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Throwback Thursday Classic Post – Types of Deployments

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This post will help you learn all that you can about deployments. I’ve done three deployments, one as a General Medical Officer (GMO) during the initial invasion of Iraq, and two after residency. In 2010, I deployed with the 15th Marine Expeditionary Unit (MEU) and in 2016 I deployed to Guantanamo Bay (GTMO). In addition, as both a Detailer and Emergency Medicine Specialty Leader I’ve deployed a number of physicians, so I’m pretty familiar with all the details of the current deployment situation.

In the current operational environment, there are a few types of deployments. They include platform-based deployments, individual augmentee (IA) deployments, global support assignment (GSA) deployments, and what I’ll call parent unit deployments.

Let’s deal with the last one first because it is the easiest to explain. For what I’ll call a parent unit deployment, you deploy when your parent unit deploys. For example, if you are assigned to the Marine Corps with a MEU, when that MEU deploys so do you. You go with the unit you are primarily assigned to. The same could be said for a medical battalion, a Preventive Medicine Unit, and many other units.

A platform-based deployment happens to people who are stationed at Navy Medicine Readiness and Training Commands/Units (NMRTC/NMRTUs). Some people who are primarily stationed at NMRTCs are assigned to what is called a “platform.” A platform is an operational unit of some kind. It could be the MERCY or COMFORT, a Marine Corps unit, an Expeditionary Medical Facility, etc. In essence, it is an operational unit who “owns” you if they get activated or deployed. In other words, if your platform is a medical battalion and that medical battalion gets deployed, you would go with them because it is your platform. If your platform regularly drills or does exercises, since it is your platform you may have to participate in these drills and get pulled away from your primary duties at your NMRTC.

How is it decided whether you get placed on a platform, and if so which one? The main determinant is most likely which billet you get orders into. Some billets at NMRTCs have secondary assignments to platforms. For example, the billet I was in at NMRTC Portsmouth was “mobilized to” or “MOB’ed to” an Expeditionary Medical Facility. That was my platform. To be honest, sometimes commands will rearrange platforms, so it is not always determined by the billet you are in. If you want to know if you are on a platform, you will have to go to your command’s Plans, Operations, Medical Intelligence or POMI officer. They are the ones who manage platforms and can tell you if you are on one.

Platform based deployments are the wave of the future in Navy Medicine, and you can expect an increased focus on platforms, platforms training, and deployments as a platform.

An individual augmentee or IA deployment is when a request in placed by an operational unit somewhere for an individual person, you are selected to fill that requirement, and you individually augment that unit. When they deploy, you deploy with them as an IA but stay attached administratively to your parent command. In other words, if you are at NMRTC Portsmouth but deploy as an IA, you stay attached to NMRTC Portsmouth the entire time you are deployed. This is the type of deployment most of us have experienced for the majority of our career, but the Navy is trying to get out of the “IA business” and is shifting, as already mentioned, to platforms.

The final type of deployment is a global support assignment (GSA). With this type, you detach from your current command, move or execute a permanent change of station (PCS) to a processing center that becomes your new military command, and then you are given orders to deploy. For example, my last deployment was a GSA. I detached from Navy Personnel Command, my old command, PCS’ed to my new command, the processing center in Norfolk, and then was given deployment orders to go to my unit in GTMO. During this time my parent command was Expeditionary Combat Readiness Center or ECRC, the processing center, and they were primarily responsible for my fitreps and pay issues.

The unique part of a GSA deployment is that pretty much as soon as you report to the processing center you have to contact your Detailer and Specialty Leader to get orders to your next command. The GSA orders usually only last up to a year, and you’ll need orders so you can PCS to your next command when you get back from the deployment. This is the major downside that people complain about with a GSA…the fact that you get PCS orders and have to leave your old command, which people may not want to do. On the other hand, it can be a major benefit. If you are stationed somewhere you don’t want to be, volunteering for a GSA can get you out of there because you’ll PCS away. In addition, because you are volunteering or accepting a deployment, it may give you some leverage with the Detailer or Specialty Leader. For example, you could say, “I’ll deploy on this GSA, but only if you are willing to write me orders to Hawaii as follow-on orders.” That may not always work, but it is worth a try.

Those are the major types of deployments that currently exist, and here are some additional resources:

Active Duty Augmentation FAQs

Navy Individual Augmentee Website

Navy Medicine’s Augmentation Program

Throwback Thursday Classic Post – How to Find Out Your Reporting Senior’s Fitrep Trait Average

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One of the most important markers of a good fitrep is that your trait average is above your reporting senior’s trait average.  Since most officers initially write their own fitrep and create their own trait average on the first draft, it is important to find out your reporting senior’s trait average so that you can try to be above it.  Here are a few ways to find out what it is.

First, in order to have a trait average, your reporting senior has to have served as the reporting senior for officers of your same rank from any corps.  If they have not done this, they’ll have no pre-existing average.  For example, if you are a LCDR, your reporting senior does not have to have ranked LCDR physicians.  If he/she has ever ranked a LCDR of any kind (nurse, line officer, etc.), then they will have an average.

If they have an average, here are the ways I know of to find it:

  • If you’ve already received a fitrep from them in your current grade, then you can look at your Performance Summary Report or PSR, which you download from BUPERS On-Line.  The number in the lower right in the “AVERAGES” column (circled below) is their average for that rank.

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  • If you haven’t received a fitrep from them, maybe you have a friend in the same rank who has received a recent fitrep from them.  You can look at their PSR if they’ll let you.
  • You can ask your chain of command or command fitrep coordinator.  They often know because they are trying to make sure that all of the fitreps being done don’t change the reporting senior’s average in ways he/she doesn’t want.
  • You can ask the reporting senior.  They just may tell you.

The bottom line is that if you are drafting your fitrep, you want to try and find out the average and grade yourself above it.  In the end, the ranking process may move you below it, but by submitting the draft with an above average grade you may increase the chances you stay above it.

Throwback Thursday Classic Post – You Didn’t Make CDR. Now What?

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I receive questions all the time about what happens when you are passed over for promotion and are now “above-zone”. If you find yourself in this position, here is what you need to do:

  • Realize that it is not the end of the world. Based on the FY20 CDR promotion board statistics, 47% of in zone officers were passed over, but a large number of the officers selected were from the above zone group.
  • If you do nothing, you will continue to get looked at by 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…
  • You need to try to promote. At a minimum, you should consider sending a letter to the promotion board. What do you say in this letter? First, briefly state that you want to be promoted and to continue your career in the Navy. Second, 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 be a Department Head at a large military treatment facility (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.
  • 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.
  • Have your record reviewed by your Detailer, Specialty Leader, other trusted senior advisor, or by me. Because of promotion board confidentiality, you will never know the reason(s) you did not promote, but most of the time experienced reviewers 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.
  • 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 a promotion. As a LCDR who got passed over for CDR, try to get one of these jobs and excel at it (this list is not exhaustive and these positions are not the only path to CDR, but they are a good start):
    • Medical Executive Committee (MEC) member
    • SMO on an amphibious platform
    • Regimental Surgeon
    • Member of a hospital committee or chair of a smaller committee
    • Department Head in a small MTF
    • Medical Director/Senior Medical Officer in a medium/large MTF
    • Detailer
  • 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 continuing 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:

  • 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.
  • 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.
  • 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.
  • 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. You can usually stay in as a LCDR for 20 years, and I personally know of people who got promoted their 4th look and have heard of people who succeeded on their 9th try!

Throwback Thursday Classic Post – How to Read Your Performance Summary Report (PSR)

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One of the most important documents viewed during promotion boards is your Performance Summary Report or PSR.  It is the document that summarizes all of your FITREPs for the board, and it can be difficult to interpret.  I created a screencast that will show you how to read your PSR.  Here are the PPT slides and the screencast:

How to Read Your PSR

Throwback Thursday Classic Post – FY20 CAPT Board Statistics and Basic Promotion Board Math

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The FY20 Staff Corps O6 promotion board basic statistics are here. Let’s go over the basic stats for Medical Corps so that everyone understands them as they can be very confusing.

According to page 2 of the convening order, the promotion opportunity was 81%. The number of people in zone was 96.  In order to find the total number of officers they could select for promotion, you take the promotion opportunity x the size of the zone:

(81% promotion opportunity) x (96 officer zone size) = 78 officers could be selected for promotion

As you see in the stats, they selected exactly 78:

  • Above Zone – selected 24 of 134 or 18%
  • In Zone – selected 49 of 96 or 51%
  • Below Zone – selected 5 of 162 or 3%

As you can see, even though the promotion opportunity was 81%, the chance you got selected in zone was only 51% because selects came from above and below zone.

Throwback Thursday Classic Post: Specialty Leader vs Detailer – What’s the Difference?

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Many Medical Corps officers don’t understand the difference between their Specialty Leader and their Detailer. After you read this post, this won’t be a problem.

DIFFERENCE #1 – WHO THEY WORK FOR

A Specialty Leader works for Navy Medicine (BUMED), the Surgeon General, and the Medical Corps Chief while a Detailer works for Navy Personnel Command (NPC or PERS). NPC/PERS is a line command, while BUMED is obviously medical. This difference is probably not of significance to the average Naval physician, but it can make a difference at times because these two commands (and people) will look at things from a different perspective.

For example, let’s say you are one of two subspecialists at NMC Camp Lejeune and you have a fairly light clinical load. You decide you want to leave early to get to your next command, Naval Medical Center Portsmouth (NMCP), because they are actually down one provider in your specialty due to the illness of another member of your community. Your Specialty Leader will probably endorse this early move because it makes sense. You are underemployed at Lejeune and there is a need at NMCP.

Your Detailer, however, will look at it differently. First, you haven’t served your full tour, so moving you early will require a waiver that may be denied by PERS. This largely has to do with money and PCS rules and has nothing to do with your specialty or the needs of the Navy. I’m not saying that Detailers don’t care about the needs of the Navy because they do, but they are constrained by the rules of PERS while a Specialty Leader is not.

DIFFERENCE #2 – WHAT THEY DO

A Specialty Leader serves as a liaison between you, BUMED, and your specialty as a whole. He or she also coordinates deployments, although the control they have over this was lessened by the return to platform-based deployments (deployments determined by what billet you are in or what unit/platform you are assigned to rather than whose turn it is to deploy). They also serve as a consultant both to you and your Detailer when it comes to career management and PCS moves.

A Detailer is your advocate to help you advance in your career, prepare for promotion boards by improving your officer service record, and negotiate orders for your next PCS. They will often speak with both you and your Specialty Leader while trying to balance your needs with the needs of the Navy. They also are the final approval authority for extension requests and actually write your PCS orders.

DIFFERENCE #3 – WHAT THEY DON’T DO

Specialty Leaders do not write orders. Many physicians think that the Specialty Leader is the one who decides what orders they get and where they PCS, but the reality is that Specialty Leaders can’t write orders. Only Detailers can, therefore it is the Detailer who makes the final decision in nearly all cases. If there is a good Specialty Leader-Detailer relationship, most of the time both are in agreement and there is no controversy, but about 5% of the time there is at least some level of disagreement that has to be worked out.

Detailers can write your orders to a command, but they do not influence who gets command-level leadership positions. For example, you may want to go to Jacksonville to be the Department Head of your specialty’s department. A Detailer can write you orders to Jacksonville, but which physician the command picks to be Department Head is up to them, not the Detailer (or the Specialty Leader).

Specialty Leaders will often talk to commands, but Detailers usually do not. The Detailer is SUPPOSED to talk to three people – you, the Specialty Leaders, and the Placement Officers. The Placement Officers are officers at PERS who represent the commands. You can think of them as the detailers for commands. They make sure that commands aren’t taking gapped billets, that the providers sent to the command meet the requirements of the billet they are entering, and weigh in on other issues like extension requests.

I say that a Detailer is SUPPOSED to talk to three people and USUALLY does not talk to commands, but the reality is that commands frequently call the Detailer instead of talking to their Placement Officers. This often happens because the Director at a command knows the Detailer but doesn’t know the Placement Officer. In addition, the Detailer is usually a physician (3 of 4 Medical Corps Detailers are physicians, the 4th is a MSC officer) and the Placement Officer is always a MSC officer. Physicians like talking to other physicians.

Finally, Specialty Leaders do not alter your officer service record. In fact, unless you send it to them, they can’t even see it or your FITREPs. Detailers, on the other hand, can see just about everything and can update/change some things, mostly additional qualification designators or AQDs.

WHY SHOULD I CARE ABOUT ANY OF THIS?

Because you must actively manage your career to get what you want. This means you should talk with both your Specialty Leader and Detailer 9-18 months ahead of your projected rotation date (PRD). You should discuss your short and long-term goals, whether you want to PCS or extend, whether you are planning a Naval career or want to resign or retire, your family situation, and your medical situation if applicable.

Most importantly, though, is to be honest with both your Detailer and Specialty Leader. Most Specialty Leaders get along well with the Detailer, so if there is any disagreement between the three of you make sure that you keep things professional and respectful at all times. It’s a small Navy and, to be honest, it will be readily apparent if you are playing one off against the other.

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

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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.

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. That link will take you to your detailer’s contact info, but note that it is CAC protected:

https://www.public.navy.mil/bupers-npc/officer/Detailing/rlstaffcorps/medical/Pages/default.aspx

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 pass 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.