By Dustin Schuett, DO (with MCCareer.org editorial comments in italics)
Note: The views expressed in this blog are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government.
One of the strongest parts of Navy Graduate Medical Education (GME) is the ability to pursue Full-Time Outservice (FTOS) fellowship training. Being approved for Navy FTOS fellowship training makes you essentially a “free” fellow to whatever program you enroll in as you will continue to receive active duty Navy pay and allowances.
The biggest difficulties of a FTOS fellowship are typically logistical issues associated with being assigned to a ROTC or Reserve Unit Command. (For example, when I did my FTOS fellowship in emergency ultrasound in Delaware, I was assigned to the University of Pennsylvania ROTC unit.)
Here are some of the things I and some colleagues have learned thus far in our FTOS fellowship experiences that I wish I would have known before I started fellowship and even before PCSing from my prior Navy command.
- Big key: when in doubt, ask. Mark Sullivan at the Navy Medical Corps GME Office is your go-to for any questions/issues. He’s a phenomenal resource who does a great job helping out and keeping you informed leading up to and during your FTOS fellowship. (His contact info can be found on the right hand side of this page.)
- Look to see if you’re eligible for a retention bonus running concurrently to your fellowship and fellowship payback entitling you to additional money without added payback.
- If you’re going from an actual Navy command, I strongly recommend taking advance dislocation allowance (DLA, money to partially reimburse a member for the expenses incurred in relocating the household on a PCS)
- The location of your fellowship is likely not near a major Navy base with normal Navy admin support. Many are assigned to a ROTC unit or Reserve center which may be severely lacking in admin support.
- I’m currently 8.5 months into waiting for my DLA from PCSing last June and wishing I would have taken advance DLA.
- Start your state license application process early. Unless your fellowship is in the state where you are already licensed, you will likely need to get licensed in that state. This can take 3-4 months or even longer. For more arduous states like Massachusetts, I would recommend starting the October before you start fellowship. (Normally you can used any state license to practice in the Navy, and this same requirement should apply to FTOS training, but the civilian hospitals almost always want you licensed in the state they’re in. Mine did.)
- You are still required to complete the Body Composition Assessment (BCA) and the Physical Readiness Test (PRT) because you are still on Active Duty. The opportunity to skip the PRT if you scored an “Excellent Low” average with no event below “Good Low” should still apply, but check with your command.
- Because you are on Active Duty, even if you are exempt from the PRT, you will still have to pass the BCA within standards.
- Check-in is extremely variable with some commands having a full orientation day. My NROTC Unit in Boston had us coordinate a time to check in with the civilian administrative assistant. This was approximately a 2 hour process to check in, stop PCS leave, and complete the basic unit transition paperwork. It was very informal and done in civilian attire
- Command structure varies by area. If you are part of a ROTC unit, you fall under their CO and abide by their rules. Leave is arranged through your command and the rules of when you must be on leave depend on your command. The NROTC Boston rules are if you’re flying or driving more than 300 miles, you have to be on leave. (They will also do your fitreps as well. My reporting senior was a Marine Colonel at the ROTC unit.)
- Leave is typically performed through NSIPS. On arrival at your new command, see what needs to be done to get you transferred to their NSIPS roster so that you can request leave. Since you’re not actually doing work at the ROTC/Reserve unit, almost any leave will be approved.
- International leave still has the same rules as at a regular Navy command, so plan in advance for any trips out of the country and engage your Chain of Command early.
- Access to mail.mil email is variable. My account was disabled by my old command soon after I arrived while a friend doing fellowship across town still can access his email account with his CAC reader. Plan to not have access to your military email during fellowship, so save important emails and email addresses you may need outside of Outlook just in case.
- Fitreps in FTOS fellowships are almost exclusively non-observed. There are stories of rare commands completing observed Fitreps, but this is not the norm. (I do know someone who was able to contribute to the ROTC command and got a ranked fitrep.) You can still put text into the block 41 narrative detailing your accomplishments during your fellowship to include publications, meeting presentations, obtaining board certification, etc.
- You will have a non-observed Fitrep when your rank’s normal Fitrep hits (January for LT, October for LCDR, April for CDR) and a non-observed departing Fitrep when you check out. The only exception could be a CAPT in fellowship with potentially just a July regular non-observed Fitrep.
- Funding for TAD/conferences is usually through your fellowship or out of your own pocket. There may be very limited opportunities to get TAD funded by your local Navy command, but check with your command first. Most commands have no issue with placing you on no-cost TAD or special liberty for trips to conferences/meetings and other travel outside of your leave boundaries required by your training program.
- You will be on your command’s random urinalysis (UA) roster. Most commands understand that you have a busy and often inflexible schedule. When my name has come up for random UA, I received an email a day or two ahead saying the available times with the opportunity to reply if I could not make those times with the understanding that another time ASAP would need to be worked out.
- If you will be taking your Board Certification Exam or the final step of your Board Certification Exam soon before reporting or while PCSing, you will be eligible for Board Certification pay once you have been notified of passing. Board certification pay requests are routed through Mark Sullivan at the Medical Corps GME Office in Bethesda. You will need to route an endorsement through your CO at your unit, but the majority of the paperwork and the funding is handled by the GME office.
- If you are in zone for consideration by a promotion board, being in a FTOS Fellowship does not change this. I highly recommend doing everything you can to prep your record including ensuring all documentation is correct, you have an officer picture, and everything else listed in the Promo Prep document Dr. Schofer has put together 6-12 months BEFORE PCSing from your pre-fellowship command. It is exponentially easier to do this at an actual Navy command than through a reserve/ROTC command. Your access to BUPERS Online (BOL) and other CAC-enabled sites may be limited during your fellowship and most of the time you will be very busy. Getting your record ready 6-12 months before your start fellowship ensures you have plenty of time to correct any discrepancies well in advance of the board.
- Letters to the board can potentially help your promotion odds. FTOS fellows in the past have had their fellowship program directors write letters to the board detailing their performance in fellowship, some even had the fellowship directors write the letter hitting all of the Fitrep performance traits (Professional Expertise, Command Climate/EO, Military Bearing, etc.) specifically to replicate a Fitrep as closely as possible.
- Moonlighting is not permitted in any form during FTOS fellowship. Sorry. Your co-fellows may be moonlighting a ton and making more money, but keep in mind they’re likely making around $70,000 from the fellowship while you are making $100,000 plus and potentially close to $200,000 if you’re able to do the retention bonus/fellowship loophole plus untaxed money in the form of Basic Allowances for Housing (BAH) and Subsistence (BAS).
- Industry/externally funded travel/courses may come up during your fellowship. These are often great opportunities to obtain additional education and training without paying for it. You will need a Proffer letter from the company specifically detailing what is being offered in terms of monetary value in travel, lodging, meals, education etc. You will send this Proffer letter to Mark Sullivan who will also need an email from your fellowship program coordinator/director stating that the training is an integral part of your education and that it is being offered to all fellows and not just because of your affiliation with the DoD.
- Mark will then forward this on to Navy legal who will reply with any requests for information and usually give you a final decision within a few weeks. The decision will be sent in a Navy standard letter detailing your being allowed to proceed. Often, the company sponsoring your travel will need a copy of this letter for their records.
- Try to stay as far ahead as possible for this. I had an instance where the entire process was able to be completed and approved in a 2 week period, but ideally a month or more should be allotted. It’s a pretty simple process overall and you do not want to get into an unauthorized commitment situation.
- My command has allowed me to take special liberty for all of these courses so far which has allowed me to save up leave.
- Keep in mind that while you’re FTOS, you’re still in the Navy. You may not need to shave/put your hair in a bun every day, but don’t show up for your PRT with a full beard (yes that happened and yes the whole unit got an email from the XO about it).
- Enjoy the time in fellowship and being as close to a civilian as many of us will have for a 10-20 year stretch of our lives!
- What other questions do you have about FTOS fellowship? Please leave a comment or email me at djschuettdo < at > gmail < dot >com and I will try to answer any further questions.
Last week was the Specialty Leader Business Meeting, which is always held in conjunction with the GME Selection Board. If you want to see the following Powerpoint decks, they are available on the Medical Corps Sharepoint Site (pick your e-mail CAC certificate or it won’t open for you):
- DHA Organizational Update
- Finding Joy in Work
- GME Interdependency Brief
- GME Overview
- Military Unique Curriculum
- PERS Pearls
I would post them, but the one about DHA is labelled “for internal use only” and there are too many authors of the other ones to get permission to post them on the blog. Because of all the change going on, I wanted to call attention to their availability.
Here is the relevant info for two Program Director (PD) positions in the National Capital Consortium/Washington DC area. If you are Internal Medicine-Critical Care or Preventive Medicine, check them out:
Here are two announcements for program director positions, one in Pathology and the other in Internal Medicine:
I don’t have the due date for interest in this position, but the Position Description is here:
The POC is CDR Robert Liotta (contact info in the Global Address Book).
Anyone interested in this position is supposed to route the requested documents to CDR Frank Mullens at BUMED via their Specialty Leader (with Detailer concurrence) by 11 MAY. Here is the information: