Executive Medicine
Command/Milestone Screening Packages Due 15 JUNE
Please see the message from the Deputy MC Chief:
ALCON,
FYSA. The NAVMED 1410 and 1412 has been updated and a new form is available to complete on our website. To ensure the issue does not perpetuate I will not be attached them to this email- please direct any and all to our website. We believe the issue has been resolved thanks to many rounds of testing. With that said should anyone have issue please point them my way and I will address. An email went out to about a dozen applicants that already applied and we requested they complete the new form. We have gotten just about all of them back so far without any issue.
Being Efficient as a Senior Leader
This post is based on a presentation I give entitled “Being Efficient as a Senior Leader.” The handout from the talk will be at the bottom of the post.
How to Be Efficient as a Senior Leader
As you ascend the leadership pyramid and assume more responsibility, being efficient will be critical. In order to be efficient, you’ve got to manage four things:
- Your boss
- Your people
- Yourself
- Technology
Your Boss
You have got to manage your boss to maximize your efficiency. Most senior people have a reputation. Perhaps you’ve worked with them before. Do everything you can to gather information about them, how they work, and what it is like to work for them. If you have not worked with them, talk to those who have. What hours do they work? How many days a week? How do they communicate (text, e-mail, phone, in person)? How demanding are they?
For example, my first Commander during my Deputy Commander/Director/Executive Officer (XO) tour was someone who I’d worked with before. She had unmatched work ethic, worked longer hours than anyone, and her life was running military treatment facilities. It was going to be impossible for me to arrive at work before her (she usually arrived around 0530) or leave after her (She tried to leave around 1930). Luckily, I had worked with her before, and I knew how she rolled and that we got along very well. There is about 5% of the world’s population who thinks I’m hilarious, and luckily for me she is in that 5% and has a good sense of humor.
Once you gather info about your boss, you’ve got to book a meeting with them. If there are issues you anticipate may cause problems, they need to be directly addressed right up front. For example, I knew work hours and communication were going to be a huge issue. As a result, I booked a meeting on the first day I was her XO.
In that meeting, we discussed work hours and established that she was good with me arriving after her (usually by 0700) and leaving before her (usually before 1800). I told her that I’d jump back on e-mail, if needed, in the evening after I ate dinner. This was almost always necessary, but usually I could handle things with my phone only and did not need to VPN in.
We also discussed communication. She wanted lots of information, so we decided the easiest thing for all involved would be for anyone communicating with us via text or e-mail to just include both of us. It was a little unconventional, but it was the only way it was going to work efficiently for all involved.
The first night I was an XO, I got 27 text messages. The Skipper had a superpower I did not possess. She could wake up to a text notification, respond, and go right back to sleep. I have no idea how she does it, but she does it.
The next day we had another meeting about text messages. Unless she had an alternative idea (which she didn’t), I was going to turn off my text notifications when I was asleep. My wife and I could not endure 2+ years of nightly text message notifications. If people needed me at night, they would need to call me. Otherwise, I would respond to text messages in the morning when I got up (usually around 0500).
While she was hesitant to agree to this plan, we went with it. It allowed me to get sleep for 2+ years as an XO. I only received 1 emergent phone call for 2+ years that I remember.
What’s the message? Learn about your boss, figure out issues you think need to be addressed, and have a meeting to directly address them.
Your People
Your people have the greatest potential to both optimize as well as adversely impact your efficiency. As a result, you have got to provide guidance for them. Tell them what you want explicitly. For example, here is my “XO’s Guidance” I used as an XO at Portsmouth. I handed it out the first day I was there:
Feel free to use my guidance as a template you can modify for your own purposes.
In addition to providing explicit guidance, you need to delegate tasks whenever possible. The more senior you get, the less likely it is that you should be in charge of a project or producing a work product. If you do want to be the lead on a project, it should either be something you are passionate about or something that you feel is a no-fail mission. That said, I have found that 99% of the time I delegate something my people don’t let me down. Even when they do, we can recover almost all the time. Don’t be afraid to delegate tasks/projects.
Meetings with your people should be avoided whenever possible. If you do have to have a meeting, always have an agenda and start on time.
Finally, we have assumed a culture of leadership by Powerpoint. Do what you can to unburden your people and yourself from this. Avoid long Powerpoint slide decks whenever possible. Try to limit them to a single quad chart with backup slides or 1-2 page executive white papers or summaries. There is a reason flag/general level officers (FO/GO) frequently do this. It is because it is efficient. Don’t wait until you are a FO/GO to move to this policy.
Yourself
You have go to find a way to optimize the use of your calendar and to-do list. Personally, I do not like Outlook and prefer to use Google Calendar so that all of my business and personal things are on one calendar. I admit, though, that there are other ways to do it. Do what works for you.
My to-do list is also on Google Calendar. I just make anything I put on my to-do list an all day event on Google Calendar.
You need to be deliberate and plan your work week. Every Sunday I take a look at the calendar for the upcoming week. I spread tasks on my to-do list evenly across all workdays, biasing toward having more early in the week than at the end. This provides space for things that will inevitably crop up on Monday or Tuesday.
Another strategy I recommend is that once a day starts, do not add tasks or events to your calendar unless it is absolutely necessary. This ensures that once the day starts, you are always moving in the right mental direction, with less and less left to accomplish. If a new task pops up that can wait, add it to tomorrow or another day. Don’t add it to today.
Find a way to cognitively unload things that need to be tracked. For example, at Portsmouth we have something we call the “tasker tracker.” It is an Excel spreadsheet maintained by the command suite staff and is reviewed at the Command Executive Board (CEB) every Monday, Wednesday, and Friday. I know that by adding something to the tasker tracker, I don’t have to think about it. I won’t forget about it, and it’ll get done because it is reviewed 3 times a week.
Most people arrive at work and the first thing they do is open their Outlook e-mail. Do not fall into this trap. The first thing you should do after you arrive at work is tackle the things on your to-do list that are most important. For example, I usually arrive 1-1.5 hours before my first meeting (which as an XO was at 0800) so that I can knock off most of my to-do list before the day starts.
You also need to batch repetitive tasks and only do them at whatever frequency works. For example, I don’t approve DD200s (the form for lost equipment) whenever they roll in. I do it monthly. I don’t approve NSIPS leave requests or retirement/resignation requests every time they roll in. I create an Outlook e-mail rule (another efficiency tip that invaluable and will be discussed below) that dumps those e-mail notifications automatically, and I have it on my calendar to do it weekly. Yes, occasionally someone will put in a leave request that can’t wait, but most of the time they can.
You need to develop a strategy for tackling distasteful tasks. We all have them. For me, I hate reviewing instructions and building Powerpoint slides. If I have to do these things (or anything else I’m not looking forward to), I just break it up into manageable bites and do a little bit at a time. Read 1-2 pages of an instruction…go do something else…come back to the instruction again later. Or delegate the task to someone else.
Everyone will have a different way to tackle distasteful tasks, but you need to develop a deliberate strategy. If you don’t, you’ll be prone to procrastination, and that doesn’t usually help.
Make sure you don’t get into the habit of reviewing things multiple times. Tell your people you only want their best/final products. Do not tolerate the Friday afternoon “here’s my draft for you to review before I go home for the weekend” strategy you will frequently find. That is a recipe for ruining your weekends. If you read something someone gives to you and you find multiple spelling errors in the first paragraph, send it back, demanding better. Do not read multiple drafts. Try to read things only once.
Finally, limit clutter. It is 2024. Go electronic. Most things can be filed away and located again with electronic search functions.
I strongly recommend the filing system described in the book Getting Things Done. You create 26 folders, 1 for each letter of the alphabet. And you just file things in the folder that makes intuitive sense to you. For example, you get an e-mail from me. When you think Joel Schofer, you think of the MCCareer.org blog, so you file it in the M folder. Maybe you think of my last name, so it goes in the S folder. The point is you put things where you first mentally bucket them. Then when you need them again, you go to the M or S folder and search for “Schofer”. There the e-mails are!
Avoiding paper keeps your workspace clean and tidy. Do not underestimate who much this can impact your workflow.
Technology
Managing technology can help you sink or swim as a senior leader. You need to use it to maximize your efficiency.
Automate repetitive tasks whenever possible. For example, when this blog post goes live, it will go to multiple platforms (Facebook, LinkedIn, etc.). That will happen automatically. I don’t do it manually.
Use Outlook e-mail rules to minimize the size of your e-mail inbox. Even as the XO at Portsmouth getting hundreds of e-mails a day, my e-mail inbox was almost always at or near zero, which would blow people’s minds. It isn’t that hard if you develop a system.
Repetitive e-mail notifications should be turned off so when e-mails arrive they don’t distract you. You don’t need a pop-up or sound every time an e-mail arrives. Turn them off.
Use Outlook e-mail rules to divert e-mail you don’t need to read. As discussed above, all the e-mails from NSIPS about retirement/resignation requests are auto-dumped with a rule into my R folder. I have weekly task on my calendar to review them all. All e-mails about leave requests are auto-dumped to my L folder. I review them weekly. When I was a LCDR, I created a rule so that any e-mail with the word “urinalysis” got deleted. The one things I could guarantee was that if I was on the urinalysis list, 12 people would tell me before I even got to my desk.
E-mail has already been discussed to some extent, but it needs to be deliberately managed. It should not be the equivalent of texting. E-mail should be used for issues when a response by COB the next business day is sufficient, or when no response is needed. If you expect responses COB of the next business day, you will tie your people to their Outlook inboxes, reducing their efficiency and ability to lead at the deckplate. You don’t lead from your Outlook inbox.
When an e-mail arrives that is not automatically diverted by a rule, you need to have a strategy to deal with it. If you can deal with it within a few minutes, do so. If you can delegate the response, do so. If you cannot deal with it in a few minutes, file the e-mail away in one of your A-Z folders but create an item on your to-do list, preferably for tomorrow.
You should also deliberately plan your time on e-mail versus other tasks. For example, I can catch up on e-mail while in meetings or while on the move on my work phone, so I commonly spend time in my office on other tasks like signing correspondence that I can’t do in meetings or while out of the office. For example, there was a monthly meeting at Portsmouth called Shipmate of the Month. During this meeting the CO and CMC were in the front of the auditorium, but I was not. I routinely used it to catch up on e-mail on my phone.
Finally, I strongly encourage you to only have one phone that you use as a phone. Having multiple phones to answer voice and text messages on would reduce efficiency. Pick one phone to use for all voice and text messages. There is nothing wrong with using your command phone as an e-mail/calendar device only. For 2+ years I did not know the phone number of command phone, when it rang I never answered it, and I never responded to a text message. The “1 spouse, 1 house” financial rule should be expanded to “1 spouse, 1 house, 1 phone.”
Resources
I you are looking for references that can help you get organized, I’d recommend these books in order from most to least recommended. They are all good, but GTD is my favorite with 4-Hour Workweek a close 2nd:
- Getting Things Done (Allen)
- The 4-Hour Workweek (Ferriss)
- Extreme Productivity (Pozen)
The Handout
Here is the handout I use when giving this talk:
What Is It Like To Be an XO?
BLUF – You will have a wild range of emotions, experiences, and hours, which in the end will probably be worth it.
I was the Executive Officer (XO) at Portsmouth for 2 years and 2 months. Technically, I was not an XO but a Deputy Commander (DCOM) because we had a subordinate command (Expeditionary Medical Facility-Juliet), but most people still called me “XO”. To give you some idea of the scale, Portsmouth had about 5,500 people, 150 staffed inpatient beds, 10 outlying clinics, and 30 training programs with a budget of $550M. It is among the largest military treatment facilities (MTFs). Experiences at small to medium-sized places and non-MTFs will certainly vary.
The Hours
Unless you are TAD or on leave and have an Acting XO, you are always on duty as an XO. You never know when something may happen that you have to deal with.
Monday through Friday, you are at work. My actual hours depended on what was going on and was largely driven by my Commander, but they ranged from Monday through Friday from 0600-1830 to 0700-1500. I pretty much always spent 8 hours at work every day, but would occasionally have 13 hour days. If your Commander is more intense and spends more time at work, so will you. If they are more laid back, you’ll probably spend less time at work.
I found it most convenient to work out in the early AM before I came to work, but if I wanted to clear white space to workout while at work I imagine I could have. There really are only a few people that can affect your schedule when you are an XO, and you are largely in charge of how you want to run it.
After those work hours, I would go home and eat dinner. I nearly always would check my e-mail at night before I went to bed, usually only on my phone. I rarely had to VPN in at night.
On weekends, I would always check my e-mail at least once a day. I would also get periodic text messages or phone calls I had to deal with whenever something happened. It could be a facilities problem, questions about an inpatient unit going on divert, a problem dispositioning a patient, a request for permission to transfer someone in an unusual situation, or just about anything. Sometimes I would have FITREPs or EVALs, instructions, or other documents I had to review on the weekend. Some work weeks were a survival exercise, and I needed Saturday to catch up.
On my first night as an XO, I got 27 text messages. That was the first and last night I kept text message alerts on. From then on, my team knew that between 2100-0500 they needed to call if they wanted me. Otherwise, I would respond to texts when I woke up in the AM. I only received one emergent phone call that I remember in two years.
Overall, you will have a lot of control over your schedule, but hours can get long and you are always on duty unless you have an Acting XO. Don’t apply for XO unless you are ready for some long days and weekend fires that need to be put out.
The Experience
You are the XO, and you will have massive impacts on people’s lives. This is what makes the job rewarding. You can mentor, lead, admonish, hold people accountable, lay down the law, enforce policy, give exceptions to policy, set policy, swing the hammer of justice at Executive Officer Inquiry (XOI), deliver bad news, deliver great news, make sure things get done, decide what not to do, and all other sorts of things. An effective XO can dramatically improve the lives of those who work for you and your command. An ineffective XO can have the same negative effect. I think I was effective and made a largely positive impact, but ask the people who worked for me and see what they think if you really want to know. They are the judge and jury of how I did.
You become an XO because you want to lead people. If you don’t want to lead people and make hard decisions, I don’t know why you’d apply.
Things You Never Thought About Will Drive You Crazy
I have never thought more about pipes, generators, HVAC units, weather, temperature, humidity, or water. Leading people is a challenge, but it really was facilities that kept me on my toes. In a facility as large as Portsmouth, the physical building and all its associated challenges were the biggest headaches of being an XO. Luckily, I had excellent leaders in the facilities department. If I didn’t, it would have been VERY ROUGH. A good DFA and facilities manager are indispensable. If you don’t have competent people in these areas, you will need to train them ASAP. If they are untrainable, you will need to do something about it.
You Are a VIP!
You are a VIP, and you will be expected to act like it. People will stand when you enter the room. Your personal appearance and behavior will need to conform with standards. If you violate a policy, someone will know. You will be invited to and expected to attend many ceremonial events. You will have to serve as the MC and speak publicly numerous times. You will need every type of uniform. During my XO tour, I wore them all. This also means I had to purchase the ones I didn’t have, which was expensive, but my wife’s a doctor…
If you don’t want to be a VIP, don’t apply to be an XO.
The Bottom Line
You become an XO because you want to lead people. You will experience a range of emotions while doing so, and you will spend more time worried about facilities than you imagined. There will be some “get out of the Navy” days and weeks (as I call them), but the impact you can make will make those the minority of the days/weeks. It will likely be the most professionally challenging tour you’ve had, but also the most rewarding. You might not realize how rewarding it has been until it is over.
If you are up for the challenge, apply.
Should You Apply for XO?
I’ve been the Deputy at Portsmouth since FEB 2022. In addition, before I came to Portsmouth I was the Deputy Chief of the Medical Corps. I made the sausage for 3 years when it came to the Executive Medicine application, screening, and slating process. Finally, I’ve been on a Milestone and Executive Medicine screening board in Millington, TN.
These three facts qualify me to answer the question, should you apply for XO?
People Who Should Definitely Apply for XO
You should definitely apply for XO if you are sure you want to lead people and be an XO/Deputy MTF Director or Commanding Officer (CO)/MTF Director. There is no other path to these positions.
People Who Should Not Apply for XO
I believe strongly that the following people should not apply for XO:
- People who don’t want to be an XO or CO or don’t want to lead people.
- People who don’t really want to do the job but want to use it to try and promote. This is not fair to the people you will be leading. You have to be 100% in or your people will suffer.
- People who do not want to move/PCS. XO applicants are expected to worldwide assignable, and the Navy Medicine leadership is not kidding.
- People who do not want to make hard decisions. No XO of any command has everything they need, and you will be balancing risk and making hard decisions your entire tour.
People Who Should Consider Applying for XO
If you are not in the above categories, you are on the fence about applying, and there is nothing wrong with that. My usual advice if you find yourself in this fairly large group:
- Review the application materials and available opportunities in detail.
- Talk to those who can give you some insight. This would include previous applicants, officers in your Corps Chief’s office (or those who previously were, like me), and admirals involved in the process (Corps Chiefs, the DSG, the SG).
After you’ve taken these steps, I recommend you review what you’ve learned with your significant other(s), if you have any. Most officers want perfect information, but it does not exist. You have no idea how things will actually go after you apply, so all you can do is gather as much information about the process as you can and make the best decision you can about whether or not to apply.
You Hold All the Cards Until You Apply
Do not underestimate the power of your application. They cannot make you apply, and until you apply you hold all the cards. Make sure you really want to apply and are willing to move. The associated geographic uncertainty is the number #1 reason people don’t apply and should not apply.
What if you get something that is not on your rank list? That is an important question you and your significant other(s) need to think through BEFORE you apply.
I say it again…BEFORE you apply. Remember…once you apply, you are worldwide assignable.
What’s It Like to Be an XO?
That’s the next post…
Command and Milestone Application Instructions
Here’s the message from CAPT Allen, the MC Deputy Corps Chief:
The new Command and Milestone Instructions have been signed and are attached at the bottom of this post. The Corps Chief team posted them to the Executive Medicine Webpage.
You will see that there are now “FY25 Opportunities,” which has all the milestones and command opportunities we anticipate slating this year. Since the opportunities list has changed several times in the last month, we decided to avoid posting multiple PDFs when opportunities change. The list on the executive medicine page will be updated when new opportunities come up and will be available for all to view. To access the complete list of all command and milestone positions, click “FY25 Opportunities.”
LCDR Mollema received notification that there has been some issue with the website’s NAVMED 1410 and 1412 form links. I have not had those issues, nor has our SharePoint administrator, Mr. Corpuz. However, I attached them and sent them out with instructions. I will also point out that we have a note under the links that says, “The NAVMED forms are fillable and may need to be downloaded and completed in Adobe Acrobat.” Lastly, the “Submit Application” button/link where applicants have to upload their application has been tested and been deemed functional.
COURSE OPPORTUNITY – Navy Senior Leadership SEMINAR – NSLS (IN-RESIDENT)
Navy Postgraduate School, Navy Senior Leadership Seminar – April 22-26, 2024
Who: O-6, O-6 selects or high-potential O-5 officers who are on track for executive medicine
What: Navy Senior Leader Seminar (NSLS)
When: April 22-26, 2024 (only 1 seat for Navy Medicine Corps)
Where: Navy Postgraduate School, Monterey – Center of Executive Education
Process: A list of interested participants will be solicited through Corps leadership and returned to the Corps Chief’s Office for review and selection as noted below. Interested applicants will submit a nomination via their Chain of Command.
Funding: Tuition is covered by NPS. For NSLS-NPS, parent command will provide travel expense, lodging, and per diem. NPS will reserve a block of rooms for participants on the NPS campus at the Historic Del Monte Hotel. Nomination for the course implies the command will commit to funding the nominee if selected.
Course Description: NSLS provides senior leaders with an intensive five-day executive education program that introduces the latest “best practices” in strategic planning, goal setting, strategic communication, effects-based thinking, risk management, financial management, and innovation. Learning is enhanced using case studies, small-team exercises, practical applications, seminar-style discussions, peer learning, and faculty presentations. Participants will be introduced to subject matter experts within DoD and industry, to include insights from senior Navy leaders and academic researchers. The course is designed to prepare participants to meet organizational challenges in their current and future assignments, and to empower them to become more effective change agents and better-informed stewards of the Navy’s resources. For more information about NSLS, please visit:
Prospective applicants should send a CV and BIO to CAPT Shauna O’Sullivan NLT 1200 Tuesday, February 20, 2024.
Navy Senior Leadership Seminar – Dec 11-15, 2023 (Online)
Who: O-6, O-6 selects or high-potential O-5 officers who are on track for executive medicine
What: Navy Senior Leader Seminar Online (NSLS-O)
When: Dec 11-15, 2023 (only 1 seat for Navy Medicine Corps)
Where: Online via the Navy Postgraduate School – Center of Executive Education
Course Description: NSLS provides senior leaders with an intensive five-day executive education program that introduces the latest “best practices” in strategic planning, goal setting, strategic communication, effects-based thinking, risk management, financial management, and innovation. Learning is enhanced using case studies, small-team exercises, practical applications, seminar-style discussions, peer learning, and faculty presentations. Participants will be introduced to subject matter experts within DoD and industry, to include insights from senior Navy leaders and academic researchers. The course is designed to prepare participants to meet organizational challenges in their current and future assignments, and to empower them to become more effective change agents and better-informed stewards of the Navy’s resources. For more information about NSLS, please visit:
Prospective applicants should send a CV and BIO to CAPT Shauna O’Sullivan NLT 1200 Tuesday, October 17, 2023.
Executive Medicine AQD – Talking Points and Changes
The Corps Chief’s Office has providing talking points created by all the Corps related to changes for the 67A AQD executive medicine qualification. These changes are based on the cancellation of courses (clinic management, Tricare financial management executive program, and clinical informatics course) and the original intent of this congressional mandate for COs and XOs to have this AQD. This AQD update will be placed in the upcoming FY24 Course Catalog. Please use this when discussing with your community.
The email (usn.bethesda.navmedprodevctrmd.list.nmpdc-jmesp@health.mil) in the attached document is currently not working but Mr. Garrett’s team is working to ensure that it will be functional. In the short term, if any questions or concerns please contact Mr. Clinton A. Garrett (e-mail in the global).
Executive Medicine Opportunities in 2024
Please see the attached BUMEDINST 1412.1C with the requirements for applying for Executive Medicine positions. Clarifying information is available at https://esportal.med.navy.mil/bumed/m00/m00c/pages/executive-medicine.aspx.
Officers desiring to be screened must submit an application to NAVPERSCOM, Medical Officer Assignments (PERS-4415) containing the following documents by 15 June 2023:
(1) NAVMED 1412/1 Command Screening Application, fully completed.
(2) CO’s letter of recommendation. Template provided.
(3) An endorsement from the echelon 3 commander or immediate superior-in-charge (flag grade officer). Template provided.
(4) Curriculum vitae and biography.
Commander, Navy Personnel Command(PERS-4415) must receive application packages by 15 June 2023. Only applicants who submit a screening package before the deadline will be eligible for screening. The preferred application method is e-mail, with scanned copies of signed documents attached. Send all e-mails encrypted to protect personally identifiable information. An officer may submit an application via mail or facsimile (FAX) (signed copies only) when another more secure means is impossible. The appropriate address and FAX number are on the NAVMED 1412/1. The board will only consider complete applications received on time. An officer applying for executive medicine must complete an oral board before being considered by the command screening board. The oral board is a one-time requirement. However, an officer may reapply for command screening in a subsequent year if not recommended by an oral board for command screening. The oral board is conducted to determine understanding of and readiness for the command responsibilities.
Sitting XOs do not need to screen again, but you need an endorsement letter from your CO and a wish list with any special considerations that need to be considered (EFMP, dual mil, allergic to sunny places, etc.) by June 15, 2023.
Sitting COs, if requesting an extension, I will need a letter requesting the extension by June 15, 2023
Joel Schofer's Career Planning Blog 