Army Early PCS?

[Baron Samedi]

Long story short: very dissatisfied with first duty station and would like to depart as quickly as possible. The standard PCS cycle is 3 years, but I've heard of people leaving after 2 if requested.

Does anyone have experience doing so? My fear is that I know things can always get worse, such as ending up in an operational or administrative position rather than my subspecialty. My understanding is that in order to initiate this request, I let my HRC officer know my desire to leave and that puts me back in the cycle and opens up my current position on AIM2. My concern is that I won't have visibility of AIM2 prior to initiating this and won't really know what's even available, other than very early information from my consultant that's subject to change based on personnel needs(due to retirement, others' PCS, etc.).

Any advice would be greatly appreciated.

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[HighPriest]

Talk to your consultant. They will know what is available.
I PCSed in 2, but there were extenuating circumstances (as in, they decided not to host my specialty at the MEDDAC anymore.)
I don’t think I ever spoke to anyone at HRC. They just folded me back in to the rotation, except that I had 2 years seniority over the graduating residents, and a colleague pulling for me at the place I ended up.

 

[HighPriest]

Keep in mind that they have absolutely no obligation or necessarily any incentive to move you. I’m sure some of it involves how easily it is to move around within your specialty.
Lots of people try this all of the time. And most of them have a sob story as to why they absolutely “have” to move. Sometimes they have a real issue like a special needs kid. I know a few guys who submitted paperwork for that kind of thing on very, very shaky grounds just to try to hedge their bets.
If you find someone else at a duty station you would like who is willing to trade with you, that can often times help as well. It just greases the wheels a bit.

 

[HighPriest]

I’ve known guys who asked to move because they wanted a pediatric physical therapist for their 17 year old kid’s sports-related injury. And then I once saw an E-3 with a 3 year old with a tracheostomy sent to a post where the nearest children’s hospital was at least a 3 hour drive. It’s not necessarily a fair system.

 

[Baron Samedi]

Unfortunately, I dont have a compelling sob story; just professional development reasons that I want to leave with haste. They also cut my slot at this station as soon as I arrived, so there will be no backfill when I depart -- making the swap option not possible.

 

[Perrotfish]

Long story short: very dissatisfied with first duty station and would like to depart as quickly as possible. The standard PCS cycle is 3 years, but I've heard of people leaving after 2 if requested.

Does anyone have experience doing so? My fear is that I know things can always get worse, such as ending up in an operational or administrative position rather than my subspecialty. My understanding is that in order to initiate this request, I let my HRC officer know my desire to leave and that puts me back in the cycle and opens up my current position on AIM2. My concern is that I won't have visibility of AIM2 prior to initiating this and won't really know what's even available, other than very early information from my consultant that's subject to change based on personnel needs(due to retirement, others' PCS, etc.).

Any advice would be greatly appreciated.

1) How much time do you owe to the military?

2) Can you moonlight in your specialty near your duty station?

3) Are you considering staying in the military or are you trying to get out as fast as possible?

 

[Baron Samedi]

1) How much time do you owe to the military?

2) Can you moonlight in your specialty near your duty station?

3) Are you considering staying in the military or are you trying to get out as fast as possible?

1) 5 year ADSO, so 4.5y left.
2) Possibly. I need to get a state license and work on making some contacts. It would be more in the form of practice vacation coverage, I think.
3) Very quickly starting to think I'll civilianize.

 

[HighPriest]

I will say, as someone who hated their first duty station and ultimately was not happy with their military experience:

You’ve only been there 6 months? Give it some time. Try to build your practice a bit. If nothing else, try to do these things while you’re working to PCS. They may have decided to cut services at your MTF, but you may be surprised As to how willing command might be to help you do as much as possible in the interim. That was, at least, my experience.
If they’re not interested in helping you see and treat patients, that’s a pretty good argument to be made to your consultant that you need to move early in light of losing services after you PCS. They can’t support you, they’re not willing to try, and the Army is already dropping your specialty at that location, so let’s just shoot this horse.
You can definitely moonlight. I started about 6 months out of residency. PM me if you like and I can give you more specific advice there.

 

[HighPriest]

Make sure you decide based upon all factors, but I will say that once you make the decision that you’re not career military, it’s extremely liberating especially with regards to how aggressively you can look out for number one.

 

[Baron Samedi]

and the Army is already dropping your specialty at that location, so let’s just shoot this horse.

Thanks for the advice. This is one of the biggest factors -- I was sent here to establish a practice in my subspecialty starting from basically zero, but there are no plans to continue once I leave. It feels like I'm building a house of cards by going through all these administrative hurdles just for it to come tumbling down the second I leave. What's the point?

An example: we have a well-beyond life expectancy piece of equipment that is on its last leg, and replacing it will require a ton of legwork over the course of about a year and almost an act of congress due to the high cost. What's the point, if it will become useless the second I depart? It's not like I'm helping out the next guy.

My thought is that I do what I can during these (hopefully) 1.5 years, don't stress about building the practice up, and look for moonlight opportunities to keep the skills up before departing for a (hopefully) more supportive environment.

 

[HighPriest]

Why did they put you in this billet? Have you spoken with your consultant about it? Am I correct that there wasn't anyone there before you in your field either?

 

[Baron Samedi]

Why did they put you in this billet? Have you spoken with your consultant about it? Am I correct that there wasn't anyone there before you in your field either?

Great question.

There was someone here before in my primary specialty. I replaced him, and my consultant sent me here in order to continue what he was doing as well as expand the clinic capabilities to include my subspecialty. Pretty much as soon as my orders were produced the billet was cut and I arrived in an already dead slot.

My consultant is also retiring shortly, and there is no info regarding who the next person will be.

 

[HighPriest]

So I was in a very similar situation. I would try to talk to your current consultant ASAP. I'd concomitantly try to expand services where you are, because you are going to do better if you can show examples of how it's really pointless for you to be there. (I tried, and it didn't work, and you're closing us out here anyway).
Try to get your current consultant on board, because there is always a better chance of at least getting the gears turning before he leaves his post. If the new consultant comes in, a lot of things may happen:
1 - He may just PCS you. But that's a gamble.
2 - He may decide that he doesn't agree with closing the department where you are, and he may try to postpone that.
3 - He may decide that he doesn't want to stir the pot too vigorously as a new consultant, so he may make you stay there until you're due to leave.

But if you at least get the ball rolling before then, he is just as likely to let those wheels turn because it's too much a PITA to stop them just as he's coming in to his position. Plus, by the time he gathers enough information to decide if he agrees with your leaving early, it may be to late to make it worth stopping it.

Your best bet is the current consultant, unless he's out the door in a few weeks or something like that.

They're going to be looking at shuffling graduating residents around very soon here, so I would get started. At least put the bug in his ear that you think it is best to move. Just have good reasons as to why. Something more than just "I don't like it here." They don't care if you like it there.

 

[pgg]

You can definitely moonlight. I started about 6 months out of residency. PM me if you like and I can give you more specific advice there.

This is important and all of us who work with residents should encourage them to get the ball rolling on moonlighting while they're still a resident. As soon as they are reasonably certain where their first duty station will be. It's too important to put off starting the process until after they get to their first duty station and realize they're in a caseload wasteland. The time immediately after residency is critical, it's a steep part of the learning curve, and you've got to be seeing patients.

What this means in practice is two things:

1) Obtain a license in whatever state they're going to (perhaps also ones bordering it), at the latest in the spring of their final year of residency. Some states this takes months. I applied for a CA license in January of my last year of residency. It wasn't issued until July.

2) Start looking for work at the same time. I had a moonlighting job lined up before I finished residency.

Most graduating residents will have some leave to burn, given the +30 earned per year while ACGME only permits 20/year away from the program. Spend leave as you must to moonlight.

I'm fortunate in that my specialty is especially conducive to shift work consisting of a day here and a day there, with a need to cover nights and weekends. Everyone who's not in a specialty the military can saturate with caseload should engage in moonlighting as much as they can tolerate and as much as their command permits.

 

[HighPriest]

Even if you don't know where the resident will end up, you can look for moonlighting opportunities. Due to my specialty there were almost never local options, and so I worked with companies like comphealth and wetherby, and ended up flying all over the place to moonlight. It's not as nice as working local, but you could in theory have gigs set up before you even finish residency (start right after you PCS).

 

[crazybrancato]

This is important and all of us who work with residents should encourage them to get the ball rolling on moonlighting while they're still a resident. A

Asking for a friend but what would happen if you got caught moonlighting without formal permission. I've been doing it for 2 years, never completed the paperwork (or I think I did, but I never saw a formal approval). I don't do anything stupid: I only pull shifts when I'm on liberty/leave and there's no chance I'll get called in, never missed a command urine drug screen, I smoke the PRT, I don't ruffle any other feathers at work, very much a team player.

 

[HighPriest]

It's really variable. Worst case scenario: they take you to the cleaners. I would imagine (but do not know specifically) that this is UCMJ actionable. Best case scenario: you don't get approval to moonlight anymore, and they also revoke privileges from your colleagues.

My first duty station, the anesthesiologists were all moonlighting all of the time. They were within 250 miles, so they just never asked permission. They got away with it for years until command changes and actually looked at it. They found out that not only were they moonlighting without approval, but that they were actually covering for each other during duty hours so that they could take turns moonlighting instead of being at work.

I don't recall what they did to anyone specifically, but I know it was a couple-few years before anyone was allowed to moonlight. This was a small MTF, however.

 

[HighPriest]

I mean, best case scenario is that someone you know who is above you in the food chain finds out, makes you do the paperwork, and tells you to keep a lid on it and don't do it again. But that would require a specific set of circumstances.

 

[crazybrancato]

They were within 250 miles, so they just never asked permission. They got away with it for years until command changes and actually looked at it. They found out that not only were they moonlighting without approval, but that they were actually covering for each other during duty hours so that they could take turns moonlighting instead of being at work.

I don't do anything like that, i'm strictly on liberty or leave, pick up some extra shifts at a local ER. I guess I could get caught if someone from work walked into said ER, hasn't happened yet. I might even have approval, I know I turned it in, i'll look into it.

They got away with it for years until command changes and actually looked at it.

How did the command "look at it"? What can a command really do, are they going to go out to every hospital and ask who's moonlighting there? Ask for your 1040 tax return, to see how much more money you made last year??? (that'd probably be the smart way to do it). My guess is most commands ask people to come forward and admit they're doing it, maybe give some amnesty.

 

[militaryPHYS]

Asking for a friend

Make sure you get a copy of the signed/approved paperwork you submitted before you started moonlighting. If both you and your command lost it (very common scenario), request that it get re-submitted to have on file. Not worth the risk of them using you as an example.

 

[HighPriest]

Well in this specific case they just started asking what all their anesthetist were doing with their time at work, since it seemed like there wasn't enough work available to support all the anesthesia staff they had. And they were right. At least 1-2 of them just weren't there every day.

Someone could come forward. That's one way it could come out.

Someone could get caught drunk driving after they finished their shift and were driving home. Which "isn't an issue" if you're working in the same town.

Someone could see you and report you. Just playing the odds. Might be very unlikely.

Someone could call you during a shift and ask you to report. Might also be very unlikely. Hard to say.

Someone could call your credentialing office and they could start asking questions.

You could have a lawsuit brought against you while moonlighting. And maybe you can keep that under wraps, but it wouldn't be easy. Plus credentialing at the MTF will hear about it eventually.

You might see a patient at the civilian ER, and they might follow up on post, and someone might recognize your name on a chart and wonder how that happened. Again, maybe very unlikely.

 

[HighPriest]

Make sure you get a copy of the signed/approved paperwork you submitted before you started moonlighting. If both you and your command lost it (very common scenario), request that it get re-submitted to have on file. Not worth the risk of them using you as an example.

I really do agree with this. You may get away with it your whole career, but it only takes someone with a chip on their shoulder to put the spotlight on you. And, you know, it's the right thing to do.

 

[Gastrapathy]

I saw a command handle this quite aggressively via Admiral’s Mast. It was exposed by a routine privileges renewal at the OSH. I’m a little reluctant to spell out the details but some MTF COs used to be flags and this particular flag officer resented physicians already. Said flag definitely was able to make it not worth it. I knew many people that bent the rules but never getting permission at all is not worth the risk.

 

[Gastrapathy]

OP, I would refer you to the 8th law. If your current CoC is just disinterested, it could be so much worse.

 

[pgg]

Don't do it without command authorization. Do the paperwork now.

Better to get right with the policy now, when you can honestly claim a good faith effort to belatedly comply, than to get caught and get explicitly individually ordered to quit. Then you're screwed.

And you will get caught. Someone knows you're doing it. At some point someone will have something to gain - even if it's an unrelated rule or policy they feel a need to counter - and the first rule of defensive whining taught in kindergarten is to whatabout-the-other-guy's-transgression ...

One reason not to file the paperwork that I've heard people express is that they fear (know) it'll be denied because the terms of their desired moonlighting job violate the published limits the command has set (usually distance or hours).

The answer here is to file the paperwork with a waiver request accompanied by a rational explanation of why a particular rule should waived and how you're mitigating the associated risks. Most directors and commanders are reasonable people. There's no help for the ones who aren't, but you've got to act in good faith.

 

[Baron Samedi]

OP, I would refer you to the 8th law. If your current CoC is just disinterested, it could be so much worse.

The unfortunate thing is that I actually like my CoC. They have been quite supportive and reasonable throughout the entire process. The problems I am having are related to my work area, where the attitudes range from apathy to incompetence to actual maliciousness. Within the first two weeks of my arrival one of the other physicians in my work area had to be formally reprimanded for bullying me(as ridiculous as this sounds) -- absolute insanity. Thankfully, my CoC responded but it still has made for a toxic work environment where it's difficult to practice medicine.

 

[Gastrapathy]

Yeah that’s tough. Toxic personalities can survive in that environment. Is the problem physician in your specialty (it didn’t sound like it) because otherwise maybe get into a different space.

 

[HighPriest]

the attitudes range from apathy to incompetence to actual maliciousness.

This is the Army milmed SOP, unfortunately. I think the only variable is the degree of maliciousness. Just keep in mind that you have a good command. That’s ‘yuge. The duty station I transferred from had a terribly malignant command. There was no hiding from it.
But just as a point to be made: if you think you can escape apathy and/or incompetence by PCSing, I have nothing but bad news for you.

 

[Baron Samedi]

Yeah that’s tough. Toxic personalities can survive in that environment. Is the problem physician in your specialty (it didn’t sound like it) because otherwise maybe get into a different space.

Yes, unfortunately. He is a generalist and I am a subspecialist within the same primary field.

 

[d2305]

You can end up as a battalion surgeon doing cattle call. "My feet hurt"

 

[Gastrapathy]

If you talk with your consultant, just realize that it’s not some anonymous conversation. The detailing shop could easily “help” by using you to fix some other problem. If your CoC is good and the problem is literally one jerk, I’d encourage you to see if you can win that fight.

 

[Monty Python]

Asking for a friend but what would happen if you got caught moonlighting without formal permission. I've been doing it for 2 years, never completed the paperwork (or I think I did, but I never saw a formal approval). I don't do anything stupid: I only pull shifts when I'm on liberty/leave and there's no chance I'll get called in, never missed a command urine drug screen, I smoke the PRT, I don't ruffle any other feathers at work, very much a team player.

Part of the issue stems from how you, as a salaried officer (versus an hourly employee) are considered an on-duty government worker 24/7 even when home in bed ... or when moonlighting. Tricare cannot be billed for services you perform on/for a Tricare beneficiary while moonlighting in the civilian sector. Things can get sticky were that to happen, even if you weren't personally putting the invoices in the mail. You don't want to be extricating yourself from that situation at the same time you're trying to explain it to JAG or your previously-uninformed CoC.

 

[Perrotfish]

Yes, unfortunately. He is a generalist and I am a subspecialist within the same primary field.

Is this guy a civilian or military?

If military, is he around your rank or senior to you? Does he hold any administrative positions where he could affect your career?

 

[Baron Samedi]

Is this guy a civilian or military?

If military, is he around your rank or senior to you? Does he hold any administrative positions where he could affect your career?

Fortunately hes a civilian. He did, unfortunately, go on a smear campaign and dragged me through the mud with my actual higher ups which took a fair amount of time and effort to correct. Luckily, I had the support of my local CoC to help clarify the situation with them but I'm sure some damage was done.

 

[Perrotfish]

Fortunately hes a civilian. He did, unfortunately, go on a smear campaign and dragged me through the mud with my actual higher ups which took a fair amount of time and effort to correct. Luckily, I had the support of my local CoC to help clarify the situation with them but I'm sure some damage was done.

Damage in what sense? Aren't you getting out in 4 years?

 

[Baron Samedi]

Damage in what sense? Aren't you getting out in 4 years?

He sent scathing emails about me to my senior rater, every member of the hospital command, my consultant, and god knows who else. He has been at this hospital for a long time, so I'm sure his word carried some weight.

You're right, in that I'll likely get out in a few years and look back at this with disregard. For now, it sucks.

 

[DrMetal]

He sent scathing emails about me to my senior rater, every member of the hospital command, my consultant, and god knows who else. He has been at this hospital for a long time, so I'm sure his word carried some weight.

You're right, in that I'll likely get out in a few years and look back at this with disregard. For now, it sucks.

Well what in sam hell did you do?! I know you probably don't wanna give too many details, but was it patient care related, administrative, are you a Dallas Cowboys fan? Some back story might help if you're looking for honest solid advice.

 

[Baron Samedi]

Well what in sam hell did you do?! I know you probably don't wanna give too many details, but was it patient care related, administrative, are you a Dallas Cowboys fan? Some back story might help if you're looking for honest solid advice.

It's honestly a super bizarre and, frankly, embarrassing situation. I'm obviously biased, but this is my attempt at a nonbiased account of what happened.

Basic generic story:
1. I arrived as the first subspecialty trained provider as a part of this primary specialty clinic, sent to expand the clinic capabilities to include my subspecialty
2. Guy who has been there a long time is resistant to this change, as the guy previously in my billet did 100% primary specialty and he expected me to pick up where he left off. On my first day, he told me straight up that there was no need for my subspecialty care and that they had requested a generalist and that's what he expected me to do.
3. He tried to transfer some of his caseload onto me -- things that, frankly, a subspecialist shouldn't really be doing as my biggest priority was in expanding the clinic capabilities. When he did this, I talked to my supervisor regarding whether or not this was appropriate. My supervisor agreed it was not.
4. He retaliated by threatening to take away my support staff(he does not supervisor me, but does supervisor my nurse and my tech). At this point told him that I felt I was being harassed and that our discussions were no longer productive and should stop.
5. I, of course, reported this to my supervisor who, once again, reprimanded him
6. He retaliated by shouting at me in a clinic space, calling me unprofessional, calling me a child for involving my supervisor, and kicked me out of his office when I tried to smooth things over.
7. He then proceeded to email all of the people I mentioned, telling them that I was unprofessional and basically smearing me in a series of epic multipage emails. He also trash talked me to several other clinic staff.
8. He was formally reprimanded by my supervisor and has since stopped his harassment, but it has now left an incredibly uncomfortable work involvement.

I've tried to reflect on this a lot, trying to see where maybe I was at fault -- but I'm left empty each time. I just want to leave and start fresh, and hopefully go somewhere that my skills will be utilized. I would like to think I didn't extend my ADSO for this.

 

[DrMetal]

It's honestly a super bizarre and, frankly, embarrassing situation. I'm obviously biased, but this is my attempt at a nonbiased account of what happened.

Fair enough. I've seen this happen a lot to sub-specialists, happens in my specialty (Internal Medicine) all of the time. A freshly minted Endocrin or Rheum gets thrown on the wards, asked to do general internal medicine. Then we're surprised when they have to defer consults out to the network b/c they don't have the clinic time. Seems like a thing in the mil.

Call it gut instinct, but I don't really believe your supervisor reprimanded him (b/c he didn't change his behavior).

Sounds like you're dealing with an A-hole, I'd file a formal command-level complaint---pick your favorite flavor: sexual harassment, EO, 'hostile work environment', 'bullying'. That'll draw everyone's attention to him very quickly.

 

[Gastrapathy]

He’s a weebee. Not accountable to anyone and will outlast everyone. Prob a retired O6 or some ****.

 

[HighPriest]

Well, here's my take: if your consultant is big on letting you PCS, so be it. If not, you have to try to make things work where you are. Your choices are to do what this clown wants, or not, and if you don't then it will be awkward. You can ignore him entirely if he's not in the chain of command, and he's some GS physician. My advise would be different if he were a uniformed officer, mind you.

Go to your supervisor, and get your OER support form. Make sure it indicates that your primary goal is to expand specialty services. If it doesn't, ask to modify it. Make sure that you and your commander/rater agree as to your role at the institution. If your CO/rater agrees that your primary goal is to expand sub-specialty services, then it really doesn't matter what this jerk-off thinks. Just pretend he isn't there.

The minute he steps out of line and makes it impossible for you to provide the care for which you were billeted to your MTF, write a letter to the command suite. If he tries to make a stink, tell him you're happy to hear him our with your direct CO present, otherwise he should expect you to document and/or record any conversation you're having. Or, he can keep it to himself and let you do your job. Don't go out of your way to be a pain in his a$$, mind you. You're just a highly trained instrument of the US Army, sent to this MTF to expand the care and services provided to our soldiers. That's all you're trying to do. You are willing to make sacrifices to make that happen, but you'e not willing to sacrifice the chances of it happening.

Just don't curl up if he starts waving his feathers like a peacock. If he's a civilian, ex-COL or not, he's an employee of the federal government. He doesn't make decisions for the Army. Your consultant does. Your consultant put you there. The hospital expects you to do your job. You have verified what that job is by reviewing your OER-support form with your rater. If he is impeding that, then he is the broken link in the chain, not you.

This does, of course, assume that you are doing your job, and that you are carrying your weight. If there's only enough sub-specialty work to do a half day of clinic, then you probably do need to pick up some generalist stuff to make up for it, but the sub-specialty stuff needs to take priority, meaning that those patients get booked first until your schedule is full. If you feel like they're purposefully impeding your ability to fill sub-specialty patients (meaning you find them on other schedules, or you're booked out 12 weeks, but half of your days are general stuff), then bring it to your rater/CO. Best way to do it is to send an e-mail to this jerk (if you think you need to do so) and your CoC together. This is what CC mails are made for. If he wants to berate you about this, tell him you want your CO present or that you will record the conversation. Is that a jerk move? Yes. But, giving you the benefit of the doubt, he started this and assuming he won't let it go. He wants you to play his game by his rules, and you don't have to do that. Because the game is milmed, and the rules are: do what you were sent there to do by HRC and your consultant, and what the hospital wants you to do. Keep looking like a crusader for patient care to the command suite, and he will end up looking like an obstacle at some point. Even if your supervisor didn't write him up despite having said that they did, at some point either this will fade away or it will become enough of a nuisance that they will address it just so that they can not have to deal with it anymore. And when that time comes they'll have to make a choice: side with the guy who is trying to do what he's there to do, or side with the guy who is trying to stop him because he feels too busy. And it's a politically bad decision to choose the latter. They won't fire this guy, because they'll be cutting him a paycheck when he's 5 years dead as a GS. But they'll eventually tell him to back off. Again: key is that you have to stay on the high road through all of this.

Your other option, if you can't PCS, is to just choke down his $#!t sandwiches until you PCS or he wins and you see a general clinic for 4 years. And if you do that, he'll still be an @$$, I promise.

 

[narcusprince]

It's really variable. Worst case scenario: they take you to the cleaners. I would imagine (but do not know specifically) that this is UCMJ actionable. Best case scenario: you don't get approval to moonlight anymore, and they also revoke privileges from your colleagues.

My first duty station, the anesthesiologists were all moonlighting all of the time. They were within 250 miles, so they just never asked permission. They got away with it for years until command changes and actually looked at it. They found out that not only were they moonlighting without approval, but that they were actually covering for each other during duty hours so that they could take turns moonlighting instead of being at work.

I don't recall what they did to anyone specifically, but I know it was a couple-few years before anyone was allowed to moonlight. This was a small MTF, however.

Spent some time in Jax hehe.....
Get your paperwork in. Moonlight with peace of mind. Hopefully you are in a command where moonlighting is not stigmatized. In addition I understand your environment may be toxic. Do you understand the formal grievance process? What are your professional goals and whats the win win? Oftentimes as junior physicians we are reluctant to set professional boundaries. You are a physician and should not tolerate getting walked over. Good luck!

 

[HighPriest]

Spent some time in Jax hehe.....
Get your paperwork in. Moonlight with peace of mind. Hopefully you are in a command where moonlighting is not stigmatized. In addition I understand your environment may be toxic. Do you understand the formal grievance process? What are your professional goals and whats the win win? Oftentimes as junior physicians we are reluctant to set professional boundaries. You are a physician and should not tolerate getting walked over. Good luck!

I didn't. But I'm sure this has happened at more than once place.

 

[Perrotfish]

He sent scathing emails about me to my senior rater, every member of the hospital command, my consultant, and god knows who else. He has been at this hospital for a long time, so I'm sure his word carried some weight.

You're right, in that I'll likely get out in a few years and look back at this with disregard. For now, it sucks.

I doubt his word caries any weight at all. First he is a civilian in a military facility and the military does not, in general, value the observations and advice of civilians under any circumstances. Second his length of tenure at the hospital is irrelevant. The reason that doctors with long tenures in civilian hospitals are influential is because they have built up relationships with the hospital leadership over many years. The leaders he would need to build up relationships with for his word to carry more weight all PCS every 2 years. The leadership knows you at least as well as they know him.

I don't know the specifics but I doubt this guy could hurt you even if you wanted to stay in the military, much less if you are determined to leave after your obligation is up.

 

[Baron Samedi]

Excellent advice from everyone and very much appreciated.

I reached out to my consultant, he is aware of my situation and supportive of me PCSing early. We are awaiting word back from HRC to see what steps need to happen for this to occur -- likely an exemption to policy request. In the meantime, I am treating every day like I'm going to be here for the long run and trying to make the best of it and improve things where I can.

I'll definitely look into moonlighting. Some of it will depend on what HRC says. If I can leave quickly(doubt it) then it might not make sense to get another state license.

 

[Baron Samedi]

For follow-up:

I heard back from HRC regarding my request. They basically said that it's a 36 month tour and I should expect to stay for the whole time. They said early moves can be requested with justification but are far from a guarantee. I replied back with my reasoning, but since I don't have a compelling family story and my reasons are much more professional than personal, I'm not sure how far I'll get with it. I'm sure having the support of my consultant helps, but my understanding is that nowadays they have far less pull than in years past.

We'll see what happens.