Hey,
Haha go for it, laughter is the best medicine 🙂
I think alot of what goes on in the US will translate to Australia, we copy tonnes of American organisation and thinking.
SO it sounds like once a person has finished the board exams (rank of majour) - the rest has nothing to do with how good a doctor you are, its all about making friends and administration/red tape work. Is it kind of like joining a club, you have to be one of the boys in order to get in?
What kind of people useually end up in these posts? Burnt out doctors, dont like medicine, power trip??
What was your guys experience with the higher ranks? I dont mean the pro and cons of military service as a doctor, I mean how were the lt colonels and higher up, what were they like?
In the US, making Colonel as a doctor is simply about doing the right steps.
Residency: Captain. If you are in a really long residency, such as say neurosurgery, you will likely be promoted to Major before you finish
Attending: Get assigned somewhere. Might be operational, with a unit as their doctor? flight surgeon? clinic? Hospital? All depends. No matter, that is the time that you should be sitting down and thinking about whether you want to make a career of the military or get out as soon as possible. If you decide to make a career of it, then at some point you should go to the Captains Career Course, else you will likely never see Lieutenant Colonel. At some point, if you are going to deploy, early in your career as a Captain/Major is when this is likely to happen.
Leadership: Okay, as a Captain or Major fresh out of residency, you might be tasked with pseudo-leadership roles. E.g. Clinic chief, Brigade surgeon, Chief of (insert something). After you make Lieutenant Colonel, you may want to consider other leadership roles such as chief of an entire department, deputy commander of a small hospital, Division surgeon, etc etc. If you do not perform those "higher up" leadership roles, then it will be harder to make Colonel. At some point as a Lieutenant Colonel, go to the ILE course or again, will likely be passed over at your promotion board.
The complaint that many US Army docs have is that as you travel up these ranks and place all of your "checks" into the proper boxes to make Colonel, you deviated further from clinical medicine.