About 6 years ago I saw Army anesthesiologist (O-6) who was an excellent physician but he never did CCC. Lack of military education did not prevent his promotion. Current system rewards doctors who have shorter residency (primary care) and spent a lot of time in operational environment. Promotional rates of family medicine doctors are 83% whereas general surgeons are 66%. O-4 who did ILE got promoted 100%.
the old guard O6's who are in charge have largely reaped the benefits with little of the work they now expect of those junior to them. There was a time when people were given constructive credit for CCC for deployments and BDE surgeon rotations. split deployments were common. above center of mass OERs were good, but not required. O6 was nearly universal, and the "broadening" experiences were not a prerequisite for promotion. Now you have to have a 60A job, a deployment, ILE, and maybe operational time to maximize your chances. You need 1, more likely 2, above center of mass OERs. the bar has been raised and the goalpost moved for reasons I can't figure out. Unless they're trying to impress the line with their lower PZ rates (see! we are hard core too!) or squeeze an extra year of work or a few early retirements I don't know. at my hospital in my department alone there are a total of five people in the senior O-4 to junior O-5 group separating this year and next. I can't imagine it's that much different army wide
Now If you are doing fellowship after residency there have been increased emphasis on post residency utilization tours (BDE surgeon) adding years in the military. It is not just 4 years commitment. After utilization tours you may find youself doing fellowship and not getting picked up O-5 given lack of leadership under current environment. .
BDE surgeon tours don't add to your ADSO. a little confused over what you meant. they would delay you from being able to start if that's what you meant.
I don't know if military was ever a good place to start medical career or stay for 20 years but military is changing for worst for Army doctors esp specialists.
specialists aren't viewed as such by the army. split deployments are now almost impossible and the wage gap isn't getting any better. plus the resources someone needs as a subspecialist they are hesitant or unwilling to provide. for primary care, specialties like ID, or people who don't really want to see patients and like admin or operational stuff, it's not such a bad deal. but if you have any aspirations to O6 you have to be willing to jump through a lot of hoops-- and your family will be jumping through them with you.
Couldn't one argue that those with shorter residencies (usually primary care) have thus had more opportunity to do things outside of training, and thus the higher promotion rate? Not sure I would have expected anything differently. At the same time, ENT/Ortho appear to have promoted closer to the rates of primary care, so maybe it's just general surgery that's an anomaly this year?
yes. which is why people are unfairly "punished" for doing residency, then maybe a year or two utilization (or straight to fellowship), then staff. this is usually a 6+ year thing, and if their first position after fellowship is "staff" the board sees no deployments, no operational time, and no leadership positions. even those people with 1-2 years of utilization tour won't have OIC time.
although someone who has taken this path has made a significant increase in skills, responsibilities, and capabilities, on paper it just looks like someone completed some schooling, was a minion, did more training (fellowship) and was a minion again. it doesn't hold the weight that it should. people in longer residencies start out behind just by the nature of what the board looks at.
personally unless I find some a compelling reason I'm finished with the hoops. I don't even know what the national guard/reserve promotion rates are but frankly to me it's irrelevant when it comes time to figure out what to do if/when I REFRAD.
--your friendly neighborhood resume buffing by seeing sick call in Kuwait caveman
