Navy O-5 promotion shenanigans

[bricktamland]

Staff promotion list for O-5 recently released. I noted a peculiar anomaly. I'm in-zone right now, and most of my classmates from an FP internship who continued in FP promoted to O-5. However, I changed course after GMO and went into Rads. Neither myself nor any of my Rads classmates from residency who were in-zone this cycle promoted. As staff at my hospital, I am department head, have held several "high visibility" collaterals, I have a trend of improving fit rep ratings with an EP for my most recent fit rep, and I was ranked 1st among the Medical Corps LCDRs at my hospital. I'm somewhat surprised I didn't promote, but frankly I'm more surprised that my residency classmates didn't promote, as IMHO they were all better officers than myself. Rads is currently "overmanned" in the Navy right now. I don't know about FP. But I wonder if my former FP classmates were promoted over equally qualified Rads this year as an incentive to try to retain primary care providers. No knock against my FP peeps, more power to them. Regardless, it doesn't have much of an impact for me, as I'm planning to get the f*$& out next year. It would have been cool to get out as an O-5, but ultimately I'm not sweating it--I've got a world-class (civilian) fellowship set up next year and looking forward to civilian life and no more Navy BS. But anyone else feel like the O-5 promotion was a bit screwy this year? For me, it's just got me convinced more than ever my decision to exit is the right one.

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[bobbyseal]

I thought there was a shortage of O4 currently which would thus make promotion to O5 easier in the Navy. Who knows, maybe word somehow got to the selection committee that you hadn't signed an ISP contract and were likely getting out. Doesn't make much sense to promote you if they knew you were out of there.

 

[jabreal00]

It's just the writing on the wall to get out. I am 04 that will be in the zone this coming cycle for the Army. I am not even thinking about it as I ETS in one year.

 

[pgg]

O5 isn't a gimme any more. I can't make any sense of who is and isn't getting promoted.

They claim that the promotion boards are specialty blind. I am skeptical.

 

[Chonal Atresia]

Staff promotion list for O-5 recently released. I noted a peculiar anomaly. I'm in-zone right now, and most of my classmates from an FP internship who continued in FP promoted to O-5. However, I changed course after GMO and went into Rads. Neither myself nor any of my Rads classmates from residency who were in-zone this cycle promoted. As staff at my hospital, I am department head, have held several "high visibility" collaterals, I have a trend of improving fit rep ratings with an EP for my most recent fit rep, and I was ranked 1st among the Medical Corps LCDRs at my hospital. I'm somewhat surprised I didn't promote, but frankly I'm more surprised that my residency classmates didn't promote, as IMHO they were all better officers than myself. Rads is currently "overmanned" in the Navy right now. I don't know about FP. But I wonder if my former FP classmates were promoted over equally qualified Rads this year as an incentive to try to retain primary care providers. No knock against my FP peeps, more power to them. Regardless, it doesn't have much of an impact for me, as I'm planning to get the f*$& out next year. It would have been cool to get out as an O-5, but ultimately I'm not sweating it--I've got a world-class (civilian) fellowship set up next year and looking forward to civilian life and no more Navy BS. But anyone else feel like the O-5 promotion was a bit screwy this year? For me, it's just got me convinced more than ever my decision to exit is the right one.

You are spot on - just leave. You can make WAY more $ as a civilian and will actually be afforded respect unlike the military where you are regarded as a financial liability by the "line."

Military medicine is digging a deep grave which, IMO, they won't be able to recover from once the next major conflict starts. There will be a dearth of physicians available for deployment. Get your pound of flesh out of them (i.e. GI bill transfer, VA disability, etc) and give them the bird as you walk out the door. Believe me, you won't miss the extra $20/day as LTC.

 

[Monty Python]

FWIW, here's the "Board Convening Order." Bottom of page 3 doesn't indicate any particular preference for MC:
http://www.npc.navy.mil/bupers-npc/boards/activedutyofficer/05staff/Pages/FY-16.aspx

I had time to kill this morning, and made the attached chart from the board archives for anyone curious. Very sorry about your outcome; sometimes it seems PERS operates in vacuum devoid of any logic.

 

[bricktamland]

For promotion purposes, I suspect primary care has an advantage due to the shorter residency and more time post-residency to compile leadership bullets. Add this to the super low-ball bonuses, and the ever-present skill atrophy at small commands, and specialists get especially hosed in the military.

I agree with Chonal Atresia. As the economy is picking up steam, more military physicians will be ditching the military. IMO, the "overmanning" of many specialties right now is an artifact of the recession, but this will revert to shortages soon enough as more specialists leave in droves.

 

[backrow]

An interesting trend I have noticed with an N of about 5 is that if you are still in residency when the O5 board meets (eg prior service and a GMO tour especially) then you are very likely to be picked up on the first look.

Seems somewhat weird when you think of others who have trouble making O5...

 

[DrMetal]

An interesting trend I have noticed with an N of about 5 is that if you are still in residency when the O5 board meets (eg prior service and a GMO tour especially) then you are very likely to be picked up on the first look.

Seems somewhat weird when you think of others who have trouble making O5...

I thought board certification was a requirement for promotion?

 

[backrow]

I thought board certification was a requirement for promotion?

Apparently not in the Navy. (And for amplification none of the ones I know of were doing a second residency)

 

[155HE]

There were at least 4 radiologists on that list. One was woefully above zone and one who is a current resident.

 

[haujun]

O5 isn't a gimme any more. I can't make any sense of who is and isn't getting promoted.

They claim that the promotion boards are specialty blind. I am skeptical.

As for Army...COL (non-medical) guy who worked in promotion committee told me that it is not.

 

[Gastrapathy]

Current residents have the advantage of being in a very junior summary group (ranked only against other residents) so most go into the board with consecutive EPs. If they graduate as a senior O4, they are screwed. Just one more example of a broken system.

 

[haujun]

An interesting trend I have noticed with an N of about 5 is that if you are still in residency when the O5 board meets (eg prior service and a GMO tour especially) then you are very likely to be picked up on the first look.
Seems somewhat weird when you think of others who have trouble making O5...

I wonder if you did not pick up during primary and above zone you can leave military without paying back obligation...if that is true doctors who are in training status would just get promoted?

 

[NavyFP]

Ummm. No. You have to stay until payback is complete.

I think part of the issue with FPs getting picked up is that many are shuffled off to operational jobs with opportunities to deploy. These are nice feathers when it comes to promotion. They are also not competing in large MTFs as a rule.

Promotions are getting harder. I am glad I am at terminal rank.

 

[Gastrapathy]

Are you sure? I remember a guy getting involuntarily separated after being passed over twice just after finishing interventional cards ~10 years ago. Dude was dumb like a fox.

 

[DrMetal]

Do you guys think that JPME Phase 1 and the Advanced Medical Officer Course (given in Bethesda) matter much? Does completion of these give any real edge?

 

[Monty Python]

Do you guys think that JPME Phase 1 and the Advanced Medical Officer Course (given in Bethesda) matter much? Does completion of these give any real edge?

JPME is a major-league plus to have, especially in the eyes of the line officer voting member of the board (who, based on random chance, might be the voting member assigned to brief your particular record to the board). AMDOC, although an enjoyable two weeks in the tower building, doesn't add the same amount of beneficial horsepower to your record as does JPME. It adds perhaps a little benefit, but not nearly as much as does JPME.

 

[NavyFP]

Are you sure? I remember a guy getting involuntarily separated after being passed over twice just after finishing interventional cards ~10 years ago. Dude was dumb like a fox.

I will rephrase. Not supposed to happen. The rules are that they can hold onto you if you Fail to Select, are too fat, or have a medical condition which renders you unfit for full duty. It would be the option of PERS and/or BUMED to separate.

 

[Gastrapathy]

I will rephrase. Not supposed to happen. The rules are that they can hold onto you if you Fail to Select, are too fat, or have a medical condition which renders you unfit for full duty. It would be the option of PERS and/or BUMED to separate.

He did have an affair with a senior officers wife that included some sordid Cosby-like accusations at the end.

Terminal Rank? Hope its O6.

 

[idq1i]

I wouldn't even take a direct promotion to O-10 over my VIR fellowship at a top name program, starting next July.

i see people continuing to try to make sense of promotions policy, dictated by a system that nominated a nurse as the surgeon general, system that cancelled CME conferences, and a system that promotes based on completion of courses a nitwit could pass...

 

[d2305]

Boorda screwed up the Fitrep system 20 years ago, and it's still a mess.

 

[pgg]

Boorda screwed up the Fitrep system 20 years ago, and it's still a mess.

It works for the line, basically. They are a reasonably fair and efficient meritocracy, per the line's definition of merit (leadership and administrative prowess).

If you accept the notion that medical corps leadership desires worker-bee clinicians to remain at junior rank, and administrator non-clinicians to attain senior rank, then it's working for that too.

 

[bricktamland]

Junior rank/worker-bee clinician would be acceptable, if that was actually feasible. Problem is being forced and coerced into administrative and leadership roles regardless of any interest or desire to take them, and at stages in one's career where it is inappropriate.

Right out of residency, I was sent to a small command where I had to take on department head. On top of that, I had officers rotating out who were desperate to dump "high visibility" head of committee positions to the new guy, so, wanting to contribute and do my part, I accepted one of those major collaterals too. As a new attending, at a time when I should really be focusing on perfecting the craft I spent the last 4 years working my backside off training for, I was instead spending 60% of my time doing admin duties in which I had no training. The severe skill atrophy from working at a tiny community hospital only makes things worse.

Since I was planning on separating regardless, the promotion pass-over is relatively minor. But when I see the folks I went to internship with from a different specialty being promoted, it seems like the final slap in the face. I did my part. Did my GMO tour, deployed to Iraq, etc. I took on admin jobs I didn't want but didn't complain and put forth my full effort. Got that EP.

Oh, to hell with it.

 

[DrMetal]

Junior rank/worker-bee clinician would be acceptable, if that was actually feasible. Problem is being forced and coerced into administrative and leadership roles regardless of any interest or desire to take them, and at stages in one's career where it is inappropriate.

Right out of residency, I was sent to a small command where I had to take on department head. On top of that, I had officers rotating out who were desperate to dump "high visibility" head of committee positions to the new guy, so, wanting to contribute and do my part, I accepted one of those major collaterals too. As a new attending, at a time when I should really be focusing on perfecting the craft I spent the last 4 years working my backside off training for, I was instead spending 60% of my time doing admin duties in which I had no training. The severe skill atrophy from working at a tiny community hospital only makes things worse.

Since I was planning on separating regardless, the promotion pass-over is relatively minor. But when I see the folks I went to internship with from a different specialty being promoted, it seems like the final slap in the face. I did my part. Did my GMO tour, deployed to Iraq, etc. I took on admin jobs I didn't want but didn't complain and put forth my full effort. Got that EP.

Oh, to hell with it.

It really doesnt make sense that folks such as yourself arent promoting on time.

Is this a retention issue? What I mean is: Is it that we have an abundance of O-5s and O-6s, that creates some backlog? Are we limited in the # of CDRs and CAPTs we can have in the MC?

 

[pgg]

Junior rank/worker-bee clinician would be acceptable, if that was actually feasible. Problem is being forced and coerced into administrative and leadership roles regardless of any interest or desire to take them, and at stages in one's career where it is inappropriate.

Right out of residency, I was sent to a small command where I had to take on department head. On top of that, I had officers rotating out who were desperate to dump "high visibility" head of committee positions to the new guy, so, wanting to contribute and do my part, I accepted one of those major collaterals too. As a new attending, at a time when I should really be focusing on perfecting the craft I spent the last 4 years working my backside off training for, I was instead spending 60% of my time doing admin duties in which I had no training. The severe skill atrophy from working at a tiny community hospital only makes things worse.

Since I was planning on separating regardless, the promotion pass-over is relatively minor. But when I see the folks I went to internship with from a different specialty being promoted, it seems like the final slap in the face. I did my part. Did my GMO tour, deployed to Iraq, etc. I took on admin jobs I didn't want but didn't complain and put forth my full effort. Got that EP.

Oh, to hell with it.

I know the feeling. I was passed over for O5 my first time up. Board certified, deployed in my specialty, dept head at my small MTF, chair of two committees, EP fitreps ranked against peers going into the board, no PFA failures, never out of weight standards, no problems, no black marks. Board results came out while I was in Kandahar to add some extra insult. I was rather bent about it all.

It was even worse to see the list include names of people I knew who lied their way out of deployments or were just terrible clinicians.

Got home from that deployment, still with years left on my ADSO. Could not imagine finishing out that time as an O4, so I doubled down on admin, asked for and took the DSS job. Was 90% admin for the better part of a year, and did a good job at it. Even enjoyed bits of it, as I learned some things about how hospital ran. That got me promoted.

Now, looking ahead to O6 ... if I did promote and put that on, I'd have to stay past my 20 year mark. Also, being at a large MTF now, for an O5 to make O6, it's necessary to take major command-level collaterals. There are 20 or 25 physicians in my specialty in my dept here, perhaps 1/3 are O5s ... but not a single O5 got an EP last cycle. Not the dept head, not the residency program director, not the fellowship trained subspecialist who set records with RVUs done. O5s in my specialty don't get promoted here.

In a way, knowing that I don't have any hope or prayer of making O6 is kind of liberating. I've taken on a couple of collateral duties that actually interest me, but the others ... meh, I don't have time. I'm not going to burn any bridges, but I'm not looking to cross them either. I'm pretty happy doing what I'm doing now.

Off to fellowship in a year or two, GMESB willing, then a few more to retirement. I'll retire an O5 and that's OK.

 

[Gastrapathy]

I know an anesthesiologist who put his rank as TDR on email for a while. (It meant terminal CDR, or termander as he liked to be addressed.

 

[bricktamland]

I know the feeling. I was passed over for O5 my first time up. Board certified, deployed in my specialty, dept head at my small MTF, chair of two committees, EP fitreps ranked against peers going into the board, no PFA failures, never out of weight standards, no problems, no black marks. Board results came out while I was in Kandahar to add some extra insult. I was rather bent about it all.

It was even worse to see the list include names of people I knew who lied their way out of deployments or were just terrible clinicians.

Got home from that deployment, still with years left on my ADSO. Could not imagine finishing out that time as an O4, so I doubled down on admin, asked for and took the DSS job. Was 90% admin for the better part of a year, and did a good job at it. Even enjoyed bits of it, as I learned some things about how hospital ran. That got me promoted.

Now, looking ahead to O6 ... if I did promote and put that on, I'd have to stay past my 20 year mark. Also, being at a large MTF now, for an O5 to make O6, it's necessary to take major command-level collaterals. There are 20 or 25 physicians in my specialty in my dept here, perhaps 1/3 are O5s ... but not a single O5 got an EP last cycle. Not the dept head, not the residency program director, not the fellowship trained subspecialist who set records with RVUs done. O5s in my specialty don't get promoted here.

In a way, knowing that I don't have any hope or prayer of making O6 is kind of liberating. I've taken on a couple of collateral duties that actually interest me, but the others ... meh, I don't have time. I'm not going to burn any bridges, but I'm not looking to cross them either. I'm pretty happy doing what I'm doing now.

Off to fellowship in a year or two, GMESB willing, then a few more to retirement. I'll retire an O5 and that's OK.

pgg, you've got an amazing attitude and I admire everything you've accomplished. The Navy needs docs like you to stay in and provide leadership. I really mean that.

At my MTF, both the DCSS director and the head of the medical staff are on leave next week. Guess what? They both independently asked me to cover for them next week. Why? Because I'm one of the few O-4s around who seems to give a shiz. They trust me because I'm responsible and get the job done. I have zero interest in admin but I agree to help out because I'm a team player, and when I agree to do a job I do it right. There are several O-5 physicians around who have zero collaterals and pretty much do nothing other than see clinic, but they don't ever seem to get tasked with anything--I suppose they're just regarded as burnouts. They're quite mediocre physicians too, and that's probably giving them too much credit.

I've realized I'm not interested in playing the game. O-4 is a given. But to make O-5, I'm just not willing to do 90% admin. I don't enjoy it. I like radiology. THAT'S what I want to do with 90% of my time. In fact, I'm still in my infancy as a radiologist, not even 3 years out of residency. Frankly, it seems ******ed to train for 9 years to become a radiologist (med school + residency), practice for 3 years, and then totally switch tracks to become a hospital administrator. If I wanted to do that, I would have gone into hospital administration. But the fact is, the Navy just doesn't value me as a radiologist. They need administrators. I guess there's a constant supply of HPSP-ers coming out of residency to fill the void of doing all the clinical medicine.

It's sad because most of the quality O-4 physicians that want to practice medicine leave. When I look back on residency, all the best teaching staff were O-4s or they were civilians. The O-5s fell into three camps. One, they were burnouts who didn't care and were just hanging around to get to their 20 years. Two, they were hard-core admin types pushing to make O-6 and have pretty much put clinical medicine in the rear-view mirror. Or three--in my experience the rarest of the O-5s, and pgg probably falls into this camp--are the docs who really care, want to practice medicine, yet still contribute to the command.

For me, I've realized that what the Navy wants and what I want aren't very compatible. We've had a great time together, and I will always look back with fond memories. But we've grown apart. I think we need to start seeing other people. . . . . now if I could only get that divorce paperwork expedited.

 

[bricktamland]

It really doesnt make sense that folks such as yourself arent promoting on time.

Is this a retention issue? What I mean is: Is it that we have an abundance of O-5s and O-6s, that creates some backlog? Are we limited in the # of CDRs and CAPTs we can have in the MC?

Thanks for the vote of confidence. Again, I don't consider myself the greatest O-4 ever by any stretch of the imagination. But the guys/gals I went to residency with were truly top-notch, and to see them passed over is just crazy. I don't really know the true answers to your question, but if I were to hazard a guess, I'd say: yes, depends on your opinion, and yes.

 

[TheEarDoc]

I know the feeling. I was passed over for O5 my first time up. Board certified, deployed in my specialty, dept head at my small MTF, chair of two committees, EP fitreps ranked against peers going into the board, no PFA failures, never out of weight standards, no problems, no black marks. Board results came out while I was in Kandahar to add some extra insult. I was rather bent about it all.

It was even worse to see the list include names of people I knew who lied their way out of deployments or were just terrible clinicians.

Got home from that deployment, still with years left on my ADSO. Could not imagine finishing out that time as an O4, so I doubled down on admin, asked for and took the DSS job. Was 90% admin for the better part of a year, and did a good job at it. Even enjoyed bits of it, as I learned some things about how hospital ran. That got me promoted.

Now, looking ahead to O6 ... if I did promote and put that on, I'd have to stay past my 20 year mark. Also, being at a large MTF now, for an O5 to make O6, it's necessary to take major command-level collaterals. There are 20 or 25 physicians in my specialty in my dept here, perhaps 1/3 are O5s ... but not a single O5 got an EP last cycle. Not the dept head, not the residency program director, not the fellowship trained subspecialist who set records with RVUs done. O5s in my specialty don't get promoted here.

In a way, knowing that I don't have any hope or prayer of making O6 is kind of liberating. I've taken on a couple of collateral duties that actually interest me, but the others ... meh, I don't have time. I'm not going to burn any bridges, but I'm not looking to cross them either. I'm pretty happy doing what I'm doing now.

Off to fellowship in a year or two, GMESB willing, then a few more to retirement. I'll retire an O5 and that's OK.

I just have to say I am so sorry to hear this. I can't imagine the frustration of busting butt and getting hosed. Finish your time and then come join us at the VA we would love to have a smart go getter like yourself!

 

[TheEarDoc]

pgg, you've got an amazing attitude and I admire everything you've accomplished. The Navy needs docs like you to stay in and provide leadership. I really mean that.

At my MTF, both the DCSS director and the head of the medical staff are on leave next week. Guess what? They both independently asked me to cover for them next week. Why? Because I'm one of the few O-4s around who seems to give a shiz. They trust me because I'm responsible and get the job done. I have zero interest in admin but I agree to help out because I'm a team player, and when I agree to do a job I do it right. There are several O-5 physicians around who have zero collaterals and pretty much do nothing other than see clinic, but they don't ever seem to get tasked with anything--I suppose they're just regarded as burnouts. They're quite mediocre physicians too, and that's probably giving them too much credit.

I've realized I'm not interested in playing the game. O-4 is a given. But to make O-5, I'm just not willing to do 90% admin. I don't enjoy it. I like radiology. THAT'S what I want to do with 90% of my time. In fact, I'm still in my infancy as a radiologist, not even 3 years out of residency. Frankly, it seems ******ed to train for 9 years to become a radiologist (med school + residency), practice for 3 years, and then totally switch tracks to become a hospital administrator. If I wanted to do that, I would have gone into hospital administration. But the fact is, the Navy just doesn't value me as a radiologist. They need administrators. I guess there's a constant supply of HPSP-ers coming out of residency to fill the void of doing all the clinical medicine.

It's sad because most of the quality O-4 physicians that want to practice medicine leave. When I look back on residency, all the best teaching staff were O-4s or they were civilians. The O-5s fell into three camps. One, they were burnouts who didn't care and were just hanging around to get to their 20 years. Two, they were hard-core admin types pushing to make O-6 and have pretty much put clinical medicine in the rear-view mirror. Or three--in my experience the rarest of the O-5s, and pgg probably falls into this camp--are the docs who really care, want to practice medicine, yet still contribute to the command.

For me, I've realized that what the Navy wants and what I want aren't very compatible. We've had a great time together, and I will always look back with fond memories. But we've grown apart. I think we need to start seeing other people. . . . . now if I could only get that divorce paperwork expedited.

Come to the darkside of the VA. We have candy.

 

[idq1i]

Personally I enjoy my terminal O-4 rank. It's high enough that I'm not bothered with the menial hooah crap, my word carries enough weight when I point out gross inadequacies in the system and suggest changes, and I don't have to worry about "broadening" opportunities and ass kissing.

Your rank should be commensurate with your clinical skills and potential, and not out lasting force shaping projects. WTF does the line know about me when looking at an orb at the time of a promotions board?

 

[j4pac]

Come to the darkside of the VA. We have candy.

Does the darkside have spots for PM&R?

 

[TheEarDoc]

Does the darkside have spots for PM&R?

Yep! You could go hit up a SCIU at one of the larger VA's.

What is your specialty or what do you want to be your specialty?

The VA constantly needs rehab docs with all the ortho issues and TBI's.

 

[j4pac]

Starting a 3-yr PM&R residency in 2016. I'm going in with an open mind. Right now I am most interest in Sports Med, but that's because it's what I'm most familiar.

I hope to go back to either Tampa or Jacksonville, FL.

Yep! You could go hit up a SCIU at one of the larger VA's.

What is your specialty or what do you want to be your specialty?

The VA constantly needs rehab docs with all the ortho issues and TBI's.

 

[Shikima]

Lots of VA jobs to convert your military time.

 

[NavyFP]

Terminal Rank? Hope its O6.

yep.

 

[SoftGel]

Reviving an old thread here.

I'll be transitioning from unrestricted line (O4) to navy dental corps (selres). Does the medical community value JPME1 for promotion to O5? I have some time in the next year and could knock it out, though I have less than zero interest. If I was staying in my old community (SWO) it's basically required for O5, but if I can side step it as a dentist I will do so.

Thanks.

 

[IlDestriero]

I still remember when the worst physician that I ever met pinned on O5. It was then that I realized that there can’t be any logic to this system. If this dunce was on the faculty at my current gig, he wouldn’t be promoted for volunteering for a bunch of BS committees etc. that nobody else wanted to do, he’d be DOA and out the door long ago for clinical incompetence, professional problems, boundary issues, etc. $50 says he’s a Captain now because he would have no career as a civilian.