The Top 5 Critical FITREP Mistakes

Posted on Updated on

When I was a Detailer, I would review a lot of records for people who failed to promote. Over and over again I would see FITREPs that reflected poorly on the officer. A lot of the time they didn’t realize it was even an issue, and sometimes they did it to themselves. Here are the top 5 FITREP mistakes you want to make sure you don’t make:

  1. Getting anything other than an early promote (EP) when you are getting a 1/1 FITREP, also known as an “air bubble.”

If you are the only officer in your competitive category (meaning that you aren’t competing against anyone on that FITREP), make sure you get an EP. Just like a single air bubble, you should “rise to the top” and get an EP. If you don’t get the air bubble and get a promotable (P) or must promote (MP), it reflects poorly on you unless it is CLEARLY EXPLAINED in the narrative why you are getting a P or MP. Here you can see an officer who got a 1/1 MP in his/her last FITREP and how it would be noted at a promotion board:

Air Bubble

For example, if your reporting senior doesn’t give newly promoted officers an EP, your narrative should say something like, “Newly promoted officers do not receive EP rankings.” Sometimes this happens because your reporting senior is an officer from another service and he/she doesn’t understand the “Navy rules” for FITREPs. Sometimes it happens because either you or your reporting senior wants to give you a P or MP so you can “show progression” and get an EP. If you want to show progression, do it on the overall marks, not the final promotion recommendation. For example, give yourself a 4.0 EP, then a 4.17 EP, and finally a 4.33 EP. DO NOT give yourself a P or MP if you are getting a 1/1 FITREP.

  1. Both officers in a competitive group of 2 getting a MP FITREP.

If you are in a competitive group of 2, your reporting senior should give 1 of you an EP and the other a MP. If he/she gives you both a MP, it reflects poorly on both of you. Most often this will happen at an operational command and/or when there are 2 officers who are competing but are in the same promotion year group. Make sure your reporting senior doesn’t take the easy road and give you both a MP. One of you should get the EP, and the other can get a MP with a strong narrative explaining why.

  1. Declining from an EP to an MP without changing competitive groups (or “moving to the left”).

Most often I would see this when a resident who was in a large competitive group was given an EP FITREP. Then when they graduate from residency, their competitive group shrinks and they don’t get an EP but are left with an MP. Here’s what it looks like on when projected at the promotion board:

Moving to Left

If I was you, I’d fight this like a dog. If they can’t keep you at an EP and you didn’t do anything wrong to deserve this, make sure the reason for your drop from an EP to a MP is clearly explained in the FITREP narrative.

If this happens to you because you are changing competitive groups, like when you get promoted or move from residency/fellowship to a staff physician at the same institution, it is not a black mark in any way and is expected.

  1. Not getting a 5.0 in Leadership.

If you are writing your own FITREP, you can’t give yourself a 5.0 in every category, but of all the categories Leadership is probably the most important one. Make sure you give yourself a 5.0 in Leadership because that is what the promotion board is looking to promote, future leaders. Having less than a 5.0 can send a bad message to the board.

Sometimes you have no control over this, and sometimes you may deserve less than a 5.0 in Leadership, but do your best to get a 5.0 there if at all possible.

  1. Giving yourself an overall trait average less than your reporting senior’s average.

Every reporting senior has an overall trait average for each rank that includes all of the FITREPs that they’ve done for that rank. You want to try and find out what it is.

While a reporting senior can look up their average on BOL, you can’t. You can, though, see it on your Performance Summary Record if you’ve received a FITREP from them at your current rank. Although it changes every time they do more FITREPs, their average the last time they did a round of FITREPs can be found on your PSR and is highlighted below by the red arrow with blue text (this reporting senior had ranked 6 LCDRs and had an average of 3.50 at that time) on one of the slides from my FITREP video podcast:

Average

If you have never received a FITREP from your reporting senior at your current rank, maybe your one of your friends has. The other way to find out their average is to ask your chain-of-command. Someone, usually the command’s FITREP coordinator, will know their average for your rank.

It is probably obvious that once you find out their average, you’d like to make sure you are above it. Sometimes there is nothing you can do to be above it because you are getting a P and/or you deserve to be below it, but make sure you don’t rank yourself below it if given the chance to write your own FITREP.

In summary, those are the top 5 FITREP mistakes I often see. If you are interested in learning more, grab a copy of your FITREP and watch this video podcast. In 45 minutes you’ll know everything you need to know to write effective FITREPs.

Fall 2015 Medical Corps Newsletter

Posted on

Here is the Fall 2015 Medical Corps Newsletter:

Medical Corps News Fall 2015

Reader Submission – History of the Medical Oak Leaf and Acorn Corps Device

Posted on

I usually stick to career planning topics on this blog, but a reader submitted this interesting article. I had no idea where our corps device came from, and since I didn’t know I’m sure there are others out there who don’t know either. Enjoy reading if this topic intrigues you:

The History of the Navy Medical Corps Insignia

FAP & NADDS Graduates – Check the Reserve LCDR Promotion List

Posted on

Navy physicians who participate in the FAP & NADDS programs often get promoted off of the reserve list.  Here is the ALNAV for promotion to LCDR.  If any of your friends are on the list, let them know as they often don’t even realize it:

 

UNCLASSIFIED//

ROUTINE

R 021500Z SEP 15

FM SECNAV WASHINGTON DC

TO ALNAV

INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC
CMC WASHINGTON DC

BT
UNCLAS
ALNAV 067/15

MSGID/GENADMIN/SECNAV WASHINGTON DC/-/SEP//

SUBJ/FY-16 NAVY RESERVE LIEUTENANT COMMANDER STAFF CORPS SELECTIONS//

RMKS/1.  I am pleased to announce the following Staff Corps Officers on the 
reserve active-status list for promotion to the permanent grade of Lieutenant 
Commander.

2.  This message is not authority to deliver appointments.  Authority to 
effect promotion will normally be issued by future NAVADMINS requiring 
NAVPERS 1421/7 preparation and forwarding of documents to PERS-806.

3.  Frocking is not authorized for any Officer listed below until specific 
authorization is received per SECNAVINST 1420.2A.

4.  For proper alphabetical order read from left to right on each line.  The 
numbers following each name to the right indicate the relative seniority 
among selectees within each competitive category.  Members are directed to 
verify their select status via BUPERS On-Line.
                           Medical Corps
Aquino Theodore Lee          0005  Bower Paul Edgar             0013
Crosby Mark Isaac            0002  Fitzgerald Steven Matt       0001
Freeman Brian Lee            0007  Kaminsky Michael Edwar       0011
Kulzer Matthew Henry         0008  Mallick Ronobir Ranjan       0003
McCord Caitlin Meghan        0015  Menger Richard Philip        0019
Morrisonponce Daphne P       0016  Philipp Sarah Kathleen       0006
Pride Keth Mackenzie         0012  Pulos Nicholas Alan          0018
Schneider Eric Peter         0004  Stockslager Steven Gre       0010
Thorpe Mary Arbuthnot        0017  Tran Diepdenise Ngoc         0020
Werner John Kent Jr          0014

Senior Operational Opportunities for Summer 2016

Posted on

Here are some new opportunities.  If you are interested, contact your Detailer:

1. CTF 76 Surgeon – Medical representative to admiral’s staff currently located at White Beach, Okinawa. The medical staff includes a Medical Planner (O-4 Billet), a Task Force IDC (E-8 Billet) and a Medical Inspector (E-7 IDC based in Sasebo). Responsibilities include being ISIC for the ships within CTF 76. There are 9 total (1 LHD, 1 LPD, 2 LSDs, and 4 MCMs based in Sasebo and 1 LCC in Yokosuka). CTF 76 Surgeon is Medical OPCON to all amphibious ships transiting through the 7th Fleet AOR and aid in any MEDEVAC issues that develop while ships are transiting the AOR. The CTF 76 Surgeon is responsible for monitoring the ships’ Medical Readiness and acting as clinical supervisor for the SMOs, GMOs and IDCs. CTF 76 Surgeon has a significant role in the planning and execution of the medical aspects for wartime contingencies, Pacific theater exercises, and in the event of natural disaster, the planning and execution of the medical portion of HA/DR.

2. OIC FST-7 – FST 7 is a 16 member surgical team that deploys aboard USS BONHOMME RICHARD (BHR). The team consists of 1 Surgeon, 1 Nurse Anesthetist, 1 OR nurse, 1 ICU Nurse, 1 Family Practitioner, 1 MRCO (Medical Regulating Control Officer) and 9 Corpsmen. The OIC is responsible for the credentialing, evaluations, fitness reports and training of team members. When not underway on the ship, FST 7 is ADDU to USNH Okinawa in order to maintain their skills and proficiency in their areas of expertise. There is usually a Spring Patrol (~2 months), a Fall Patrol (~3 months) and every other year a Summer deployment to Australia. This year the Summer deployment will role into the Fall Patrol with a number very exciting port visits in between. FST7 provides emergent and resuscitative surgery for Surgical Emergencies (i.e. Acute Abdomen, Trauma, etc). With FST7 aboard, BHR acts as a Level 2 trauma center and provides ICU care and stabilization for medical as well as surgical cases.

3. CPR11 Surgeon – COMPHIBRON11 is the afloat Amphibious Ready Group Commander usually embarked on the BHR. The CPR11 Surgeon is the Senior Medical authority afloat for all ships OPCON to CPR11 as well as the embarked Marine Forces (usually 31st MEU). While aboard the BHR, CPR11 Surgeon attends operations and
intelligence briefs, and provides daily updates to the COMMODORE and MEU COMMANDER on the medical status within the ARG. The FST is TAD to the BHR and reports directly to the Ship’s SMO who in turn reports to the CPR 11 Surgeon. Often while underway the CPR11 Surgeon provides medical advice for the junior GMOs and IDCs aboard the ships within the ARG. The CPR11 Surgeon with the MRCO coordinates all MEDEVACs from ARG Shipping. CPR11 has a busy deployment schedule and participates in many 7th Fleet exercises to include PHIBLEX (Philippines), COBRA GOLD (Thailand) and Talisman Saber (Australia).

 

FY16 Special Pays NAVADMIN Released

Posted on

Per the BUMED Special Pays website (http://www.med.navy.mil/bumed/Special_Pay/Pages/default.aspx):

8 Sep 2015:  The FY16 Medical Special Pays NAVADMIN 212/15 has been released.  FY16 Special Pay requests can now be submitted in accordance with OPNAVINST 7220.16.  Submit requests no earlier than 60 days prior to, and no later than 30 days after the effective date.   Send ALL requests and questions to the email address listed below.

usn.ncr.bumedfchva.mbx.specialpays-bumed@mail.mil

Templates for submission can be found here, although your Special Pays person in PSD usually can do this for you:

http://www.med.navy.mil/bumed/Special_Pay/Pages/SpecialPaysTemplatesforSubmission.aspx

Here is the NAVADMIN.  If I’m interpreting it correctly, all amounts remain the same from FY15 and can be found here, FY15 MC-DC Special Pay Implementation Guidance.

2nd Step to Financial Freedom – Get Properly Insured

Posted on Updated on

Having adequate insurance is a fundamental part of your overall financial plan and the 2nd step to financial freedom after establishing an emergency fund (perhaps it should even be 1st). It is also something that most people struggle with, as there are innumerable types of insurance with many options to choose from. At it’s most basic, insurance is a method to transfer risk from you to an insurance company, and you should only pay to transfer risks that you are not willing or able to shoulder. While insurance companies are happy to insure everyone and everything, in general you should only insure against large losses. Below is one man’s attempt to treat insurance with a “KISS” (keep it simple, stupid) approach. This post will discuss insurance that you probably need, insurance you might need, and that which you probably don’t need.

TYPES OF INSURANCE YOU PROBABLY NEED

If you cannot afford the costs involved in any life scenario, then you should probably insure yourself against it.

Disability Insurance

While an emergency fund and the Navy’s disability policy can “self-insure” you against short-term disability, you may need help in the event of a long-term disability unless you are wealthy enough that you can make up the difference between your military pay, including all physician bonuses, and your disability payments, which will not reflect the higher pay of a physician. Most physicians probably rely on their higher pay, and would be pretty disappointed with the Navy and VA payments in the event of 100% disability, in which case you’d get approximately your annual/monthly basic pay.

Typically, you should obtain enough coverage to replace 60-70% of your income up to the age of 65 in the event of total disability. Ideally, the policy will cover your specific specialty as a physician, what is called “own occupation,” and will not rely on you finding alternative means of employment, such as working in a different specialty. You will also want coverage if you can only work part-time. Key components of the ideal policy include:

  • Non-cancelable – they can’t cancel your policy or raise your premiums
  • Guaranteed renewable – no medical exam is required to renew
  • Residual benefit protection – pay you part of your benefit, or “residual benefits” if you are partially disabled
  • Cost-of-living allowance – the amount you are paid is adjusted for inflation

If you think the Navy/VA disability payments would be inadequate, look for a private policy, which may be expensive and difficult to find as an active duty physician. After years of searching, I was able to get up to $2500/month of supplemental coverage from the American Medical Association. In addition, a private company called DI4MDs.com was able to get me the level of coverage I needed, although it was pretty expensive (but not as expensive as being under-insured in the event I’m disabled).

Try to reduce the expense by lengthening your “waiting” or “elimination” period. The waiting/elimination period is the amount of time you have to wait after becoming disabled until your disability payments begin. If you have a substantial emergency fund, you can lengthen your waiting/elimination period and lower your premiums. In addition, I figured it would take at least a year for the Navy to separate me if I was significantly disabled. If you don’t have a large emergency fund or you feel the Navy will move fast in the event you are disabled, you may need a shorter waiting/elimination period and will likely pay higher premiums.

Homeowner’s Insurance

You need homeowner’s insurance to protect the structure of your house, its contents, and to insure against injuries to other people or damage to other people’s property. Make sure that the contents of your home are covered for “replacement cost” and not “actual cash value.” For example, replacement cost coverage will give you $800 to replace the 3 year old laptop that was damaged, while actual cash value would only give you the $200 it is worth after 3 years. In addition, you will likely have to purchase a “floater” to cover any high-value items, such as jewelry or expensive art.

Renter’s Insurance

If you rent, you’ll need renter’s insurance to protect your belongings, but it also offers liability protection, similar to homeowner’s insurance.

Auto Insurance

You need auto insurance in case you have a serious accident and damage your car, injure yourself or others, or damage someone else’s property. Lower your rates by having a deductible on the policy that is as high as you can comfortably afford, and carefully evaluate how much collision and comprehensive coverage you need. If you are driving an older vehicle that is not worth a lot of money, paying for this coverage may not make sense.

Umbrella Liability Insurance

Umbrella liability insurance protects you in case you get sued and adds liability coverage on top of your homeowner’s, renter’s, and auto insurance. It will come in handy if your dog bites someone and they develop necrotizing fasciitis, the mailman slips and falls on your front porch and can no longer work, or a neighborhood child drowns in your pool. It is typically sold in $1 million increments and is relatively inexpensive. A $1 million dollar policy will typically run $150-300 per year. As a physician, you should have AT LEAST $1 million of coverage, and should consider up to twice your net worth.

What if you are early in your career and have very few assets? You should still have umbrella liability insurance as future wages can be garnished in some judgments against you.

TYPES OF INSURANCE YOU MIGHT NEED

Professional Liability Insurance

If you are practicing medicine outside of the Navy (moonlighting), you need professional liability insurance. (If you don’t moonlight, you don’t need it.) This insurance will cover attorney fees, expert witnesses, court costs, costs of gathering evidence, and settlements in the event you are sued.

There are two types of policies, “occurrence” and “claims-made.” Claims-made policies only cover your liability if a claim is made before the policy ends. With this type of insurance, when you leave a job you need to purchase “tail coverage” that extends your liability. Tail coverage can be expensive, and before you take a job moonlighting you need to make sure you know who is going to “pay the tail.” Occurrence policies are more expensive (and therefore less commonly offered) because they cover your liability in perpetuity and do not require a tail.

Life Insurance

“More money is wasted on life insurance than probably any other insurance product…It cannot be overemphasized that cash-value life insurance is probably one of the biggest scams around.” – Paul Sutherland in the AMA Physician’s Guide to Financial Planning (2008)

If you were to die, would anyone suffer financially? If the answer is “no,” then you don’t need life insurance. If the answer is “yes,” then you need life insurance, and probably a lot of it until you build your investment portfolio.

There are two types of life insurance. First, there are products that combine insurance with an investment account, often referred to as “cash-value” or “permanent” life insurance. Many insurance agents and companies (including USAA in my experience) will try to sell this, but it is probably not the kind of insurance you need. It does have some tax advantages, but the downside of these policies is that the insurance agent/company who sells them collects high fees. In addition, early premiums go mainly toward sales commissions and other expenses and not into your investment account.

The second type of life insurance is “term” insurance. It provides a death benefit only and does not build any cash value or serve as an investment. This is likely the only kind of life insurance that you need, and this is the type that Servicemembers Group Life Insurance or SGLI is. To quote again from the AMA’s financial planning guide, “I cannot emphasize enough the importance of sticking to simple, unencumbered term life insurance – it fits 99% of insurance needs.” It is less expensive than cash-value/permanent policies and you can take the difference and invest it in a retirement account or other low-cost investment vehicle. You don’t need an insurance agent to purchase this and should simply try term4sale.com, selectquote.com, accuterm.com, insure.com, or other similar websites. Both USAA and Navy Mutual Aid Association (and other companies you can find in Navy Times) offer military-focused term life policies.

When you buy term insurance, ensure that it is renewable without a medical examination. You can also consider decreasing term insurance, where the death benefit progressively decreases. As you age, the need for life insurance typically declines as dependents age and your investment portfolio grows. Eventually you will need no life insurance at all, which is why many arguments for “permanent” life insurance should fall on deaf ears.

Long-Term Care Insurance

Sometimes called “nursing home insurance,” this is usually purchased by people over the age of 50 to pay for nursing or at-home care. If you are under 50, you should probably purchase disability insurance instead of long-term care insurance.

The rates and terms of these policies are highly variable, and whether you want to get one is an individual decision. The earlier you purchase it, the cheaper it is, but the total money you’ll pay out over the life of the policy is obviously higher. If you are a successful investor, as a physician you will probably have enough assets to self-insure in the event you need prolonged care, so I would suggest that most will not need this, but circumstances and goals obviously vary, so it is something to consider. If it is important to you that your nest egg is passed to your heirs, you may want to consider this insurance so it is not passed to a nursing home instead.

Flood Insurance

Homeowner’s and renter’s insurance do not cover flood damage. To find out if your home is at risk of a flood, go to floodsmart.gov. There you can also find out information about the government’s low-cost flood insurance programs.

Earthquake Insurance

If you live in an area at risk for earthquakes, you’ll need earthquake insurance in addition to your homeowner’s insurance. California’s earthquake website, earthquakeauthority.com, is a good place to start.

TYPES OF INSURANCE YOU PROBABLY DON’T NEED

Supplemental Medical/Health Insurance

TRICARE has got you covered here, and there is no need to consider supplemental insurance until you retire.

Life Insurance for Children

While you will be sad if one of your children dies, you do not rely on his/her income; therefore you are unlikely to need life insurance for children. The same thing is likely true for a spouse/partner who does not have a job, unless you would need money to replace the childcare he/she provides.

Rental Car Collision Insurance (Loss Damage Waiver)

They always ask if you want collision insurance or a “loss damage waiver” when you rent a car, but a lot of auto insurance policies automatically cover your rental cars. In addition, some credit cards provide this too if you use their card to pay for the rental car, which is one reason you have to use your government credit card for officially authorized rental cars. Make sure you find out if your policy or credit cards have this before you step up to the rental car counter and are put on the spot.

Flight Accident Insurance

If you need life insurance, buy it. Don’t buy insurance on a whim when purchasing tickets in the off chance that your plane goes down.

Travel Insurance

This is a common credit card benefit when you use them to pay for your trip, so check with your credit card company. Even if you don’t have it, it is unlikely to be worth your money for domestic flights.

Credit Protection Insurance

This is designed to protect your credit by insuring your credit card or mortgage payments in the event you become unemployed, disabled, or dead. If you have life or disability insurance, this is probably unnecessary.

Extended Warranties

Most products that offer extended warranties are not costly enough to insure with an extended warranty. If the new TV happens to break shortly after the warranty expires, you’ll probably be able to afford a new one. Most of these offers are a waste of your money.

GENERAL INSURANCE ADVICE

Insurance companies occasionally go under, so you want to make sure that you only get insurance from quality companies with strong financials and that you diversify your larger policies. You can find information on the finances of insurance companies from AMBest.com, FitchRatings.com, Moodys.com, and StandardAndPoors.com (NOTE: most of the sites require you to register to access their ratings). For example, if you need $2 million in life insurance, you should strongly consider diversifying and getting 2-3 different policies from various companies.