Career Intermission Program
What to Do if You Didn’t Get Selected for GME
With the recent release of the 2022 graduate medical education (GME) results, I’d like to give tips for those who didn’t get selected. I’ve participated in eight of the last nine GME selection boards as a Detailer, Specialty Leader, and Deputy Chief of the Medical Corps, so I’ve seen it from all angles. Here we go…
Be Realistic
If you are personally interested in this post, I’m sorry but you need to be realistic about your chances of matching. You probably failed to match at least once. 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 for that specialty should be able to give you some idea of your future chances of matching. Will they be honest and direct with you? I’m not sure, but it can’t hurt to ask them for an honest assessment of your chances of matching.
Be Open to Other Options
If you are having trouble matching in the Navy for GME, you may have a better chance as a civilian or with a civilian deferment. By the time you pay back your commitment to the Navy or do an operational tour, 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. In addition, the bar is often lower at the GME selection board for those who are willing to consider a non-funded civilian deferment for training called RAD-to-NADDS.
Most applicants who want to train in a civilian institution want a full-time outservice (FTOS) training authorization. When you are FTOS, you are on active duty, you are paid your active duty salary (which is usually more than you’d make as a civilian resident or fellow), and your time counts toward your active duty retirement. The downside is that FTOS authorizations cost the Navy money and are therefore limited. This means they are more competitive to get.
The other type of civilian deferment is called “Release from Active Duty to Navy Active Duty Delay for Specialists” or RAD-to-NADDS. This is the one that is less popular and desirable than FTOS, but that means it can be easier to get in certain specialties. When you are in RAD-to-NADDS, you are not on active duty, you are making a civilian salary, and your time does not count towards your military retirement. Because you are not on active duty, this type of deferment is basically free for the Navy, so in certain specialties they can give out as many training slots as there are qualified applicants.
There are restrictions on RAD-to-NADDS. Most importantly, the Navy is not supposed to use it to train specialties in which it has unused training capacity in the Military Health System (MHS). For that reason, RAD-to-NADDS is only used for specialties where the training doesn’t exist in the MHS or it is full and there is no additional training capacity. For example, the Navy doesn’t use all of the training slots in Internal Medicine, so you probably couldn’t do RAD-to-NADDS in Internal Medicine. Because all the General Surgery residency slots are full in MHS training programs, you could do RAD-to-NADDS in General Surgery.
Past GME boards have been willing to give anyone who was willing to take a RAD-to-NADDS training goal in the undermanned specialties with no additional MHS training spots available (Emergency Medicine, Anesthesia, General Surgery, etc.).
If you are willing to consider RAD-to-NADDS, closely examine the GME note and by-site goals. You’ll see that some specialties are offering RAD-to-NADDS opportunities. If you are interested in one of these specialties, you’ll need to apply for civilian programs ahead of time, likely before the military GME results are released.
Make sure that the specialty leader is aware you will take a civilian deferment if one is offered to you, and make sure you apply to the civilian match. You don’t want to be given a RAD-to-NADDS spot and then tell the specialty leader you didn’t apply for civilian training spots.
Make Sure They Know Who You Are
Do everything you can to make sure the leaders in the specialty know who you are at your GME program of choice. This can usually be accomplished by rotating there as a student/intern, volunteering if you are a General Medical Officer (GMO), Flight Surgeon (FS), or Undersea Medical Officer (UMO), or attending journal clubs or academic conferences when you can make it. Over the years, we have had GMO/FS/UMOs that have volunteered to work in our Emergency Department during conferences or journal clubs. They often matched the following year. Many applicants do not go this extra mile, and those that do have a leg up in matching.
Avoid Red Flags
Some applicant red flags are obvious like failed board exams and repeated medical school rotations, but there isn’t much you can do about those anymore. One other under appreciated red flag is when someone has an operational tour where they are eligible for a warfare device and they don’t get it. Always get the warfare device if one is available during your operational tour.
The Career Intermission Program
I know of multiple physicians who used the Career Intermission Program (CIP) to temporarily leave the Navy, obtain the fellowship they wanted but couldn’t get in the Navy, and then came back on active duty. All the details are on this website. There is no guarantee that your request to use the CIP for GME will be approved, but you never know unless you ask.
Eventually, You Need to Get Board Certified in Something
If you want to match in the Dermatology residency in San Diego, I get it, but if you’ve tried a few times and haven’t matched, you may need to change your approach. Is there really only one specialty that will make you happy?
Eventually, you need to get board certified in something. If you can be happy doing a less competitive specialty, you should consider adjusting course and applying for them. What are the less competitive specialties? It depends on the year, but Family Medicine, Internal Medicine, Occupational Medicine, Pathology, Preventive Medicine, Psychiatry, and the Residency in Aerospace Medicine (RAM) come to mind. This list will also change over time. My own specialty, Emergency Medicine, was extremely competitive, but that has changed over the last two years for a variety of reasons.
Updates to Career Intermission Program
The Navy won’t give you the fellowship you want? This is one way to do it and now it is only 1 month of commitment instead of 2 for every month of intermission…
INFO CNO WASHINGTON DC BT UNCLAS NAVADMIN 089/22 PASS TO OFFICE CODES: FM CNO WASHINGTON DC//N1// INFO CNO WASHINGTON DC//N1// MSGID/GENADMIN/CNO WASHINGTON DC/N1/APR// SUBJ/UPDATE TO CAREER INTERMISSION PROGRAM// REF/A/DOC/SEC 521 PUBLIC LAW 117-81/27DEC21// REF/B/DOC/OPNAV/12MAR18// NARR/REF A IS SECTION 521 OF S. 1605, NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2022. REF B IS OPNAVINST 1330.2C, NAVY CAREER INTERMISSION PROGRAM GUIDELINES.// RMKS/1. This NAVADMIN announces a legislative revision to the Navy Career Intermission Program (CIP). Reference (a) reduces the CIP service commitment, specifically, that CIP participants will payback one month, instead of two, for every month of program participation. This applies to all applications made after 27 December 2021. 2. The program changes announced by this NAVADMIN will be incorporated into the next revision to reference (b). More information can be found at https://www.mynavyhr.navy.mil/Career- Management/Reserve-Personnel-Mgmt/IRR/Career-Intermission/.aspx. 3. This NAVADMIN will remain in effect until superseded or canceled, whichever occurs first. 4. Point of contact is the CIP manager at CIP(at)navy.mil. 5. Released by Vice Admiral John B. Nowell, Jr, N1.// BT #0001 NNNN UNCLASSIFIED//
Updated Guidance on Career Intermission Program
Within the last few months there has been some updated guidance on the Navy’s Career Intermission Program (CIP) released in a new OPNAV instruction. In addition, the Medical Service Corps Chief put together this summary document for senior officers entitled “Talking Points #42 – Career Intermission Program” that is certainly relevant to the Medical Corps as well.
Just in case you are allergic to clicking on links and reading PDFs, here is the test from her summary document:
Director’s Guidance – The Career Intermission Program’s guidelines have recently been revised and updated with the release of OPNAVINST 1330.2C dated 12 March 2018. Senior MSC Officers should know of its existence as a talent management initiative and be able to discuss the potential benefits, risk and career impact with anyone who expresses a desire to participate.
Background – The Navy continues to explore talent management initiatives to ensure we are accessing and retaining the highest quality officers to ensure readiness. The CIP was piloted back in 2009 with the goal of reducing the number of quality service-members separating from Naval service for short- term personal reasons or to pursue professional or educational goals. The updated instruction delineates changes to the program, expands opportunities through the removal of the initial minimum service requirement and adds policy regarding ineligibility.
Key Messages:
- Participants are transferred from Active Duty to the In-active Ready Reserve (IRR) for a minimum of 12 months and a maximum of 36 months. This is a one-time per career opportunity.
- Participants and their families are still entitled to health care, commissary and exchange benefit.
- They will receive 2/30ths of their current base pay while in the IRR.
- Members must apply for CIP 12 months in advance of their PRD or “soft” end of active obligated service, whichever comes first.
- Participants are not eligible to receive any special or incentive pays or bonuses. Nor are they eligible for SGLI coverage, contributions to TSP or TA benefits.
- They will receive not observed fitreps during IRR.
- Participants are authorized PCS travel and transportation to their designated residence and to their subsequent duty station.
- Members must serve at least 12 months in IRR, but may return early.
- Some examples of non-eligible personnel: FOS’d officers, personnel in training pipeline, PFA failures within last 36 months or who don’t meet current standards, any record of legal issues within 36 months, currently deployed, limited duty status, or in receipt of PCS orders.
- Upon return to Active Duty, a service member’s date of rank (officers) or TIR (enlisted) will be adjusted 1 day forward for every day spent in the IRR (e.g, 365 days in the IRR will adjust a DOR of 1 January 2019).
- Requests will be processed as delineated in OPNAVINST 1330.2C
Talking Points:
- The Navy in general, and our Corps specifically, seeks to retain quality officers. The CIP is a talent management initiative to allow Sailors to take an intermission for personal or professional reasons.
- The Navy is tracking participation numbers in the CIP, retention numbers, and the impact of participation in the CIP as it relates to promotion statistics or leadership opportunities.
- It is a viable option for Sailors, officers and enlisted, to attain or achieve personal or professional goals without sacrificing their Naval careers.
Navy Asks Congress for More Authority to Sidestep ‘Up-or-Out’ Personnel System
This article is an interesting read about continued efforts to revise the Navy personnel system:
Navy Asks Congress for More Authority to Sidestep ‘Up-or-Out’ Personnel System
Summary of Specialty Leader Business Meeting
Here is a brief summary of last week’s Specialty Leader Business Meeting that is always held in conjunction with the Graduate Medical Education Selection Board:
- Current interim Chief Medical Officers (CMOs) need to formally apply to the next screening board in summer 2017. I would STRONGLY encourage other people to apply as well because it is a screened/appointed leadership position that allows you to remain clinically active and that I also think will lead to promotion to O6 if done successfully.
- Announcements for nominative positions often come out with very little time until the nominations are due. They all require your CV, BIO, Letter of Intent (LOI), Officer Summary Record (OSR), and Performance Summary Record (PSR). It is best if you have these ready to go due to the often short timeline. I will tell you that I update my CV and military biography monthly and have multiple LOI templates at the ready at all times, so I practice what I preach. Your OSR/PSR can downloaded from BUPERS On-Line anytime, so that requires no prep (assuming BOL is working).
- Current overall Medical Corps manning is 103.4%. This is of no real use to you but is simply an interesting fact/statistic. It does, perhaps, limit our promotion opportunity a lit bit, but…
- The Medical Corps promotion opportunities for FY18 are expected to be higher than they have been in recent years. You never know the actual percentage until the board has concluded, but this is certainly good news.
- As of now, there is no change in the conference approval process. Sorry.
- The Career Intermission Program (CIP) has been extended until 2019. This program allows you to take up to 3 years off from the Navy to do something else, hit the pause button on progression toward promotion, and then return afterward. You have a 2:1 additional commitment for any time off. In other words, if you take 2 years off you’ll owe 4 years when you return. Some people have tried to use the CIP to do fellowships on their own, but that is not the intent of the program and requests for CIP to do a fellowship will be closely scrutinized by BUMED before approval. Info on the program can be found here or you can contact your Detailer.
- There is no special pays update. They are still awaiting the NAVADMIN. The latest can always be found here:
http://www.med.navy.mil/bumed/Special_Pay/Pages/default.aspx
Updated Career Intermission Program NAVADMIN
Here are a PDF and link to the updated NAVADMIN that governs the Career Intermission Program (CIP):
The CIP allows you to take 1-3 years off from your Naval career, maintain a small basic pay and TRICARE benefits, and then return. If you are interested, you can also check out OPNAV 1330.2B – Navy Career Intermission Program Guidelines.
Joel Schofer's Career Planning Blog 