career planning

Throwback Thursday Classic Post – You Made CDR! Now What?

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If you are one of the lucky people who made CDR, I have some things for you to consider:

  • The next 2-3 years of fitreps may mean very little to your overall career.  First, you are soon going to be in the most competitive group in the Medical Corps, Commanders scratching and clawing to make Captain.  If you are at a medium to large command, no matter what you do as a junior Commander, you are likely to get a P (promotable) on your fitreps.  That is just how it works for most commands.
  • This first bullet means that now is the PERFECT time to do something “alternative” (off the usual career path for a physician) or take a position that you know will get you 1/1 fitreps or be part of a very small competitive group.  Go to the War College.  Take a senior operational job where you’ll get a 1/1 fitrep.  Become a Detailer.  Apply for fellowship because the NOB fitreps won’t hurt you as a junior Commander or Commander Select.  Now is the time to do these type of things.  You don’t want to wait until you are a few years below zone for Captain.  When you reach this stage you’ll need competitive EP fitreps.
  • After you are selected for your next rank is also a great time to move/PCS.  Have you ever been OCONUS?  If not, now would be a great time to go.  You can PCS somewhere for 2-3 years and then PCS to the command where you are going to set up shop and try to make Captain.  At OCONUS commands there is more turnover of staff, so major leadership jobs like MEC President, Department Head, and Director positions open up more frequently, setting you up to get a senior position when you return to CONUS.
  • You may think I’m crazy, but it is time to start thinking about how you are going to make Captain.  As I mentioned in the first bullet, getting a job that will make you a Captain is tough and competitive.  Now is the time to do the things that will make you an excellent candidate for one of those jobs.  Want to be a Residency Director?  Maybe you should get a degree in adult or medical education.  Want to be a Director?  Maybe you should get a management degree like a Masters in Medical Management or an MBA.  Want to be a senior operational leader?  Now is the time to do Joint Professional Military Education I and/or II.
  • Here is a list of the jobs that I think will likely make you a Captain.  Read the list…figure out which of these jobs you are going to use to make Captain…and get busy preparing yourself to get them:
    • Residency Director
    • Department Head in a large MTF
    • Director
    • Chief Medical Officer
    • Officer-in-Charge
    • Major committee chair
    • Medical Executive Committee President
    • BUMED staff
    • Specialty Leader
    • Deployment requiring an O-5 or O-6
    • Detailer
    • Senior operational leader
      • Division/Group/Wing Surgeon
      • CATF Surgeon
      • Amphib or CVN Senior Medical Officer

Optimally you’ll have the time when you are an O5 to do multiple jobs on the preceding list.  For example, as an O5 I had been a Detailer, a Specialty Leader, Department Head, Associate Director, and CO of a deployed unit.  My next step was to become a Director at a major MTF, and while I was a senior LCDR and CDR I obtained a Naval Postgraduate School MBA as well as achieved certification as a Certified Physician Executive to try and make myself a competitive candidate for a Director position. Ultimately, I became the Director for Healthcare Business at NMC Portsmouth.

Congratulations on making Commander…take a deep breath…and start thinking about some of the things I mentioned in this post.  Before you know it you’ll be in zone for Captain.

New Medical Corps Promotion Checklists

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There have been a lot of questions about the new Medical Corps Career Path and how to navigate it. Trying to keep things as simple as possible, I translated the path into promotion checklists for LTs, LCDRs, and CDRs. If you are wondering what you need to do to promote to the next rank, check out the appropriate checklist below (which I’ll also add to the Promo Prep page):

Specialty Specific Career Paths

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We’ve released the specialty-specific career paths (SSCP):

Please see the message below from the Medical Corps Career Planner:

Specialty Leaders,

BLUF: Encourage widest dissemination of the SSCP to your community.  Realize this is meant not to supplant but rather be complementary to the larger MC pathway, which can be found here:

Thank you for your hard work on the Specialty Specific Career Pathways.  Some that deal with smaller specialties (that have Assistant Specialty Leaders) I have rolled up into the primary specialty.  These are always works in progress, so please feel to make modifications as you see fit but please discuss with me to ensure it is in the repository, and it aligns with the larger vision of Navy Medicine.

Also, please make note of slide 1 which addresses community concerns especially regarding OP MED expectations, “tracks” and maintenance of clinical currency.  Please know that the Corps Chiefs office recognizes these pitfalls and will continue to work with you and PERS to ensure we are getting the right people to the right places, not just for needs of the Navy but also needs of the SM.

Please let me know if you have questions or concerns.  V/r, ak

Anthony Keller, MD, FACC

CAPT, MC, USN

Navy Medical Corps Career Planner

Bureau of Medicine and Surgery (BUMED)

Office of the Chief, Medical Corps (M00C1), 1NW148C

7700 Arlington Blvd

Falls Church, VA 22042-5135

Office: (703)681-8937

DSN: 761-8937

Throwback Thursday Classic Post – The New Medical Corps Career Progression Slide – What Does It Mean to You?

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(As we resume travel and speak to MC Officers at different commands, it is clear that many have not seen the new career pathway, so I’m reposting this. Please pass it to all you know in the MC. Thanks.)

Navy Medicine has been undergoing a lot of change. We have a new Surgeon General, a new Corps Chief, and a renewed focus on readiness. With these changes come a new career progression and path for the Medical Corps (MC) Officer (PDF version, PPT version). Let’s take a look at the new model and discuss some of the ways it will impact you as your career progresses. We’ll start at the top of the slide and work our way down, translating it into action items for every MC Officer.

 

Intent and Expectations

What should a MC Officer note in this section? To be competitive for promotion, you need to have been operational AND clinical. The days of camping at Military Treatment Facilities (MTFs) are over. Everyone needs to be operationally relevant, and this is consistent with the most recent changes in the O6 promotion board convening order. It can be with the Surface Force, Fleet Marine Force (FMF), Undersea, Air, Special Operations, Joint environment, Expeditionary Combat Command, or any other operational setting you find yourself in. It doesn’t matter how or in what setting, but everyone needs to be operationally relevant.

Action #1 – Deliberately develop your operational relevance.

 

Recommended Medical and Professional Development Path

Very simply, this spells out your educational pathway. Completing residency and becoming board certified is not a new concept or path for the MC Officer. What is new, though, is the expectation that everyone will serve in an operational setting by the time they are up for promotion to O5 and in a more senior operational role before they are up for O6. The concept of everyone becoming an Operational Medical Officer (OMO) is explained in detail at the bottom of the slide.

In addition to serving as an OMO, the expectation is that those who want to serve in more senior roles will complete Joint Professional Military Education Levels I and II (JPME I/II) and obtain formal management or leadership training, such as a Master’s in Business Administration or similar degree.

Action #2 – Start JPME I now if you haven’t already, and develop a strategy and timeline with your mentors to obtain more senior education.

 

High Reliability Organization Training

The new SG is a huge proponent of high reliability, and Navy Medicine is constantly striving to adopt the principles of a High Reliability Organization (HRO). Many of the classes mentioned on the career path slide are undergoing modifications and updates to incorporate high reliability education.

Action #3 – Attend or complete the listed HRO courses.

 

Example Assignments

The example assignments are divided into Fleet and Navy Medicine Readiness and Training Command/Unit (NMRTC/U) positions. They are also stratified according to the typical ranks at which they would occur. These are general guidelines and variability will certainly occur, so be flexible. For example, we know that it takes a minimum of seven years to become a Neurosurgeon, so their path will vary. Other specialties that require longer training are in a similar situation. As a result of this, we are going to ask each Specialty Leader to take this generic career path and modify it for their own specialty.

Another takeaway from this portion of the slide is to alternate between operational assignments and NMRTC/U assignments where you are serving primarily in a clinical role, likely at an MTF. Time at the MTF will allow you to solidify your individual clinical skills and contribute to our Graduate Medical Education mission. After that tour, return to the operational setting in a more senior role. Rinse and repeat this pattern as your career progresses.

Action #4 – Print the career path slide and get a red and black pen. In black circle the jobs, roles, and courses you’ve already done. In red circle ones you’d like to do. When it is time for your next set of orders, jump from realm where you currently are (Fleet or NMRTC/U) to the other and aim for one of the positions to the right that you circled in red.

 

An Example – My Career Path

Just to visualize the way we are encouraging you to use the career path slide, let’s take a look at My Career Path. I circled the things I’ve done in black, and the things I’d like to do in red.

As a 19 year O6, I have a lot of black ink, but there are some red circles to the right indicating the things I’d like to do. As the Deputy Corps Chief, I am currently in a senior headquarters role toward the right end of the Fleet portion. Most likely, my next career move will be to obtain JPME II or enter Executive Medicine as an Executive Officer (XO) because completing an XO and Commanding Officer (CO) tour is mandatory before I can compete for the more senior leadership roles. Use a similar analysis of where you’ve been (black ink) and where you want to go (red ink) to come up with options for your next career move.

 

Summary

The new MC career path should serve as the basic framework around which you structure your career. A quick summary of the actions you should take include:

  • Deliberately develop your operational relevance.
  • Start JPME I now if you haven’t already, and develop a strategy and timeline with your mentors to obtain more senior education.
  • Attend or complete the listed HRO courses.
  • Circle the jobs, roles, and courses you’ve already done in black. Circle ones you’d like to do in red. When it is time for your next set of orders, jump from the realm where you currently are (Fleet or NMRTC/U) to the other and aim for one of the positions to the right that you circled in red.

 

Throwback Thursday Classic Post – The Book – Chapter 3 – Career Progression and Promotion Board Math

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Introduction

When you start your Naval career, the future is largely a mystery. As you progress in your career, things will crystalize, you’ll become wiser, and you’ll think, “It would have been nice to know all of this in the beginning.”

I’m going to try and tell you what you should have known about career progression and promotion board math from the beginning.

Career Progression

This diagram below demonstrates the typical career progression of a Medical Corps officer who has no prior service. Assuming you are not picked early for promotion, you typically promote every six years. You will become a Lieutenant Commander (LCDR) at approximately 6 years, a Commander (CDR) at 12 years, and a Captain (CAPT) at 18 years. I had no prior service, I have never been promoted early, and this is exactly the timing I experienced in my career.

Screen Shot 2020-05-30 at 5.30.06 PM

Along the left are the ranges of promotion opportunity for each rank from fiscal year 2010-2021. In each year, the promotion opportunity for LCDR has been 100%. In theory, if all the Lieutenants are suitable for promotion they can all be promoted to LCDR. When it comes to the promotion opportunities for CDR or CAPT, interpreting them is a touch more difficult because we have to talk about promotion board math.

Promotion Board Math

In Fiscal Year 2019 (FY19), people were very excited about a 90% promotion opportunity for the FY19 Staff Corps O6 promotion board. But it was easy to misinterpret this opportunity. It did not mean that 90% of CDRs were selected for CAPT.

Where Does the Promotion Opportunity Come From?

The short answer is from manpower projections. How many physicians are getting out or retiring? What is the current Medical Corps manning level for that rank? What are future needs anticipated to be? What is the size of the promotion zone? The answers to all of these questions determines the promotion opportunity and guide Navy Personnel Command (NPC) and the Bureau of Medicine and Surgery (BUMED) when they are making their decision.

As you can see here, the promotion opportunity varies from year-to-year:

  FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20 FY21
LCDR 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%  
CDR 80% 80% 80% 80% 80% 70% 70% 65% 75% 85% 77%  
CAPT 80% 80% 80% 60% 60% 60% 50% 70% 80% 90% 81% 91%

Historical promotion opportunities for FY10-21.

But as you can see here, the percentage who are promoted from the in zone group is substantially lower:

  FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20 FY21
LCDR N/A N/A N/A 97% 89% 90% 93% 88% 85% 87% 91%  
CDR N/A N/A N/A 58% 66% 49% 53% 44% 40% 52% 53%  
CAPT N/A N/A N/A 55% 43% 47% 39% 34% 37% 41% 51% 53%

Historical percentage of in-zone candidates selected for promotion for FY10-21.

 

Promotion Board Zones

There are three “zones” for promotion – below zone, in zone, and above zone. Medical Corps officers are below zone for two years, in zone for one year, and above zone until they are either selected for promotion or get out of the Navy. A few people are usually picked early or below zone, but most people will not get picked until they are in or above zone.

FY19 O6 Promotion Board Math

In FY19, there were 74 CDRs in zone for promotion. To figure out how many officers can be selected for promotion, you have to multiple the zone size by the promotion opportunity. For example, if you take the 90% promotion opportunity everyone was excited about and multiply it by the zone size of 74, you’ll see that they could have promoted 67 CDRs to CAPT during the board:

90% opportunity X 74 people in zone = 66.6 (rounded up to 67) people they can pick for O6

These 67, though, were picked from CDRs who were below zone, in zone, or above zone. Usually, there is a small number picked from below zone, and a much larger number from the in zone and above zone categories. Here were the results:

FY19 O6

 As you can see, the 90% promotion opportunity only led to a 41% selection rate for those who were in zone. The remainder came from the below and above zone CDRs.

The Bottom Line on Career Progression

The typical career progression occurs with a promotion every six years, as detailed in the diagram below. The promotion opportunities listed, though, result in a much lower chance of getting picked when you are in zone because the selections come from those below, in, and above zone.

Screen Shot 2020-05-30 at 5.30.06 PM

Tips to Build Your Career During Residency

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Here are the slides I used for this episode of the podcast:

Tips on Building Your Career During Residency

The New Medical Corps Career Progression Slide – What Does It Mean to You?

Posted on Updated on

Navy Medicine has been undergoing a lot of change. We have a new Surgeon General, a new Corps Chief, and a renewed focus on readiness. With these changes come a new career progression and path for the Medical Corps (MC) Officer (PDF version, PPT version). Let’s take a look at the new model and discuss some of the ways it will impact you as your career progresses. We’ll start at the top of the slide and work our way down, translating it into action items for every MC Officer.

 

Intent and Expectations

What should a MC Officer note in this section? To be competitive for promotion, you need to have been operational AND clinical. The days of camping at Military Treatment Facilities (MTFs) are over. Everyone needs to be operationally relevant, and this is consistent with the most recent changes in the O6 promotion board convening order. It can be with the Surface Force, Fleet Marine Force (FMF), Undersea, Air, Special Operations, Joint environment, Expeditionary Combat Command, or any other operational setting you find yourself in. It doesn’t matter how or in what setting, but everyone needs to be operationally relevant.

Action #1 – Deliberately develop your operational relevance.

 

Recommended Medical and Professional Development Path

Very simply, this spells out your educational pathway. Completing residency and becoming board certified is not a new concept or path for the MC Officer. What is new, though, is the expectation that everyone will serve in an operational setting by the time they are up for promotion to O5 and in a more senior operational role before they are up for O6. The concept of everyone becoming an Operational Medical Officer (OMO) is explained in detail at the bottom of the slide.

In addition to serving as an OMO, the expectation is that those who want to serve in more senior roles will complete Joint Professional Military Education Levels I and II (JPME I/II) and obtain formal management or leadership training, such as a Master’s in Business Administration or similar degree.

Action #2 – Start JPME I now if you haven’t already, and develop a strategy and timeline with your mentors to obtain more senior education.

 

High Reliability Organization Training

The new SG is a huge proponent of high reliability, and Navy Medicine is constantly striving to adopt the principles of a High Reliability Organization (HRO). Many of the classes mentioned on the career path slide are undergoing modifications and updates to incorporate high reliability education.

Action #3 – Attend or complete the listed HRO courses.

 

Example Assignments

The example assignments are divided into Fleet and Navy Medicine Readiness and Training Command/Unit (NMRTC/U) positions. They are also stratified according to the typical ranks at which they would occur. These are general guidelines and variability will certainly occur, so be flexible. For example, we know that it takes a minimum of seven years to become a Neurosurgeon, so their path will vary. Other specialties that require longer training are in a similar situation. As a result of this, we are going to ask each Specialty Leader to take this generic career path and modify it for their own specialty.

Another takeaway from this portion of the slide is to alternate between operational assignments and NMRTC/U assignments where you are serving primarily in a clinical role, likely at an MTF. Time at the MTF will allow you to solidify your individual clinical skills and contribute to our Graduate Medical Education mission. After that tour, return to the operational setting in a more senior role. Rinse and repeat this pattern as your career progresses.

Action #4 – Print the career path slide and get a red and black pen. In black circle the jobs, roles, and courses you’ve already done. In red circle ones you’d like to do. When it is time for your next set of orders, jump from realm where you currently are (Fleet or NMRTC/U) to the other and aim for one of the positions to the right that you circled in red.

 

An Example – My Career Path

Just to visualize the way we are encouraging you to use the career path slide, let’s take a look at My Career Path. I circled the things I’ve done in black, and the things I’d like to do in red.

As a 19 year O6, I have a lot of black ink, but there are some red circles to the right indicating the things I’d like to do. As the Deputy Corps Chief, I am currently in a senior headquarters role toward the right end of the Fleet portion. Most likely, my next career move will be to obtain JPME II or enter Executive Medicine as an Executive Officer (XO) because completing an XO and Commanding Officer (CO) tour is mandatory before I can compete for the more senior leadership roles. Use a similar analysis of where you’ve been (black ink) and where you want to go (red ink) to come up with options for your next career move.

 

Summary

The new MC career path should serve as the basic framework around which you structure your career. A quick summary of the actions you should take include:

  • Deliberately develop your operational relevance.
  • Start JPME I now if you haven’t already, and develop a strategy and timeline with your mentors to obtain more senior education.
  • Attend or complete the listed HRO courses.
  • Circle the jobs, roles, and courses you’ve already done in black. Circle ones you’d like to do in red. When it is time for your next set of orders, jump from the realm where you currently are (Fleet or NMRTC/U) to the other and aim for one of the positions to the right that you circled in red.

Playing the Game and Managing Your Military Career

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What better to do during a global pandemic than listen to a screencast about managing your career! Here are the PPT slides I used for it:

Playing the Game – Managing Your Military Career

March 2020 Medical Corps Newsletter

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Seriously…the March 2020 Medical Corps Newsletter is packed:

  • Message from the Corps Chief
  • Transition from Active Component to Reserve Component
  • Junior Officer Spotlight – LCDR Bridget Cunningham
  • I’m Just a Bill(et)
  • Fresh Whole Blood Transfusion in the 2D Marine Division
  • A Look Back at Navy Physician Astronauts
  • The New Medical Corps Career Progression Slide (PDF version, PPT version) – What Does It Mean to You?
  • Meet the New Career Planner – CAPT Anthony Keller
  • Understanding New Language in the O6 Promotion Board Convening Order
  • Senior Leader’s Interview – CAPT Kim Davis, 4th Fleet Surgeon

Throwback Thursday Classic Post – You Made CDR! Now What?

Posted on Updated on

If you are one of the lucky people who made CDR, I have some things for you to consider:

  • The next 2-3 years of fitreps may mean very little to your overall career.  First, you are soon going to be in the most competitive group in the Medical Corps, Commanders scratching and clawing to make Captain.  If you are at a medium to large command, no matter what you do as a junior Commander, you are likely to get a P (promotable) on your fitreps.  That is just how it works for most commands.
  • This first bullet means that now is the PERFECT time to do something “alternative” (off the usual career path for a physician) or take a position that you know will get you 1/1 fitreps or be part of a very small competitive group.  Go to the War College.  Take a senior operational job where you’ll get a 1/1 fitrep.  Become a Detailer.  Apply for fellowship because the NOB fitreps won’t hurt you as a junior Commander or Commander Select.  Now is the time to do these type of things.  You don’t want to wait until you are a few years below zone for Captain.  When you reach this stage you’ll need competitive EP fitreps.
  • After you are selected for your next rank is also a great time to move/PCS.  Have you ever been OCONUS?  If not, now would be a great time to go.  You can PCS somewhere for 2-3 years and then PCS to the command where you are going to set up shop and try to make Captain.  At OCONUS commands there is more turnover of staff, so major leadership jobs like MEC President, Department Head, and director positions open up more frequently, setting you up to get a senior position when you return to CONUS.
  • You may think I’m crazy, but it is time to start thinking about how you are going to make Captain.  As I mentioned in the first bullet, getting a job that will make you a Captain is tough and competitive.  Now is the time to do the things that will make you an excellent candidate for one of those jobs.  Want to be a residency director?  Maybe you should get a degree in adult or medical education.  Want to be a director?  Maybe you should get a management degree like a Masters in Medical Management or an MBA.  Want to be a senior operational leader?  Now is the time to do Joint Professional Military Education I and/or II.
  • Here is a list of the jobs that I think will make you a Captain.  Read the list…figure out which of these jobs you are going to use to make Captain…and get busy preparing yourself to get them:
    • Residency Director
    • Department Head in a large MTF
    • Director
    • Chief Medical Officer
    • Officer-in-Charge
    • Major committee chair
    • Medical Executive Committee President
    • BUMED staff
    • Specialty Leader
    • Deployment requiring an O-5
    • Detailer
    • Senior operational leader
      • Division/Group/Wing Surgeon
      • CATF Surgeon
      • Amphib or CVN Senior Medical Officer

Optimally you’ll have the time when you are an O5 to do multiple jobs on the preceding list.  For example, as an O5 I had been a Detailer, a Specialty Leader, Department Head, Associate Director, and CO of a deployed unit.  My next step was to become a director at a major MTF, and while I was a senior LCDR and CDR I obtained a Naval Postgraduate School MBA as well as achieved certification as a Certified Physician Executive to try and make myself a competitive candidate for a director position. Ultimately, I became the Director for Healthcare Business at NMC Portsmouth.

Congratulations on making Commander…take a deep breath…and start thinking about some of the things I mentioned in this post.  Before you know it you’ll be in zone for Captain.