Basic Anatomy of a FITREP

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There is a HUGE knowledge deficit in the Medical Corps about FITREPs, which is sad when you consider that they are probably the most important document in our Naval careers.  To address this deficit I created this video podcast.  In 43 minutes you’ll know just about everything that you need to know about FITREPs.  This material is based on about 10 lectures I collected over the years and is consistent with the 2015 update of the FITREP instruction that was just released a few months ago.

Grab a FITREP to look at or start up NAVFIT98a and write your FITREP as you watch the video because it will be much easier to follow along this way.  In addition, here are the slides to download and view and the FITREP instruction:

Basic Anatomy of a FITREP

BUPERSINST 1610.10D – Navy Performance Evaluation System

O5/O6 Opportunities – USUHS Brigade Commander and SECDEF Corporate Fellowship

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Here are two opportunities for senior physicians.  If you are interested in one, contact your Detailer:

O6 Only – Brigade Commander Position at USUHS

O5/O6 – SECDEF Corporate Fellowship NAVADMIN*

*NOTE: The first two programs mentioned in this NAVADMIN are for line officers and  physicians are not eligible.  The last program, the SECDEF Corporate Fellowship, is the one physicians are eligible for.

FY16 CAPT Promotion Board Statistics

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People really enjoyed seeing the FY16 CDR promotion stats and I got requests for the same stats for the CAPT promotion board.  Here they are:

ABOVE ZONE 155 11 7.10%
IN ZONE 101 39 38.61%
BELOW ZONE 164 1 0.61%


FLT SRG 0 0 N/A 9 0 0.00% 0 0 N/A
RAM 2 0 0.00% 9 0 0.00% 3 0 0.00%
ANESTH 13 2 15.38% 10 0 0.00% 13 0 0.00%
SURG 6 3 50.00% 9 0 0.00% 7 0 0.00%
NEURO SURG 0 0 N/A 2 0 0.00% 2 0 0.00%
OB GYN 4 3 75.00% 11 1 9.09% 10 0 0.00%
GMO 0 0 N/A 0 0 N/A 0 0 N/A
OPHTH 0 0 N/A 2 0 0.00% 5 0 0.00%
ORTHO 7 2 28.57% 10 0 0.00% 12 0 0.00%
OTO 3 1 33.33% 2 0 0.00% 8 0 0.00%
URO 0 0 N/A 1 0 0.00% 4 0 0.00%
PREV MED 1 0 0.00% 3 0 0.00% 2 0 0.00%
OCC MED 4 3 75.00% 4 0 0.00% 4 0 0.00%
PHYS MED 1 0 0.00% 0 0 N/A 0 0 N/A
PATH 2 1 50.00% 9 0 0.00% 5 0 0.00%
DERM 5 2 40.00% 0 0 N/A 2 0 0.00%
EMERG 8 4 50.00% 7 0 0.00% 11 0 0.00%
FAM PRAC 9 4 44.44% 28 4 14.29% 15 0 0.00%
INT MED 18 7 38.89% 10 1 10.00% 20 1 5.00%
NEURO 0 0 N/A 2 0 0.00% 0 0 N/A
UMO 4 0 0.00% 1 0 0.00% 2 0 0.00%
PEDS 4 2 50.00% 9 2 22.22% 9 0 0.00%
NUC MED 0 0 N/A 0 0 N/A 0 0 N/A
PSYCH 4 2 50.00% 2 0 0.00% 8 0 0.00%
DIAG RAD 6 3 50.00% 14 3 21.43% 21 0 0.00%
RAD ONC 0 0 N/A 1 0 0.00% 1 0 0.00%
TOTAL 101 39 38.61% 155 11 7.10% 164 1 0.61%

FY16 CDR Promotion Board Statistics

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Here are the FY16 CDR promotion board statistics.  After a few more weeks of reviewing records of those who failed to select, I’ll have some specific promotion board takeaways.


ABOVE ZONE 113 24 21.24%
IN ZONE 135 71 52.59%
BELOW ZONE 370 0 0.00%


FLT SRG 1 1 1 2 50% 9 2 22%
RAM 0 2 0 2 100% 10 2 20%
ANESTH 4 9 4 13 69% 23 13 57%
SURG 5 3 4 8 38% 19 7 37%
NEURO SURG 0 0 1 0 N/A 1 1 100%
OBGYN 1 7 1 8 88% 11 8 73%
GMO 0 0 0 0 N/A 0 0 N/A
OPHTH 1 2 0 3 67% 3 2 67%
ORTHO 3 4 1 7 57% 13 5 38%
OTO 1 0 0 1 0% 3 0 0%
UROLOGY 1 1 0 2 50% 4 1 25%
PREV MED 3 4 1 7 57% 11 5 45%
OCC MED 3 2 1 5 40% 10 3 30%
PHY MED 1 0 0 1 0% 1 0 0%
PATH 4 0 1 4 0% 8 1 13%
DERM 1 1 1 2 50% 5 2 40%
EMERG 8 3 3 11 27% 19 6 32%
FAM MED 4 10 2 14 71% 30 12 40%
INT MED 7 6 1 13 46% 17 7 41%
NEURO 3 1 0 4 25% 5 1 20%
UMO 1 0 0 1 0% 1 0 0%
PEDS 4 4 1 8 50% 14 5 36%
NUC MED 0 0 0 0 N/A 0 0 N/A
PSYCH 1 4 0 5 80% 11 4 36%
RAD 6 7 1 13 54% 19 8 42%
RAD ONC 1 0 0 1 0% 1 0 0%


Click on this to make it larger, if needed:

Specialty Graphs


2015 Graduate Medical Education BUMED Note Released

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Here is the 2015 Graduate Medical Education BUMED Note:


O5 Promotion List Released

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Below this message is the O5 promotion list.  For those that were selected, congratulations.  Now that you are a CDR(s), you should strongly consider mixing your career up a little.  No matter what you do for the next few years as a junior CDR, you’re likely to get a promotable (P) on your fitreps if you are in a competitive group.  This fact makes it a great time to PCS, moving overseas or to a senior operational role if you haven’t done those tours yet.  It also makes it a great time to apply for a fellowship, go to a War College, take on a job that you will enjoy but will get you 1/1 fitreps that could hurt you later in your career, or pursue anything else you can think of that is rank appropriate.  Then after you spend a few years doing this, you can return to a command, try to get a senior leadership role and competitive fitreps, and give it your best shot to promote to O6.

If you did not promote, it is time to regroup.  See my June 21st post entitled “You Failed to Promote…Now What?”  Keep in mind, that most physicians are offered continuation until year 20 as a LCDR, so you likely have a few more chances to promote.

Once I have some time to analyze the O5 board results and get some statistics, I’ll do a more detailed post with O5 promotion board takeaways.


Introduction to Medical Corps Special Pays

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This is my first videocast of a lecture I gave to the Emergency Medicine residents at NMC Portsmouth a few weeks ago.  I was surprised by how many questions there were about special pays.  I think it is a topic that is mundane to those of us that have been in the Navy for a while, but can be quite a mystery to new Medical Corps officers.  As I learn how to videocast I’m sure the content will improve, but aside from one place where I said “January” instead of “July” I think it turned out well.  I hope junior physicians enjoy this introduction to the world of Medical Corps special pays.

Could a Master’s Degree Get You Promoted?

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When discussing why they failed to promote, one of the more common reasons that officers give is that they were unable to get a leadership position. When I ask them how they prepared themselves for these positions and what they did to improve their chances of getting one, they often don’t have much to say. Frankly, they didn’t do anything “extra” or above and beyond their normal duties to prepare for and get a leadership position.

Don’t be one of those officers.

The recipe for promotion is fairly simple. Superior performance in leadership positions leads to early promote (EP) fitreps, which leads to promotion. As promotion gets more difficult, the competition for leadership positions is likely to increase, and officers need to find a way to differentiate themselves from the crowd, increasing the chance they’ll get leadership positions. Obtaining a master’s degree can be one of the things that will distinguish you from other physicians and can dramatically increase the chances that you are competitive for career advancing positions.

What Kind of Degree Should You Consider Getting?

This depends on your career goals. If you want to become a leader in research or global health engagement, an area of increased focus in the Navy, you probably want to get a Master in Public Health (MPH) or similar degree. If you want to become a residency or fellowship director, a master’s degree in adult or medical education would fit the bill. If you want to become an operational leader, attending a war college would make sense. And if you want to become a clinical administrator or pursue executive medicine, obtaining a management degree, such as a Master in Business Administration (MBA), Master in Medical Management (MMM), or Master in Healthcare Administration (MHA), would make sense to me.

How Can You Get a Master’s Degree While on Active Duty?

There are many ways you can do this, but the most common include:

  1. Complete a fellowship that includes a master’s degree. Some fellowships either include or have the option of obtaining a MPH, such as the Global Emergency Preparedness and Disaster Response Fellowship. I also know of multiple officers who asked the Graduate Medical Education Selection Board for an additional year of fellowship to obtain a degree or simply for permission to obtain a degree alone. What are the chances this will be granted? Well I’m sure the chances change from year to year, but they are zero if you don’t ask.
  2. Complete the distance learning Executive MBA from the Naval Postgraduate School. This is how I got my MBA for the cost of books alone, and I think the program is excellent. You have to go to Monterey for 1 week at the beginning of the 2-year program, but after that all classes are held in person at remote sites via video conferencing. You have to have 2 years of time-on-station left at your current command, so you have to apply to start right after you get to a command or get a new set of orders. In addition, your CO has to sign a letter stating that you’ll get the time to attend classes once per week for 8-9 hours and that you are not slated to deploy. You can deploy once you start the program, but you can’t be on the hook when you apply.
  3. Use Navy Tuition Assistance ( to pay for a degree. The tuition rates they pay will not completely cover more expensive degrees, but every little bit helps.
  4. Apply for the Navy Career Intermission Program and take time off to get a degree.
  5. Attend a war college. Intermediate colleges are for officers who are O4 or below, while senior college is for O5 and above. If you’re interested, contact your detailer.
  6. Pay for it yourself and do it in your free time on-line or in person. One program to look into is offered by the American Association for Physician Leadership ( By taking some CME you can then enroll in various patient safety and management degrees that are all physician focused. The on-line University of Massachusetts healthcare focused MBA that they offer is the most reasonably priced MBA that I could find that is accredited by the top business school accreditation body. If you want a fast MBA (but pricey), look into the University of Tennessee Physician Executive MBA program (

While committing to a master’s degree program will take major time and effort, that is the point. It is a well-recognized way to demonstrate to the Navy that you’ve made a serious commitment to your professional development and could go a long way toward giving your next interview for a leadership position.

FY16 XO/CO Screening Board NAVADMIN Released

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Here is the recently released NAVADMIN for the BUMED XO/CO Screening Board.  Applications are due by 7/31/15 to be considered.  Although only Captains can apply, anyone contemplating a future in executive medicine should take a look at the NAVADMIN and the references it points you to so that you have an idea what kind of things you need to do to be considered.

FY16 XO:CO Screening Board NAVADMIN

You Failed to Promote…Now What?

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My June 13th post that discussed whether CDR is the new terminal rank and other O6 promotion board takeaways has gotten the most attention thus far. I received some questions about what happens when you are passed over for promotion and are now “above-zone.” If you ever find yourself in this position, here is what you need to do:

  1. Realize that it is not the end of the world. As we’ve previously discussed, more and more people are getting passed over, and a good number of them eventually are selected for promotion. In FY15, 36% of LCDRs who were above-zone were selected for promotion to CDR. When it comes to CAPT, the above-zone selection rate was 11% in FY14, 10% in FY15, and 7% in FY16. While those promotion rates are particularly depressing for above-zone CDRs, you have to realize that there is a significant portion of CDRs who have given up and stopped trying to promote to CAPT but are still included in the denominator of the above-zone selection rate. Because of this, I think if you try to get promoted your chances are better than the aforementioned 7-11% above-zone selection rate.
  2. If you do nothing, you will continue to get looked at for 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…
  3. 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 that you desire to continue your career in the Navy. Second, briefly 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 do Executive Medicine you need to be an O6, so tell them that you want to screen for XO. If you are a LCDR and you want to be a Department Head at a large 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.
  4. 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.
  5. Have your record reviewed by your Detailer. Because of promotion board confidentiality, you and your Detailer will never know the reason(s) you did not promote, but most of the time the Detailer 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, which is available at the top of this webpage.
  6. 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 promotion. If you are a LCDR who got passed over for CDR, try to get one of these jobs and excel at it:
  • Assistant/Associate Residency Director
  • Department Head at a small/medium sized MTF
  • Senior Medical Officer or Medical Director
  • Chair of a hospital committee
  • ECOMS member

If you are a CDR who got passed over for CAPT, try to get one of these jobs and excel at it:

  • Residency Director
  • Department Head in a large MTF
  • Associate Director or Director
  • Officer-in-Charge (OIC)
  • ECOMS President
  • Division, Group, or Wing Surgeon
  • CATF Surgeon
  • Specialty Leader

These lists are not exhaustive and are not the only paths to CDR or CAPT, but they are a good start.

  1. 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 to continue 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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. I personally know of people who got promoted their 4th look and have heard of people who succeeded on their 9th try!