Becoming a non-residency trained Flight Surgeon, Dive Officer, or General Medical Officer, collectively referred to as a GMO tour, is a unique time in a young physician’s career. It’s typically the first time you are not in a training program. In addition to increasing their fund of knowledge, a GMO tour is prime time to develop a strategy for professional development. With a proactive approach, a GMO tour can serve to lay the foundation for a successful career as a Medical Corps Officer. Below are some tips to consider during a GMO tour:
- Devise a plan: After spending the first month or so settling into your new role, devote some time thinking about what you want to accomplish in the next 5-10 years. With these goals in mind, you can set mini-goals along the way. This goal setting does not have to be done alone. In fact, I encourage you to speak to your mentor(s) about your future plans; often, they can provide insights you had not considered. If you don’t have any mentors, now is the perfect time to gain a few. The MC Chief’s Office is an excellent resource if you need some support developing mentor-mentee relationships.
- Obtain a warfare device: Depending on the unit you are assigned to, you will be eligible to obtain several warfare devices. These devices include are generally available in Fleet Marine Force, Surface Force, Flight Surgery, Undersea Medical Officer, and Seabee billets.
- Take a few leadership courses: Each fiscal year, the annual Medical Corps leadership course catalog is published by the MC Career Planner. Participating in classes that are rank appropriate and of interest to you are a great way to better prepare you for your future assignments.
- Complete Joint Professional Military Education 1 (JPME-1): Completing JPME-1 is emphasized as a requirement for promotion beyond Lieutenant Commander. Each Service branch has a version, and it does not matter which one you complete. The Navy recently restructured its online program to be completed in a year. However, there is a waitlist to register, so sign-up early.
- If you are an O-4s or above, you are eligible to register for the Air Force’s online JPME-1 program. Historically, this can be completed the quickest.
- Consider taking online classes: With potentially more free time on your hands than years past, now is the perfect time to take a few online courses either for fun or towards a certificate or degree program. Some programs to consider include a nutrition certification, clinical informatics, Master of Public Health (MPH), or Master of Business Administration (MBA). To my knowledge, these courses/programs are not funded by local commands or BUMED, but if CME is offered, it doesn’t hurt to ask. For longer degree programs such as an MBA or MPH, you can seek out scholarships or consider using your GI Bill.
- Achieve an Additional Qualification Designator (AQD) or two: AQDs are used to identify Officers with experience or education in a particular area. A common one achieved is the Executive Medicine (67A) AQD. You can track your progress and review your eligibility for this and other AQDs via the Joint Medical Executive Skills Program (JMESP) site.
Overall, a GMO tour provides the perfect opportunity to revisit your career plan and set achievable goals to obtain while in the fleet. With some planning, this time will be both fun and career enhancing. Good luck!
Ayeetin “Vibes” Azah, MD, MBA
LCDR, MC(FS/FMF), USN
U.S. NMRTU Bahrain
The views expressed in this blog post are those of the author and do not reflect the official policy of the Department of the Navy, Department of Defense, or U.S. Government.
The next lecture series for the 2021 Continuous Medical Corps Symposium will be with CAPT Joel Schofer and CAPT William Beckman on the new Operational Medical Officer Instruction and Graduate Medical Education. There will be a short presentation followed by a question/answer session to try to answer questions regarding this new instruction and what to expect from GME. Please join us on Friday 09 July at 1200 EST, https://conference.apps.mil/webconf/uqg4sfys0bjzowjeyd9ir3ho0wrtuvn3
Please widely disseminate to your communities and if you have any questions, please feel free to contact me (contact in the global).
Jennifer Eng-Kulawy, MD, FAAP
LCDR, MC, USN
Plans and Policy Officer
Office of the Medical Corps Chief
I’ve been asked this question multiple times since the FY21 LCDR promotion board stats came out. Many looking at the stats noticed these facts:
- The overall in-zone promotion rate was 83.19%.
- The rate for GMOs, UMOs, and Flight Surgeons were all lower than this:
- GMO – 66.67%
- UMO – 40%
- Flight Surgery – 42.86%
This seems to argue against the recent advice to “go operational” to successfully compete for promotion. What gives? The following is my best guess, and it is a guess. I was not on the board, and if I was I wouldn’t be able to talk about it.
Let’s look at the typical career path for a Medical Corps LT who does GMO, UMO, or Flight Surgery:
- Year 0 – Graduate from medical school and put on LT.
- Year 1 – Finish internship and go GMO, UMO, or Flight Surgery.
- Years 2-4 – Do a 2-3 year operational tour.
- Years 3-4 – Match in a residency program.
- Year 5 – You are in-zone for LCDR.
If in year 5 you are still a GMO, UMO, or Flight Surgeon, you probably haven’t matched in a residency either because you can’t or you’ve chosen to pay back the 3-4 years you owe the Navy and get out. In the latter case, you may have approved resignation orders in the system, which the promotion board will see on your record.
This timeline is obviously not applicable to anyone with prior service, entry-grade credit, or an abnormal promotion timeline, but it is applicable to the majority of Medical Corps LTs. For example, I did internship, 1 year as a GMO, 3 years of residency, and then was picked on-time/in-zone for LCDR, which I put on as a staff Emergency Physician. Back in the day, I showed up in the stats under Emergency Medicine. Anyone in a residency will show up under their specialty’s statistics.
Bottom Line – Why didn’t more GMOs, UMOs, and Flight Surgeons promote to LCDR?
Again, this is just a guess, but if you are in an operational billet your 5th year you either can’t match in a residency or are getting out, both of which do not portend well for promotion.
Takeaway – Your primary job and career goal as a LT is to match in a residency program that will lead to board certification. You can always “go operational” later. Spending too much time in the operational setting can lead to difficulties promoting.
By Dr. Keith Roxo, LCDR, MC(FS), USN*
I teach the medical logistics lecture for the flight surgery course at NAMI. I don’t do it because I love logistics or am some kind of logistical guru; I do it because it is a great way to have a discussion about mindset for young physicians.
I begin the lecture by asking if there are any medical students in the class. It seems silly, right? They smile and look around thinking that I am being silly. Next I ask how many interns or residents are in the class. I raise my own hand because I am a resident in the Aerospace Medicine program, but generally I’m the only one with my hand up. They are starting to get a little confused by my line of questioning. It is all set up for my next question: “if you aren’t a medical student, intern, or resident then what are you?”
The answer is that they are an attending physician. And after telling them that they are all, indeed, attending physicians, I get a lot of wide eyes in the crowd. The occasional student, who happens to already be board certified before going into flight surgery, already understands this, but they are few and far between.
For the last five years most of the flight surgery students have had near constant supervision and have not had the final say on any patient. Every plan or prescription had to be run through someone else before being executed. They have very little experience doing it on their own, but many are about to be thrust into that position. They need to start thinking about how they want to run their practice, solidifying resources and contacts, how do they get help for more challenging cases, how to handle a mishap, and how to transfer a patient from an austere location. Better to start thinking about this stuff from the safety of the Pensacola beaches or classroom rather than when a problem first develops.
Meanwhile, the logistics part of the talk is a way for me to get them to also think of themselves as a mini-department head. It doesn’t matter if your Marine Air Group (MAG) surgeon or the military treatment facility is supposed to manage your supplies, if you go on det or deployment missing items, it hurts you and your people. Better to be involved in your supply than to trust the system blindly.
Not all GMO positions are equal. Some are on a staff with other senior physicians. However, some are running solo with a squadron, infantry unit, etc. without much support from more experienced physicians. Getting your mindset right before you are in those positions can go a long way to better preparedness.
*The views expressed in this blog post 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.
Please see this note from the GME Detailer. Of note, I don’t have the list of available billets (but probably wouldn’t post it for OPSEC reasons even if I had it). I’d contact her if you need it (her contact info can be found here):
1. This notice is for ALL PGY1’s who intend to request GMO tours (do not have active applications submitted for GMESB consideration). If you have an active application in MODS, there is no need for you to take any action; merely wait for the GMESB to publish selection results in December…best of luck to each of you!
If you DID NOT apply, please pay attention to the steps below:
2. In order to secure PCS funding/estimate PCS budget, I am going to enter negotiations with PGY1’s (desiring GMO tours) earlier than normal.
- Monday, 11 SEP 2017 starting at 0700 CDT you may call in to discuss available GMO billets ***again, this call-in time is ONLY for those people who DO NOT have a MODS application/are not requesting consideration for GME ***
3. Please review the attached list of downstream billets. Have at least 3 choices selected from this list prior to calling/contacting me (preferably not all in the same area/type billet). Do not request a billet you are not eligible for (for example, do not select a billet marked “2nd tour GMO”), it creates frustration for both of us!
4. If you have co-location or EFM concerns, please ensure your status is current/updated prior to negotiating orders; otherwise I will be unable to complete the detailing process with you. If you are unsure of your status, feel free to contact me.
*** This slight departure from previous PGY1 detailing will hopefully provide official orders in a more timely manner and also load balance the detailing phone calls. There will always be billets for people, so no one should be stressed about having a “home”. It is not mandatory to call on the 11th of September to request orders, but that will be the first available opportunity for PGY1’s to select follow-on GMO duty station assignments.***
Kayreen K. Gucciardo
LCDR, MSC, USN
Medical Corps Assignments (PERS-4415R)
GME Placement / GMO Detailer