By Joel Schofer, MD, MBA, CPE
(Note: The views expressed in this chapter are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.)
There are many career paths available to Medical Corps officers. The five primary career paths include:
All of them can lead to promotion to O6. Here is a slide summarizing the Medical Corps career paths:
When comparing a Naval career to a civilian one, it is often easier to jump from one career path to another in the Navy than it would be in the civilian job market. All it takes is for you to take a new set of orders and you have switched career paths without having to start over. Let’s discuss the five career paths.
Academic Career Path
The academic career path involves much of the same activities as in the civilian world. You will largely be stationed at military treatment facilities (MTFs) with graduate medical education (GME) programs. In the Navy, these will include Family Medicine teaching hospitals/medical centers (Camp Lejeune, Camp Pendleton, Fort Belvoir, Jacksonville), Japanese MTFs with Japanese internships (Okinawa, Yokosuka), and medical centers with multiple residency programs and internships (Bethesda-Walter Reed, Portsmouth, San Diego). In addition, you could be stationed at the Uniformed Services University of the Health Sciences (USUHS) or in an educational support role at the Bureau of Medicine and Surgery (BUMED).
Aside from your clinical activity, you’ll be focusing on teaching and academic production. If you’re smart, you’ll work toward academic promotion in your department at USUHS by obtaining a faculty appointment (this newsletter tells you how to get one) and progressing toward academic promotion. Once you graduate from residency, you will likely be appointed an Assistant Professor, which means you are considered a local or regional expert. The next step would be to promote to Associate Professor, where you are a regional/national expert. Finally, you would strive for Professor, which usually indicates you are a national/international expert in your field.
If you receive a USUHS faculty appointment and, with the guidance of your USUHS department, actively work toward academic promotion, your academic career will be forced to progress. In my experience, most people obtain their initial appointment as an Assistant Professor but never progress from there. If you want to progress, you will need not only a curriculum vitae (CV) and biography, but also an educator’s portfolio. This portfolio can be a lot of work to create and maintain, and it is infinitely easier if you start early in your career.
The other relatively recent development in the academic career path is that there are many more options that are considered acceptable academic productivity. Traditionally, you had peer-reviewed publications and book chapters but little else. With the rise of the internet and social media, smartphone applications, blogs, podcasts, and other on-line options exist for you to produce academically and build your expertise and influence.
Research Career Path
The research career path is much like the academic one just discussed, but with a research focus. You would likely spend most of your career in MTFs with GME programs, but you can really do research anywhere in the Navy. Of particular interest, the Navy has commands whose primary missions are research, like Naval Health Research Center, Naval Medical Research Unit Dayton, and others.
Anyone planning a research career, you should strongly consider obtaining advance training. This could involve a fellowship, an advanced degree or certificate program, or additional continuing medical education. USUHS offers training in research.
Administrative Career Path
The administrative career path usually starts when you assume a leadership role appropriate for a junior to mid-grade officer. This would include Assistant Department Head, Department Head at a small/medium Military Treatment Facility (MTF), Medical Director, Senior Medical Officer, a leadership role on the Medical Executive Committee (MEC), or any other position where you assume administrative responsibility.
After the initial role, you gradually assume more responsibility, potentially at larger and at different types of commands. Although it is possible to obtain some of these roles as an O4, once you are selected to O5 a new world of positions is open to you that is easier to obtain as a CDR or CAPT. These would include Chair of a MEC committee, Department Head at a large MTF, Associate Director, Director, MEC Vice-President or President, Chief Medical Officer, Officer-in-Charge, or other positions with significant leadership roles. Once you are selected for O6, you can transition into Executive Medicine and can screen for Executive Officer and later Commanding Officer positions. If you are successful in your senior O6 leadership positions, you may be considered for promotion to the flag ranks as a Senior Healthcare Executive.
Many physicians who hope to rise to high levels of administration will try to increase their knowledge base by obtaining additional training. This can include military course like MedXellence or the Senior Officer Course in Military Justice and Civil Law. It can also include formal education in management and administration, such as a Master’s in Business Administration, Medical Management, or Healthcare Administration. There are many ways to obtain these degrees both inside and outside the service.
Clinical Career Path
The clinical career path is probably the purest and most natural career path. Why did you go to medical school? Usually, it is because you wanted to be a doctor, and the Navy needs people who want to be a doctor.
The first step in pursuing a career path is to complete a residency or fellowship in your desired field(s) of choice. After completing this graduate medical education, although not required by the Navy, you should strive to achieve board certification in these specialties, if available. First, it allows you to receive board certification pay. Second, it allows you to get a 5 in the professional expertise trait on your fitness report. Third, it is generally required to promote. Finally, when you moonlight or get out of the Navy, you will earn more than someone who is not board certified. And we all eventually get out of the Navy!
After achieving board certification, it is assumed that you will maintain it. In fact, it is required to continue receiving board certification pay. If you ever let your certification lapse, you must notify your special pays coordinator so they can terminate the board certification pay.
The downside of a purely clinical career path is that it can make it harder to promote to O6 if all you do is see patients and you are not willing to take on at least one significant collateral duty. I’m not saying it is impossible to promote as a pure clinician, but it can make it harder. On the positive side, a board certified clinician should be able to promote to O5, and some of the Commanders I know who are purely clinicians are some of the happiest physicians I know. You want me to join that committee? No thanks. I’m happy just being a doctor!
Operational Career Path
Many physicians pursue an operational career path because it is why they joined the military. You can be a doctor anywhere, but in the Navy you can be in submarines, dive, parachute, and all sorts of other fun and unique things.
An operational career path most commonly begins with a tour as a General Medical Officer (GMO) with the Marines or on a ship, a Flight Surgeon (FS), or Undersea Medical Officer (UMO). For those that go straight through in residency training, it may be that their first set of orders after residency takes them to an operational billet. In either case, physicians with an operational unit will probably find that they have a lot of responsibility for people with a work hard, play hard mentality. The 72 and 96 hour periods of leave that are common around holidays (play hard) are balanced by the requirement to deploy or train in the field (work hard).
As a physician promotes and becomes more senior, there are often opportunities to assume more senior roles specific to the operational community of choice. Along the way, it will be assumed that you are maintaining your clinical skills. Because it is often difficulty to maintain a full scope of practice in an operational setting, this may require extra effort to practice in a Military Treatment Facility or moonlight in your free time.
In summary, there are five primary career paths in the Navy. They include academic, administrative, clinical, operational, and research. In the Navy, it is usually fairly easy to transition from one career path to another without losing a step. Finally, pursuing all of them can lead to a fulfilling career and promotion to O6.