I was a battalion surgeon in Afghanistan, and a brigade surgeon in an airborne infantry unit, after derm residency. Here’s some advice on how to thrive in the line environment, which I enjoyed thoroughly. I’m assuming you’re O3.
You are no longer a doctor. You are, but really you’re just another staff officer. Also, you’re another dirty captain, most of whom are about to get out of the Army. The BN commander sees you all the same until you prove yourself useful, committed, and humble enough to take instruction. Do not bother or approach the CO until told to do so by the XO, as below.
Find the battalion XO (executive officer, a major) your first day, and ask for time on their calendar. Show them respect and genuine interest in what they want for the unit, and ask how you can help accomplish those goals. Ask for time to figure out how to get there, and for a second date to sit down a month later or so, to go over your progress and any changes in emphasis that need to be made. They may (sometimes) not seem intelligent in the way you’re used to, but they know the army, and can tell you what the unit needs to succeed. Ask for the battle rhythm, what meetings you are expected to be at, and which ones you can benefit from. There’s the bare minimum you should go to, and then there’s the rest of what happens that affects you. “If you aren’t at the table, you’re on the menu.” If you aren’t there when your role comes up, someone will make promises and decisions on your behalf.
Next stop, BN CSM. Ask what the soldiers need to succeed. How can you make that happen, what obstacles have they seen in the way? It’ll usually be something like “the hearing booth won’t see us when we need it”, or “every time someone goes to sick call they get deadlined for a week”. Absorb it, don’t explain or excuse, just sit there and let them vent. Say you’ll do everything you can to fix those issues. Mean it.
Find the battalion PA. Tell them you value their experience and knowledge, and that you’re there to empower and enable them. Use your fund of knowledge when you need to, don’t lord it over the PA as the only element of superiority you have. This person can make your life immensely easier or harder, your choice.
Find your MEDO (usually a 2LT or 1LT MSC officer). This is the person who talks medical to the commander and XO on a regular basis, and who they think is the doctor, not knowing the difference at all, or maybe just not caring. This is the person who sums up your work on a slide, and can be taught what can or cannot happen within realistic timelines. Don’t let them speak for you ignorantly.
Find your senior medic(s). Pretty much same approach as with the PA, stressing the value of their experience and how you hope to learn from them. They vaguely understand that you know a lot of hospital medicine, but hope you are there to get soldiers back in the fight.
Attend every command and staff meeting. Get to know the company commanders and first sergeants, ask them what they need from you. Take notes, ask questions, FOLLOW UP.
Now that you have met your battalion level command and medical team, go find the brigade surgeon who has been wondering why you have been avoiding him/her. If they ask/joke about it, explain that you needed to feel out your command and see how you can drive readiness on that side. Brig surg will be impressed with your drive and organizational intelligence. Most of your counterparts will spend the first week on house hunting leave bellyaching about their household goods not showing up and where they can keep their dog because on-base lodging doesn’t allow dogs wah wah wah. Feel free to take house hunting leave, but use the time off to feel out who people are and what needs to be done, so you show up actually able to do meaningful work on your first full day.
Make sure you are fully credentialed with the hospital BEFORE YOU ARRIVE. Otherwise you are a useless staff officer who can’t even do doctor stuff. Your XO would do well to put you on managed (forced) leave until you are credentialed and able to see patients, because everyone knows well in advance of arrival that this needs to be done, but half of them show up playing dumb so they can do less work. This is the same half who will hate their entire time there because everyone is mean to them and the Army tricked them, etc. Complainers love to complain and shirk. Don’t be one.
Use your rank and knowledge to enable your juniors. Whatever credibility and goodwill you build with those above you, ask to spend it on favors for those below. “Hey boss, the field exercise is over in two days, the aid station is down to tailgate only, can I let half my bubbas go home early? I’ll still be here until we’re done.”
If someone senior to you asks you to do something, make something, or change something, no matter how stupid or impossible, YES is the immediate answer.
Explain to them later, after you’ve had time to explore the options/alternatives, why their idea would not work. They’ll love the deference and the thought you put into it.
This also applies to senior NCOs, though you can be more direct, especially if they’re out of line.
Just finished IM Residency and I'm going to a very active line unit as a battalion surgeon. Looking for helpful recommendations for some desk references/web resources for the more common things I'll encounter that I might not have seen lately [Took care of mostly elderly retiree/VABs for last 3...
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