. Alexander G. Lyle through his commission and Medal of Honor citation during an episode of the “From the Vault” video series, Aug. 22, 2026. The series, produced in commemoration of America’s 250th anniversary, explores 250 years of U.S. Navy and military medical history by unlocking the Navy Medicine archives to highlight the enduring courage, innovation, and legacy of care provided by military medical professionals.
https://www.dvidshub.net/video/1019531/vault-vice-adm-alexander-g-lyle-navy-dental-corps
The US Navy has battled operational tempo ordeals for years. The Iran war exposed the flaws.
BLUF – The Iran war has exposed and intensified longstanding Navy problems with high operational tempo, an undersized fleet, deferred maintenance, manpower shortages and fragile logistics, with extended deployments and disrupted supply networks placing growing strain on sailors and ships. For Navy Medicine, the experience underscores that sleep deprivation, inadequate nutrition, prolonged stress and limited opportunities for recovery are warfighting readiness issues requiring medical leaders to anticipate and mitigate the cumulative physical and mental health effects of sustained combat operations.
Finance Friday Articles
- Let’s Talk About Cash…
- The AI buildout comes to the bond market
- TRICARE Toolkit: Extending TRICARE Into the College Years
- Why Do Passkeys Prevent Phishing?
- Why the bond market is flexing its muscles, and why everyone needs to care
- Why the Front Door Is Locked: The Origins of the Backdoor Roth IRA
- Why the Stock Market Has to Crash
Mental Health Is a Warfighting Readiness Problem for the U.S. Navy
BLUF – The article argues that the Navy’s shortage of mental health resources ashore and at sea is a warfighting readiness vulnerability, proposing expanded access to trauma care through Military OneSource, incentives to increase the TRICARE counselor pipeline near fleet concentration areas, and a 250-member civilian mental health auxiliary that could augment deployed “triads of care” during major combat operations. For Navy Medicine, the recommendations frame behavioral health capacity as an operational requirement rather than simply a healthcare benefit, particularly as prolonged maritime combat could expose sailors to sustained stress, sleep deprivation, trauma, and other conditions that degrade decision-making and combat effectiveness.
https://warontherocks.com/mental-health-is-a-warfighting-readiness-problem-for-the-u-s-navy
New recruits are joining the military in big numbers, but not for the reason Hegseth says
BLUF – The military’s recruiting rebound is real—the Navy reached its fiscal 2026 goal of 45,000 sailors—but ABC News reports that Pentagon data and interviews with recruits indicate the surge is driven primarily by economic factors such as steady pay, education benefits, job training and career opportunities rather than confidence in the current administration, as Defense Secretary Pete Hegseth has argued. For Navy Medicine, the article also highlights the continuing challenge of medical eligibility, with obesity and other health conditions shrinking the recruiting pool and MHS GENESIS medical screening contributing to delays, making prevention, accession medicine and efficient medical screening important components of maintaining Navy end strength.
Marine Corps and Navy update gas mask training to meet shaving rules
BLUF – The Navy and Marine Corps are requiring annual CBRN mask-fit and seal training for all personnel as part of the Pentagon’s stricter grooming standards, with service members required to be clean-shaven where the respirator seals regardless of medical or religious shaving waivers. For Navy Medicine, the policy directly intersects with management of pseudofolliculitis barbae and other medical shaving waivers, requiring clinicians to balance treatment of legitimate medical conditions with the operational requirement for sailors and Marines to achieve an effective protective-mask seal.