Throwback Thursday Classic Post – Is Commander the New Terminal Rank? (And Other O6 Promotion Board Takeaways)

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(2019 Note – This is one of the most popular posts on the blog and helped put it on the map. Since the FY16 O6 promotion opportunity of 50% when it was published in 2015, we’ve seen an uptrend:

  • FY17 – 70% promotion opportunity – 34% in zone selection rate
  • FY18 – 80% – 37%
  • FY19 – 90% – 41%
  • FY20 – 81% – 51%

That said, much of what I said in 2015 is still very true. Enjoy!)

In case you haven’t figured it out yet, it is getting harder to promote to Captain. Here are the historical promotion opportunities for O6. You don’t have to be a mathematician to notice the trend:

  FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16
CAPT 80% 80% 80% 80% 80% 60% 60% 60% 50%

There are a lot of physicians who came into the Navy when it was relatively easy for a physician to promote to Captain. If you could fog a mirror, you could likely promote. Well…things seem to have changed.

This has frustrated some physicians who failed to promote and is likely to frustrate more in the future. Aside from getting frustrated, though, it would benefit all involved if they could learn from this trend and try to adjust while there is still time. Here are my O6 promotion board takeaways:

  • It is now normal when you fail to select for Captain the first time. In the FY16 board only 39% of Commanders who were in zone were promoted, leaving 61%, a clear majority, who did not. Physicians should expect to fail to select or “get passed over” the first time they are up for O6. (Only FY20 got over 50%, and barely at 51%.)
  • Commander is the new terminal rank for full-time clinicians, and there’s nothing wrong with that. If the thought of taking on a significant collateral duty makes you want to cringe because you want to remain a full-time clinician during your time as an O5, you have likely reached your terminal rank. Physicians get very frustrated when they fail to promote to O6, thinking that the Navy doesn’t value clinical productivity, and this is just not true. The Navy does value clinical productivity, it just doesn’t think that they need to be Captains! The Captain rank has moved from being a reward obtained by most physicians who hang around long enough to a reward for those with senior leadership potential.
  • The overwhelming majority of Commanders who promote to O6 take on a significant collateral duty. Whether they were a department head at a large MTF, a specialty leader, a residency director, a director, president of ECOMS, or in a senior operational role, they all had to pay their dues in these roles in order to score the EPs on their fitreps that allowed them to promote. These roles almost always necessitate a reduction in clinical activity, which is why you are less likely to promote to O6 as a full-time clinician.
  • Having only one competitive EP fitrep before the promotion board is often not enough. At some of the larger MTFs it can take quite a while to “break out” from the pack of Commanders and get an EP on your fitrep. If you are lucky enough to get an EP but you only slide one in before you are in zone, it may not be enough. As the competition heats up, it is the people with multiple competitive EPs that will be in the best position to promote.
  • You need to demonstrate career diversity while not hurting your chances to promote. The best time to mix it up is right after you are selected for Commander. You are finally senior enough to get a decent position at an operational command, BUMED, PERS, or some other alternative command. If instead of mixing it up you stay where you are, you will be the new, small fish in the largest pond in the Navy, the Commander fitrep competitive group. No matter what you do you are probably going to get promotable fitreps for a few years. You might as well use those years to break things up, PCS (even locally to an operational command – I’m not saying you have to move), and demonstrate that you are willing to flex for the needs of the Navy. You may get 1/1 EP fitreps but while you are a junior commander this is unlikely to hurt you. Then once you are done with that tour, you can return to a larger competitive group and compete for one of the aforementioned jobs if you have making O6 on your radar.

Medical Corps Career Planner at BUMED – CAPT/CAPT(sel)

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Billet Title: Career Planner, Office of the Medical Corps Chief, BUMED

Location: Navy Bureau of Medicine and Surgery, Defense Health Headquarters,
Falls Church, VA

Rank: O6/O6-select

Corps: Medical Corps

Tour Length: 36 months (beginning JAN-FEB 2020)

Mission: Mentor and guide all USN Medical corps officers providing leadership and career development support and guidance. Integral to selecting and maintaining a competent and professional Medical Corps which is valued by the organization and meets the needs of the mission and the strategic goals of readiness, health, and partnerships.

Functions: Mentors and provides leadership development opportunities for Medical Corps Officers. Serve as president of the Professional Review Board, responsible for accessions of MC Officers via FAP/TMS/DA pathways. Responsible for reviewing litigation reports quality assurance reports in determination of NPDB reporting. Plans and coordinates the annual USN MC GME/Operational Intern Road Show.  Medical Corps Chief Office liaison to all other Corps Career Planners and Leadership/Career Development Working Groups. Subject matter expert on accession issues pertinent to MC Officers. Serves as member of multiple councils and boards including Medical Education Planning Council and HPSP selection boards.  Provides regular AMDOC, ODS, and command-requested briefings relative to the Medical Corps.

Command Relations: Ability to communicate effectively to a 1 or 2 Star Admiral on a regular basis.

Experience Required: Highly recommended to have: Knowledge of Department of Defense, Navy, Navy Medical Corps policies and instructions and policies of other Federal entities as needed; Experience with recruitment, retention, promotion, and sustainment of Medical Corps Officers; Proficient networking, written and oral communication, and public speaking skills.

Other: Time available to perform clinical work at multiple MTFs in the National Capital Region.  Time available to travel for CME. TAD travel possible throughout the year for Medical Corps Chief related events.

POC: CAPT Chris Quarles (contact info is in the global) by 29 JUL 2019 with Specialty
Leader and Detailer concurrence. All candidates must be eligible for PCS orders. Preferred report date is JAN 2020.

Career Planner Position Description

NOTE: CV, BIO, and Letter of Intent needed for application.  All candidates must be eligible for PCS orders.

Special Pays Update for Those Receiving a Retention Bonus (RB)

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There are a couple of items BUMED Special Pays recently learned from DFAS.

First, for those receiving RB rates over $50,000, an update to DFAS’s system prevents them from entering an initial RB payment over $50,000.  For RBs with an annual rate over $50,000, DFAS is entering the initial payment of $50,000 then going back into the member’s account at a later date and adding the remainder of the amount due.   Unfortunately, with the volume of RBs DFAS is processing, they may not be able to go back into the account to make the adjustment until after the initial payment is made so there may be a gap in receipt of the full RB amount.  This only impacts the initial payment.

Second, for those who have recently Terminated and Renegotiated an RB to a different rate, if the anniversary payment of the legacy agreement is within a few weeks of when the new acceptance letter was submitted to DFAS, this year’s anniversary payment may be made at the old rate.   DFAS will then go in afterwards to adjust the RB to the new rate.  Again, with the volume of RBs being processed, there is no way to know how soon after the anniversary payment is made that DFAS can make the adjustment.

In either scenario, if the member has not received the adjusted payment within 2 weeks after the effective date, the member should contact his/her command HRD/Admin office.  The HRD/Admin offices are to compile a list to send to the BUMED Special Pays Office via the usn.ncr.bumedfchva.mbx.specialpays-bumed@mail.mil email address.

Questions should be directed to the command HRD/Admin office.

Reminder to Graduating Residents – You are Now Eligible for GMO Incentive Pay

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Congratulations to those who just graduated residency. Please note the following on page 3 of the BUMED Medical Corps Special Pay Guidance where it discusses General Medical Officer (GMO) Incentive Pay (IP):

Medical Corps officers who complete initial residency on active duty are eligible for the GMO IP the day after completing residency.  For those who complete residency not on active duty eligibility is the date reported to first permanent command, if less than three months after completing residency.

This means you need to go to your Special Pays coordinator and apply for the GMO IP. It increases you from a residency IP of $8,000 per year to the GMO IP of $20,000 per year.

If you are not sure where to go or how to get this pay, I’d try to do what the BUMED Special Pays page says:

If there are any questions please direct them to your HRD/Admin/Special Pays Coordinator, or Specialty Leader, who will forward to BUMED inquiries they are unable answer at the command level, but no individuals should be bypassing their local command admin support, since they need to be able to understand the issues, and responses, to be able to better support the command.

Update on DHA Transition in June Message from the Principal Deputy Assistant Secretary of Defense for Health Affairs

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MHS Team,

As the Military Health System (MHS) has continued implementation of FY17 National Defense Authorization Act (NDAA) Section 702, we’ve revised our approach for transitioning administration and management of the Military Treatment Facilities (MTFs) from the Military Departments to the Defense Health Agency (DHA). Our original implementation framework required maintaining Military Department Headquarters and Intermediate Management Organization (IMO) MTF management responsibilities for an extended period of time to support those MTFs in geographic regions as we phased in MTF transfers to the DHA over several years. Recognizing this approach had several challenges in addressing civilian personnel changes, financial resources, and the Military Departments’ ability to focus on medical readiness, in May the MHS leadership team recommended a new transition framework to DOD and Military Department senior leadership. Our new framework has DHA assuming authority, direction, and control of all MTFs on October 1 of this year and DHA will oversee the MTFs through a Direct Support relationship from Military Department IMOs. The DHA will relieve the Military Departments of this support during a transition period during which responsibility for specific functional capabilities are fully transferred from the Military Departments to DHA under a controlled “hand off.” For the remainder of FY19, the DHA and the Military Departments will finalize and implement the necessary memoranda of agreement to formalize this Direct Support approach.

At the same time, our work to carry out FY17 NDAA Section 703 continues as we prepare to adjust the MHS infrastructure to better support operational readiness requirements. Over the past several months, OASD/Health Affairs-led teams have conducted site visits to dozens of facilities, assessing both “on base” health services and needs, as well as the capacity of nearby civilian networks. The goal is to complete a top-to-bottom review of MTF capacity to ensure we dedicate the right personnel and resources to meet readiness requirements and identify any insufficient network coverage for our 9.5 million beneficiaries. To date we’ve identified 73 MTFs that merit additional analysis, and we are working to provide a final report and recommendations to Congress later this summer.

The Department continues to assess the medical manpower requirements in support of the National Defense Strategy. The Military Medical Departments have put forward their recommendations for force changes based on operational requirements, manpower needed, and subsequent proposed manpower reductions. Health Affairs, the DHA, and the Military Departments continue to work closely together to implement the medical force changes to meet future operational requirements while ensuring the MHS continues to provide the highest quality health care services possible to our patients.

Amidst these major organizational changes, our colleagues across the MHS continue to support medical operational requirements and deliver outstanding medical care to service members, retirees and their families. Earlier this month I had the opportunity to see firsthand evolving capabilities of the MHS when we visited Nellis and Creech Air Force Bases, Nevada. The trip illustrated how greater integration of services between the Military Health System, VA and local health systems can strengthen readiness support to the combatant forces and the delivery of quality care to the entire beneficiary population. I had the honor to meet with several military unit commanders and their staffs including: The 99th Medical Operations Squadron (99th MDG) at the Mike O’Callaghan Military Medical Center; 66th Rescue Squadron; 57th/757th Aircraft Maintenance Squadron (AMXS); Creech Medical Clinic; and the 42d Attack Squadron (42 ATKS) and 42d Attack Squadron-Human Performance Team (HPT).  I toured the Reaper Operation Center (ROC) Orientation & Ground Control Station (GCS) where General Hogg, Air Force Surgeon General, and I had the rare opportunity to fly a Remotely Piloted Aircraft mission in the flight simulator.

Rounding out the time with the Air Force components was the opportunity to visit the University Medical Center (UMC) to learn about the benefits of the Nellis partnership with this leading Las Vegas provider. Through this partnership Air Force physicians, nurses and technicians are able to temporarily work and train at UMC of Southern Nevada to help ensure they stay current and maintain the highest levels of readiness.

Last month, Dr. Terry Rauch, Acting DASD Health Readiness Policy and Oversight and our Global Health Engagement team participated in the 43rd International Committee on Military Medicine World Congress in Basel, Switzerland. Since 1921, the ICMM has worked to strengthen cooperation between the health services of militaries worldwide. The United States is proud to be one of the founding members of the ICMM, and U.S. military medicine remains committed to this enduring partnership as we step into the Vice Chair role. That commitment is fully in keeping with one of the pillars of our National Defense Strategy, which calls for strengthening our existing global partnerships and seeking to work with new partners.

Back at the Pentagon, the Health Affairs team bid farewell to COL Jesse Ortel, CDR Tilford Clark and LCDR Kishla Askins. A special thanks to these exceptional staff members for their significant contributions and unwavering dedication to the Health Affairs team over the past years. I wish them all the best in their future endeavors. As they depart, we are pleased to hail the newest members to Health Affairs: COL Chris Warner, Military Deputy and Chief of Staff; LCDR Chris Barnes, Military Assistant; LT Ariel Campbell, Deputy Director for MHS Governance/Integration Officer; Dr. Jill Sterling, Program Director, Medical Quality Assurance and Clinical Quality Management Policy; and Dr. Richard Mooney, Director of Health Services Policy and Oversight. Welcome to the team!

Lastly, I’d like to recognize our MHS Communications Team for winning the prestigious Silver Anvil Award from the Public Relations Society of America, as well as the Hermes Creative Award for the Take Command campaign executed last year to inform TRICARE beneficiaries about the many changes to their benefit. Congratulations on this great achievement – a true testament to the MHS’s commitment to meeting the needs of our beneficiaries.

Cheaper SGLI and Finance Friday Articles

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I always read my military pay stub, the Leave and Earnings Statement or LES. This month it said:

THE SERVICE MEMBERS GROUP LIFE INSURANCE AND FAMILY SGLI PREMIUM RATES WILL BE REDUCED EFFECTIVE 1 JULY 2019. THIS WILL LOWER PREMIUM RATES FOR ALL SERVICE MEMBERS. FOR NEW RATES VISIT: HTTPS://WWW.BENEFITS.VA.GOV/INSURANCE/SGLI.ASP

My SGLI of $400,000 just went from $29 per month to $25 per month. If you click on the link above, you can see the old and new rate tables.

Here are this week’s articles:

7 Ways the Rich Pay Less in Taxes (and You Can Too)

25 Best Personal Finance Blogs (Why You Should Read)

Don’t Buy Stuff You Can’t Afford

Don’t stop believing in the benefits of indexing

Do What You Want When You Want To

How Do Financial Advisors Get Paid – A Financial Planner’s Perspective

How to Get Rich: Curbing Spending on the Big 5

How to Win Any Argument About the Stock Market

Live Rich, Die Poor

Some Advice For New Investors

This is Why Tax-Efficient Investments Are Important

Top 5 Reasons Tracking Spending is Problematic

Where’s the Value? A Discussion About Value Tilting Your Portfolio

Why Tesla Owning Doctors Hate Me

Why We Plan To Downsize From 1,000 sq ft

Throwback Thursday Classic Post – How to Manage Your PRD and Not Get Stuck with a “Hotfill”

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(I’m going to start re-posting some of the better and more popular blog posts on the site on Throwback Thursday. Much of the content is evergreen or requires minimal updates, and the blog has a much larger readership than when many of these posts first ran.)

There are many important dates in your Navy career. One of the most important and neglected dates, though, is your projected rotation date or PRD. Your PRD is the month and year that your current orders will expire and you are scheduled to rotate to a new command. If you don’t manage your PRD and pay close attention to it, you can find yourself with few career options and in a situation you never thought you’d be in. With that in mind, here are my tips for managing your PRD.

Know Your PRD

First, know when it is because many physicians don’t know their PRD. If you are in this crowd, the easiest way to find your PRD is to login to BUPERS On-Line and look at block 14 of your Officer Data Card:

https://www.bol.navy.mil/

The other way to find your PRD is to contact your Detailer because they can look it up in the detailing system. Many physicians don’t know their Detailer, so here is a link to a page with “Contact Us” in the middle.

Manage Your PRD

Once you know your PRD, the easiest way to manage it is with whatever calendar you use (an app, web calendar like Google Calendar, Outlook, a date book, etc.). Place reminders in your calendar to correspond with these time frames:

13-18 Months Before Your PRD – This is when you should start thinking about your next career move. Although the normal time period to request an extension (find a template here) at your current command is 9-12 months before your PRD, many physicians request an extension during this time period if they are sure they want to extend. This is also a great time to talk to the Operational Detailer about operational billets you might have interest in or the Senior Detailer about what I’ll call “alternative billets” like those at DHA/BUMED, BUPERS, global health engagement billets, NAVMEDWEST, NAVMEDEAST, etc. If you act on your PRD in this timeframe, you’ll be well ahead of the game.

9-12 Months Before Your PRD – This is the traditional detailing window where you contact your Detailer and Specialty Leader to negotiate your next career move. This is when physicians normally submit an extension request as well as explore potential billets for their next set of orders. The one caveat is that the availability of billets is often contingent on the results of the Graduate Medical Education Selection Board or GMESB. Since these results are not finalized until January, people with summer PRDs will find that they may have to wait beyond this time period to find out what billets are available and get orders.

6-8 Months Before Your PRD – This is when the list of billets that are actually available will solidify and most physicians will get orders. If you want to extend at your current command and you haven’t submitted an extension request yet, you should do that ASAP.

1-5 Months Before Your PRD – Many physicians will get into this period without orders. If it is because you were waiting on the results of the GMESB, you are probably fine. If you are in this period for another reason, you should get nervous. The truth is that unanticipated things always happen. Commanding Officers don’t endorse extension requests. Unanticipated openings cause a Detailer and Specialty Leader to have a “hotfill” billet. When things like this happen, a Detailer goes looking for officers close to their PRD to fill the need. If you are in this window without orders, you are low lying fruit for filling these needs. And just so you know, most of these “hotfills” are not in Rota or San Diego.

At Your PRD or Beyond – Physicians let their PRDs “expire” all the time. Sometimes it is because they submit an extension request that never gets approved because it gets lost somewhere in the process. Other times they don’t know when their PRD is. Realistically, there is often no consequence if your PRD expires, although some commands will pick up on this fact and get your attention by threatening to take away your computer access. The biggest threat, though, is the aforementioned “hotfills” that inevitably show up. If your PRD is expired, you are going to rise to the top of the list when the Detailer goes looking for people to fill that need. Have fun wherever that “hotfill” is.

The Bottom Line – Know when your PRD is and manage it according to the above timeline. This will give you the maximum chance of getting what you want and reduce the chance that you are selected for a “hotfill” you don’t want.