Podcasts
Tips to Get Selected for GME
The Graduate Medical Education Selection Board (GMESB) results were released last month with a 30 DEC deadline to accept or decline any spots you were offered. Undoubtedly there were some people who didn’t get what they want. I’ve participated in the last three GMESBs and would like to offer tips for people looking to match for GME in the future. We’ll cover general tips and those specific for internship and residency/fellowship:
General Tips
- Money is getting tight for permanent change of station (PCS) moves at BUPERS. I think you can increase your chances of matching in GME by being local, or at least on the same coast, as the GME program where you want to train. Keep this in mind when you are picking your Flight Surgery (FS), Undersea Medical Officer (UMO), General Medical Officer (GMO), or post-residency assignments.
- You can increase your score at the GMESB by having publications. If you want to give yourself the best chance of maximizing your score, you need at least two peer-reviewed publications. Any publications or scholarly activity have the chance to get you points, but having two peer-reviewed publications is the goal you should be trying to reach.
- Be realistic about your chances of matching. If you are applying to a competitive specialty and you’ve failed a board exam or had to repeat a year in medical school, you are probably not going to match in that specialty. There are some specialties where you can overcome a major blight on your record, but there are some where you can’t. If this is applicable to you, the residency director or specialty leader should be able to give you some idea of your chances. Will they be honest and direct with you? I’m not sure, but it can’t hurt to ask.
- If you are having trouble matching in the Navy for GME, you may have a better chance as a civilian. By the time you pay back your commitment to the Navy, you are a wiser, more mature applicant that some civilian residency programs might prefer over an inexperienced medical student. You’ll also find some fairly patriotic residency programs, usually with faculty who are prior military, that may take you despite your academic struggles.
Tips for Medical Students Applying for Internship
- Do everything you can to do a rotation with the GME program you want to match at. You want them to know who you are.
- When you are applying for internship, make sure your 2nd choice is not a popular internship (Emergency Medicine, Orthopedics, etc.). If you don’t match in your 1st choice and your 2nd choice is a popular internship, then it will likely have filled during the initial match. This means you get put in the “intern scramble” and you’ll likely wind up in an internship you didn’t even list on your application.
- Your backup plan if you don’t match should be an alternative program at the same site where you eventually want to match for residency. For example, in my specialty (Emergency Medicine or EM) we only have residencies at NMCP and NMCSD. If someone doesn’t match for an EM internship at NMCP or NMCSD, they will have a better chance of eventually matching for EM residency if they do an internship locally, like a transitional internship. Internships at Walter Reed or any other hospital without an EM program are quality programs, but it is much easier to pledge the fraternity if you are physically present and can get to know people, attending conferences and journal clubs when you can.
- You need to think about what you will do in your worst-case scenario, a 1-year civilian deferment for internship. Many of the medical students I interviewed did not have a plan if they got a 1-year deferment. I think every medical student needs to do one of two things. Either they should pick 10-15 civilian transitional year internships (or whatever internship they want) and apply to those just in case they get a 1-year deferment, or they should just plan to apply to internships late or scramble if this unlikely event happens to you. Most medical students do not grasp the concept that this could happen to them and have no plan to deal with it if it does. It is an unlikely event, especially if you are a strong applicant, and you can always just scramble at the last minute, but this is an issue that every medical student should think through. If you are going to just scramble at the last minute, that is fine, but it should be an informed choice.
Tips for Officers Applying for Residency or Fellowship
- You should show up whenever you can for conferences and journal clubs. Again, you want them to know who you are and by attending these events when you can you demonstrate your commitment to the specialty and their program.
- Always get a warfare device (if one is available) during your FS, UMO, or GMO tour. Not having it is a red flag.
Types of Deployments
This post will help you learn all that you can about deployments. Personally, I’ve done three deployments, one as a GMO during the initial invasion of Iraq, and two after residency. In 2010 I deployed with the 15th Marine Expeditionary Unit or MEU and earlier this year I deployed to GTMO. In addition, as both a Detailer and Emergency Medicine Specialty Leader I’ve deployed a number of physicians, so I’m pretty familiar with all the details of the current deployment situation.
In the current operational environment, there are a few types of deployments. They include platform-based deployments, individual augmentee or IA deployments, global support agreement or GSA deployments, and what I’ll call parent unit deployments.
Let’s deal with the last one first because it is the easiest to explain. For what I’ll call a parent unit deployment, you deploy when your parent unit deploys. For example, if you are assigned to the Marine Corps with a MEU, when that MEU deploys so do you. You go with the unit you are primarily assigned to. The same could be said for a medical battalion, a Preventive Medicine Unit, and many other units.
A platform-based deployment happens to people who are stationed at military treatment facilities or MTFs. Some people who are primarily stationed at MTFs are assigned to what is called a “platform.” A platform is an operational unit of some kind. It could be the Mercy or Comfort, a Marine Corps unit, an Expeditionary Medical Facility, a fleet hospital, etc. In essence, it is an operational unit who “owns” you if they get activated or deployed. In other words, if your platform is a medical battalion and that medical battalion gets deployed, you would go with them because it is your platform. If they don’t get deployed, you may never have to do anything for or with your platform. On the other hand, if your platform regularly drills or does exercises, since it is your platform you may have to participate in these drills and get pulled away from your primary duties at your hospital or MTF.
How is it decided whether you get placed on a platform, and if so which one? The main determinant is most likely which billet you get orders into. Some billets at MTFs have secondary assignments to platforms. For example, the billet I am in at NMC Portsmouth is “mobilized to” or “MOB’ed to” an Expeditionary Medical Facility. That is my platform. To be honest, sometimes commands will rearrange platforms, so it is not always determined by the billet you are in. If you want to know if you are on a platform, you will have to go to your command’s Plans, Operations, Medical Intelligence or POMI officer. They are the ones who manage platforms and can tell you if you are on one.
Platform based deployments are the wave of the future in Navy Medicine, and you can expect an increased focus on platforms, platforms training, and deployments as a platform.
An individual augmentee or IA deployment is when a request in placed by an operational unit somewhere for an individual person, you are selected to fill that requirement, and you individually augment that unit. When they deploy, you deploy with them as an IA but stay attached administratively to your parent command. In other words, if you are at NMC Portsmouth but deploy as an IA, you stay attached to NMC Portsmouth the entire time you are deployed. This is the type of deployment most of us have experienced for the majority of our career, but the Navy is trying to get out of the “IA business” and is shifting, as already mentioned, to platforms.
The final type of deployment is a global support assignment or GSA. With this type, you detach from your current command, move or execute a permanent change of station or PCS to a processing center that becomes your new military command, and then you are given orders to deploy. For example, my last deployment was a GSA. I detached from BUPERS, my old command, PCS’ed to my new command, the processing center in Norfolk, and then was given deployment orders to go to my unit in GTMO. During this time my parent command was Expeditionary Combat Readiness Center or ECRC, the processing center, and they were primarily responsible for my fitreps and pay issues.
The unique part of a GSA deployment is that pretty much as soon as you report to the processing center you have to contact your Detailer and Specialty Leader to get orders to your next command. The GSA orders usually only last up to a year, and you’ll need orders so you can PCS to your next command when you get back from the deployment. This is the major downside that people complain about with a GSA…the fact that you get PCS orders and have to leave your old command, which people may not want to do. On the other hand, it can be a major benefit. If you are stationed somewhere you don’t want to be, volunteering for a GSA can get you out of there because you’ll PCS away. In addition, because you are volunteering or accepting a deployment, it may give you some leverage with the Detailer or Specialty Leader. For example, you could say, “I’ll deploy on this GSA, but only if you are willing to write me orders to Hawaii as follow-on orders.” That may not always work, but it is worth a try.
Those are the major types of deployments that currently exist, and here are some additional resources:
IA and GSA Frequently Asked Questions
NAVADMIN 332-10 – IA Manpower Management Business Rules
The New Blended Retirement System
There has been a lot of recent activity surrounding the new Blended Retirement System (BRS), and I don’t intend to reinvent the wheel and explain the whole system to you when there are some nice resources that already exist:
Military OneSource BRS Frequently Asked Questions
What I intend to do is give you a bottom line recommendation if you have a choice about using the current retirement system or going with the BRS.
If you know you are going to resign before you are eligible for retirement, you should select the BRS. Under the current system, you would get no retirement benefit, so that is a no-brainer.
If you are not sure how long you are going to stay in the Navy, you’ll have a tough decision to make. I’d read the above resources but also check out this article that discusses how flawed the BRS is:
New Military Retirement System Has Major Flaw
If you know you are going to stick around long enough to be eligible for retirement, my personal opinion is that you should choose to stay with the current retirement system. There are a few reasons for this:
- The BRS shifts risk from the government to you. We buy insurance when there is a risk that we can’t bear ourselves. People buy health insurance because a huge hospital bill could financially ruin them. We buy life and disability insurance because if a breadwinner died or was disabled in our household we wouldn’t have enough money to continue our desired lifestyle. The current government pension system is like retirement insurance. When it comes to retirement, the largest financial risk you run is that you outlive your financial assets. Social security insures against that, but so does your military pension, which regular readers know I highly value. Although the BRS has a pension as well, it is reduced, shifting more of this risk to you.
- Shifting risk to yourself is fine if you invest diligently and aggressively and the market earns a decent return. The problem is that most people don’t invest diligently or aggressively and no one knows what the market return will be over the next 10, 20, or 30 years. There are many people who lack the financial education they need (go here or here to get it) and invest in the Thrift Savings Plan but keep their money in the default option when you sign up, the G Fund. There is nothing wrong with the G Fund and I have some of my own retirement assets invested in it, but it is not designed to earn a high return. It is designed to not lose money and beat inflation. In order to benefit from the extra TSP money that comes with the BRS, you have to earn a high return and will need to be smart enough to invest in something more aggressive than the G Fund.
- If you control your spending, live in a reasonable house, and drive a reasonable car, you can enjoy the higher pension of the old retirement system and fill up your TSP every year, enjoying the benefit of both worlds. We have routinely saved 30% of our pre-tax income for retirement during nearly our entire Navy career, invested aggressively, and reaped the benefits. And I have a retirement pension on top of that?!?! It doesn’t get any better than that.
How to Find Out Your Reporting Senior’s Fitrep Trait Average
One of the most important markers of a good fitrep is that your trait average is above your reporting senior’s trait average. Since most officers initially write their own fitrep and create their own trait average on the first draft, it is important to find out your reporting senior’s trait average so that you can try to be above it. Here are a few ways to find out what it is.
First, in order to have a trait average, your reporting senior has to have served as the reporting senior for officers of your same rank from any corps. If they have not done this, they’ll have no pre-existing average. For example, if you are a LCDR, your reporting senior does not have to have ranked LCDR physicians. If he/she has ever ranked a LCDR of any kind (nurse, Medical Service Corps, line officer, etc.), then they will have an average.
If they have an average, here are the ways I know of to find it:
- If you’ve already received a fitrep from them in your current grade, then you can look at your Performance Summary Report or PSR, which you download from BUPERS On-Line. The number in the lower right in the “AVERAGES” column (circled below) is their average for that rank.
- If you haven’t received a fitrep from them, maybe you have a friend in the same rank who has received a recent fitrep from them. You can look at their PSR if they’ll let you.
- You can ask your chain of command or command fitrep coordinator. They often know because they are trying to make sure that all of the fitreps being done don’t change the reporting senior’s average in ways he/she doesn’t want.
- You can ask the reporting senior. They just may tell you.
The bottom line is that if you are drafting your fitrep, you want to try and find out the average and grade yourself above it. In the end, the ranking process may move you below it, but by submitting the draft with an above average grade you may increase the chances you stay above it.
LCDR Fitreps – Language for Writing Your Block 41
LCDRs all over Navy Medicine are busily writing their fitreps, so I wanted to offer some assistance. Keep in mind that when you write your block 41, the narrative portion of your fitrep, you are writing it for the promotion board. Many LCDRs struggle to find the right words to express all the things they’ve done, but it shouldn’t be that hard. If you read the fiscal year 2017 promotion board precept and convening order, you’ll find the things promotion boards are looking for explained in the language they want to hear. To facilitate your quest for the perfect block 41, here is some assistance:
- Here is the board precept: FY-17 AC RC PRECEPT
- Here is the board convening order: FY-17 AO5S CONVENING ORDER
- Here is a link to the video podcast that will help you write your entire fitrep: Basic Anatomy of a FITREP
- Here is a cheat sheet to use when drafting your block 41 on Word: Block 41 Word Template
- Here are all the relevant quotes pulled from these documents. Take your accomplishments, read these quotes, and use this language to put your accomplishments into verbiage that will be easy to brief at your own O5 promotion board. For example, maybe the opening line of your fitrep will borrow the first quote from the convening order below and read, “LCDR Smith is already performing his duties at the level of a seasoned Commander!”
From the precept:
“a broad spectrum of experience, background, perspective, innovative talent, and a depth and breadth of vision, drawn from every facet of the society it serves and understanding of the world within which it operates. The Navy needs innovative and bold male and female leaders to lead, think creatively, challenge assumptions, and take well-calculated risks that maximize effectiveness.”
“rich diversity of experience, backgrounds, perspective, innovative talent, and depth and breadth of vision”
“demonstrated potential to lead large organizations in a complex world composed of men and women coming from widely varying backgrounds.”
From the convening order:
“capable of performing the duties of the next higher pay grade”
“leadership, professional skills, integrity, management acumen, grounding business practices, and resourcefulness in difficult and challenging assignments.”
“adaptability, intelligent risk-taking, critical thinking, innovation, adherence to Navy and DoD ethical standards, physical fitness, and loyalty to the Navy core values.”
“capable of leading personnel from widely varying backgrounds and mentoring a diverse workforce while executing the Navy’s strategic diversity initiatives.”
“Proven and sustained superior performance in command or other leadership positions in difficult or challenging assignments”
“successful performance and leadership in combat conditions”
“officers with relevant graduate education, experience in specialized areas, and Navy and Joint Professional Military Education (JPME).”
“completion of graduate education and development of a subspecialty. Degrees from the Naval Postgraduate School, the Naval War College and equivalent Service institutions, and civilian education programs that result in assignment of a subspecialty code or award of Additional Qualification Designation (AQD) codes are desirable. Proven expertise from an experience tour utilizing that subspecialty is fundamental to the development of Navy Leaders.”
“opportunities to broaden their cultural awareness through experiences and education and to enable better communication in a global operating environment.”
“innovation and efficiency to ensure that we retain an adaptive, flexible, and effective spectrum of conflict.”
“ability to successfully change and to manage for efficiency.”
“think creatively, develop new ideas, take prudent risks, and maximize capabilities through sound management practices.”
“demonstrating innovative thinking, efficient management skills, prudent risk taking, and effective business practices”
“ability to operate effectively with the other Services”
“leaders with knowledge and experience in a variety of settings including operational medicine, joint medical operations, and current peacetime health care delivery initiatives.”
“exceptionally high professional operational, clinical, and business competence and intellectual capacity who have the ability to think analytically and express themselves articulately.”
“energy to create and communicate the organization’s vision”
“build and motivate teams to accomplish that vision”
“calculated risk-takers, inclusive in decision-making, and trusted by subordinates.”
“courage to stand on principles and demonstrate a clear potential to lead the Navy of the future.”
“recognize talent, mentor, coach, and develop juniors, and build the environment in which they can thrive”
“understand and use the best clinical practices and business tools in managing our military population’s health.”
“clearly understand Navy Medicine’s obligation to support the fleet and Marine Corps and demonstrate the capacity to meet the challenges of our commitment to maritime superiority.”
“broad knowledge necessary to support the operating forces and are acknowledged leaders within their operational, clinical, scientific, and business specialties”
“demonstrated exceptional managerial skill and professional competence in executive and staff roles both in the support of the fleet and Marine Corps and within the naval shore establishment.”
“served in a broad spectrum of assignments requiring expertise in diverse functional areas.”
“broad military and medical perspectives beyond the Department of the Navy.”
“demonstrated superior performance in the clinical, scientific, and/or operational settings.”
Getting Your Annual CFE (Continuing Financial Education)
We are all required to get continuing medical education or CME. Just as important, however, is continuing financial education (CFE). I’m as busy as the next guy, but I am able to stay reasonably up to date on all aspects of personal finance that are relevant to my situation. Thanks to podcasts, blogs, RSS readers, Facebook, and good old fashioned books, it is easy to stay up to date. Here are some resources I recommend:
- Jonathan Clements Money Guide 2016 and his annual updates. Mr. Clements was a personal finance columnist for The Wall Street Journal, has written many financial books, and has a stellar reputation. He offers solid, no-nonsense advice and covers every topic I can imagine in this guide. Since he updates the book annually, reading it is a guaranteed way to keep up to date on personal finance. In addition, he has a blog at JonathanClements.com that you can follow, and a Facebook site as well.
- The White Coat Investor. This website is free and contains a wealth of information on personal finance topics. Founded by a physician, this site is specific to high-income professionals and often focuses on physicians. There are usually three posts per week, and you can follow on Facebook, e-mail, RSS reader, or by manually checking the blog. If you have questions on any aspect of personal finance, you can probably find a physician-focused answer on this site.
- Vanguard. The Vanguard blog and Investment Commentary podcast focus on the low-cost, passive, index fund investing that have made Vanguard the king of investment companies. The blog is an excellent source of contemporary investment information and current market trends. The podcasts occur monthly and are usually less than 15 minutes in length, making them easily digestible by busy physicians.
- Wealthfront Blog. Written by Burton Malkiel, acclaimed author of A Random Walk Down Wall Street, and other well respected financial writers, this blog is an excellent source of investing information. As you might imagine, the posts tend to focus on the benefits of utilizing Wealthfront’s robo-advisor service, but even if you don’t invest with Wealthfront the information discussed is universally applicable, especially if you invest passively with index funds.
- Mr. Money Mustache. There is an entire early retirement culture online, of which many physicians are unaware. If you have an interest in early retirement, you’ll love this website and the story of Pete (Mr. Money Mustache), a software engineer who retired in his thirties. It is filled with investing information, as well as practical advice on how to save money in everyday life. The site has an anti-consumerism, pro-Earth bent and Mr. Money Mustache is a strong proponent of using a bicycle instead of driving a car, even in the dead of winter. He will show you that retiring early and controlling your spending doesn’t have to lead to unhappiness. In fact, he’ll probably convince you that the less you own the happier you’ll be.
- Money for the Rest of Us. This podcast is hosted by a former investment manager. He does an excellent job of reviewing personal finance and economics topics in shows that are usually about 30 minutes in length. He offers additional content to those that join his “hub,” and like most money managers he thinks he can invest on the “leading edge” of the market. In other words, he thinks he can predict the future and is a little too slanted towards active management for me. That said, however, the shows are well done and extensively researched, and very entertaining with high-quality audio. Even though I don’t agree with active management, many of the topics he discusses are excellent food for thought.
If you regularly utilize these six sources of financial information, it will be easy for you to stay up to date on your CFE.
FY17 LCDR Medical Corps Promotion Board Statistics
Here is a PDF of the FY17 Medical Corps LCDR promotion board statistics, summarized here:
Above Zone – 3 of 7 eligible officers selected – 43% selection rate
In Zone – 219 of 249 eligible officers selected – 88% selection rate
Below Zone – 24 of 503 eligible officers selected – 5%
OVERALL – 246 officers selected out of 249 possible – 99%
The last line might not make much sense, so let me explain it. First, the according to page 2 of the board convening order the promotion opportunity was 100%. You take the number of officers in zone (249 in this case) and multiply it by the promotion opportunity (100% in this case) to give you the number of officers the board can select for promotion (249). The 99% overall selection rate incorporates the 3 they selected from above zone and the 24 they took from below zone and adds them to the 219 they took from in zone giving you 246 out of 249 possible or 99%.
Tips to Improve Your Concurrent FITREP
Yesterday an officer e-mailed me and asked for tips on improving his concurrent FITREP, which I thought would make a nice blog post.
A concurrent FITREP is most often received when you are deployed. It is “concurrent” because not only are you getting a FITREP from your deployed command/unit, but you are also getting one from your home/parent command. For example, I just returned from a deployment. I was gone from September 2015 to June 2016. I received both a periodic FITREP from my parent/home command and a concurrent FITREP from my deployed command.
Tips to improve your concurrent FITREP include:
- Realize that operational commanders often know very little about medical/Navy FITREPs, so you want to do everything you can to make sure that none of these critical FITREP mistakes happen to you.
- Try to get a strong soft breakout where the commander compares you to all officers of the same grade under his/her command either now or during his/her entire career. For example, “In the top 10% of over 200 O4 officers I’ve rated in my entire career.”
- Make sure your most important title/duty is in the box in the upper left of block 29. For example, don’t put “PHYSICIAN” but “OIC” or “SMO”. You can often score some titles that sound very important on a deployment, like “MEU SURGEON” or “GROUP SURGEON”. You don’t want to waste them.
Otherwise, general FITREP advice can be found in the Basic Anatomy of a FITREP.
6th Step to Financial Freedom – The Rent vs Buy Real Estate Decision
The classic advice has always been to purchase your home if you can afford it, but in the military the decision is much more complex. You can’t simply compare your rent versus a mortgage payment. You have to consider tax breaks, fees associated with purchasing real estate, and how long you expect to stay at your duty station. Here’s a breakdown as I see it:
Benefits of Home Ownership
- Interest payments and property taxes are deductible.
- When you sell, gains on home value are federal tax exempt up to $250K if single and $500K if married.
- Making regular mortgage payments forces you to save.
- You can get some significant asset protection as many states protect home equity from lawsuits.
- As you make mortgage payments and accumulate home equity, it serves as a diversifier in your investment portfolio. Real estate is a great hedge against inflation and is only moderately correlated with traditional investments like stocks and bonds.
- Mortgage rates are rock bottom right now, making it easier to purchase a home.
Downsides of Home Ownership
- Most home purchases have a 3-5 year break even period, which just happens to coincide with the length of most residencies and military tours of duty.
- Real estate appreciation barely keeps up with inflation over the long haul.
- Sudden moves can force you to either sell your house or become a landlord.
- The classic teaching is that purchasing a home is a great investment because you don’t have to pay rent, but buying a home that is too expensive will harm you financially because of all the associated costs, such as heating, cooling, insurance, maintenance, buying, and selling. Expect to pay 5% of the value of the house when buying it, 1-2% of the value each year to maintain it, and 10% of the value when selling it.
Benefits of Renting
- You avoid the fees and ongoing expenses associated with buying, maintaining, and selling a home.
- Rental contracts have military clauses that will allow you to get out of a lease in the event of a sudden military directed move.
- In high-cost areas (Hawaii and San Diego are frequent duty stations that fit this description), it is often much more affordable to rent than to buy.
Downside of Renting
- You don’t get the benefits of home ownership listed above.
Rent vs Buy Calculators
You don’t have to make this decision on your own. Here are two on-line calculators to help you make your decision:
New York Times Rent vs Buy Calculator
The reality is that this is a very personal choice, and there really isn’t a right or wrong answer. What you should do will be based purely on your personal values and likely career path. My personal bias would be to make sure that by the time I retire I have paid off the mortgage on my primary (and hopefully only) residence.
You Didn’t Make CDR. Now What?
I receive questions all the time about what happens when you are passed over for promotion and are now “above-zone”. If you find yourself in this position, here is what you need to do:
- Realize that it is not the end of the world. Based on the FY 17 CDR promotion board statistics, 56% of in zone officers were passed over, 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 on 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. At a minimum, you need to send 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) or a Residency Director (or whatever you want to do), tell them that you need to be promoted to CDR 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 3 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, other trusted senior advisor, or by 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. My promo prep document will help you as well.
- 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. 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/Associate Residency Director
- Department Head at a small/medium sized MTF
- Senior Medical Officer or Medical Director
- Chair of a hospital committee
- MEC member
- 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.
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 either write you a letter or give you a special fitrep. Ultimately it is up to them whether they do either of these or none.
- 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.
Those are my tips for those who find themselves above zone. Most importantly, if you want to promote, NEVER STOP TRYING. You can stay in as a LCDR for 20 years, and I personally know of people who got promoted their 4th look and have heard of people who succeeded on their 9th try!
Joel Schofer's Career Planning Blog 