The fiscal year 2016 promotion rate for lieutenant commanders among Navy Reserve doctors has dropped substantially from its historical average. This new selection rate undercuts the potential full value of Navy Reserve doctors to sailors and Marines.

Fiscal year 2015 saw active duty aviators struggle through a 52.7 percent% in-zone promotion rate for lieutenant commander, which has forced numerous policy changes regarding promotion practices in the Navy. Fiscal year 2016 saw a 47.5 percent% in-zone promotion rate for O-4 among United States Navy Reserve Medical Corps officers. Above-zone selection was 1/31 or 3 percent%

This FY 2016 reserve promotion rate is nearly 40 percent% less than the FY 2015 rate. It also lags behind considerably from the FY 2016 active duty Medical Corps O-4 in-zone promotion rate of 93.4 percent % which is (pending Senate approval as of Oct. 7.) Yet, in 2015, the United States Naval Institute noted the challenge in recruiting highly trained Navy Reserve Medical Corps officers.  

The bottom line is that our sailors and Marines deserve the best care possible. Within this context, the Navy Reserve Medical Corps simply increases the talent pool of physicians available in the military system. Recruit these doctors intensely, promote them reasonably, and utilize their skills effectively.

Military medicine exists to provide care to military members (and their families) in order to better accomplish the mission. Reserve medical officers are vitally important in this context. The role models we have met in the Navy Reserve Medical Corps are outstanding physician leaders.

They mobilize to back-fill deployed physicians, and they themselves deploy. The United States Navy Reserve Medical Corps allows some of the best and brightest physicians to serve in the military, who otherwise would not have the opportunity to serve.

They bring cutting edge techniques, groundbreaking research, and diversified experience from premier civilian academic and private practices to the military system. This infusion of ideas and energy helps to innovate Navy Medicine. In no field is the revolution of information and new ideas more powerful than in medicine. Healthcare is constantly evolving and reserve service allows all phases of that evolution to come to an already strong active duty Navy.

Most importantly, the reserve option allows those transitioning from active duty to continue to serve. This maintains valuable operational experience which would have otherwise been lost.

It's pivotal to look at where these physicians are in their careers. Medical school takes four years after college, transforms someone into a doctor, and, on average, generates a debt of $176,348. Medical Corps officers receive a direct commission to lieutenant. After that, the real fun starts. Doctors spend anywhere from three to nine years in specialty training (internship, residency, and fellowship.) They learn the skills they need to practice medicine, perform surgery and make a diagnosis.  This takes time.

In the active duty community, some will undergo an operational tour (flight surgeon, undersea medical officer, or general medical officer) after internship. A young physician generally promotes to O-4 either during the end of their residency or just at the beginning of their specialty practice. The most unique part of this is that the skills are substitutive and the demand for physicians is constant. Physicians can practice medicine outside of the military. Pilots cannot fly the F/A-18 commercially.

The Navy wants the finest medical care for its personnel; it needs to not only recruit these doctors but also promote them reasonably and utilize their skills effectively to entice young physicians to stay in the military. It's a competitive job market.

Physicians join the Navy Reserve because they want to serve. They are willing to make professional sacrifices to do so. Physicians already take call on the weekends for their civilian practice generally at least once a month. Two weeks away from a civilian private practice can have a significant impact on the sustainability of patient care. The mobilization or deployment of a Navy Reserve physician can have financial and professional implications. The Uniformed Services Employment and Reemployment Rights Act applies to all employers in the United States. However, it excludes independent contractors. It takes a special individual to join the United States Navy Reserve. This is in line with the Navy’s strongest core values of highest tradition of Honor, Courage, and Commitment.

The needs of the Navy always come first. The Navy Staff Corps exists to supplement the line’s ability to complete the mission. The United States Navy Reserve Medical Corps offers a relatively low-cost option to retain outstanding individuals with diverse backgrounds to better help serve that purpose. Let's encourage them to serve. They have showed at least the foundations of honor and courage. Allow them to continue to show their commitment to providing the best possible care to our sailors and Marines.

Richard Menger is a resident physician and was selected for lieutenant commander in the Navy Reserve. He is currently the Hale Champion Public Service Fellow and a Master in Public Administration candidate at the Harvard Kennedy School of Government.

John Neely is an internal medicine physician currently in an emergency medicine fellowship. He is a lieutenant commander in the Navy Reserve.

The authors would like to thank Capt. Donald Stafford for his contributions. The views expressed are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.  

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