FY 17 Guidance for Reserve Medical Officer Continuation and Retention Policy Execution

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1 FY 17 Guidance for Reserve Medical Officer Continuation and Retention Policy Execution 03 August 2016 This guidance is intended to provide recommendations to the Reserve Continuation and Retention Panel in order to standardize practices for Reserve Component (RC) medical officers based on manning and needs of the Navy. Mission: To clarify the execution of the Reserve Component officer continuation and retention policy execution. Specifically, to further clarify which skills sets are critical to RC Navy Medicine, who should be retained and for what periodicities. Updates: The contents of this letter will be updated as often as necessary for community health (reviewed at least annually) or whenever a major change to the RC Retention Policy has been approved. The updates will be made by each community, as applicable, for manning changes. Some communities have far more dynamic manpower needs, while other corps may not change greatly for long periods of time. Credentialing and/or licensure; privileged; practicing for Navy Medicine: As many medical specialties require periodic renewal of authorization to provide health care, no officer should be retained for a skill set that they are no longer able to provide. The primary Subspecialty (SSP) is the key to the skill set for evaluation concerning retention/continuation decisions. By definition the other SSPs require refresher training (NOOCS Manual VOL I. B. 2. 2) and are not usually a current skill set. All of the charts below refer to the primary subspecialty, even though a retention/continuation decision could be made regarding another skill set during the deliberation process for those not cited with the specific waivers. The retention/continuation should be revoked for any member that does not meet the skill set required for retention. A decision could be made to retain an individual that could refresh a less than current skill set, but no automatic decision should be made regarding a secondary or tertiary skill set without contacting the appropriate OCM and RAO. World-wide assignable: Exceptions can be made for certain medical SSPs that are not world-wide assignable, but only after close consideration for the likely mobilization sites (e.g. certain surgeons may only deploy to large hospitals with complete medical facilities, like Lundstuhl Regional Medical Center or Walter Reed National Military Medical Center). This consideration should be made by the appropriate BUMED RAO or the BUMED mobilization officer in their prolonged absence. General Categories of Skill Sets: Each of the medical corps will have different needs for retention, yet understanding the priorities within the corps helps set expectations for the cases that need to be determined prior to providing a continuation or allowing retention. The further down the list of skill sets, the less likely the continuation/retention becomes. The guidance in the box at the top of the page will set the procedures for each corps by category. Long Term RC Medical Critical Wartime Skill Set: This category will contain the least dynamic skill sets. Each will be evaluated during the periodic reviews, yet the expectation will be a genuine need due to heavy billet or mobilization requirements and difficulty in recruiting and/or retaining these skills. Current Manning Difficulties of Skill Set: The skill sets described in this category have some level of difficulty for manning and need short term attention for retention. Skill sets in this category may depend on timing issues and retention targets, which may not apply to all grades, thus rank restrictions and other factors may be applied to skills in this category. Current Stable Manning or No Need (Current or Projected) for the Skill Set: For a variety of reasons, these skill sets are either healthy or over-represented in the RC Medical Officer Communities. Officer statutory limits will be applied to all specialties that are stable or have no projected need.

2 Special Needs: Addresses unusual circumstances; therefore, the amount of specialties in this group will be limited. For example, there are no authorized Pediatric Dentistry SELRES billets, yet many humanitarian missions need to activate a Pediatric Dentist. Should a Dental Corps (DC) officer be current in this skill set, continuation/retention should occur for a strategic, reserve capability. Applicant Groups: Each time a person approaches the end of the waiver or a statutory limit (age or Years of Commissioned Service), the member will need to apply for either continuation or retention. Multiple requests can be made in one submission, and each request should be evaluated by the priority of the skill set in the respective corps at the time of the request. Statutory Limitations based on Years of Commissioned Service: The statutory limit for Navy RC Captains (O-6) is 30 years of commissioned service (YCS) with a maximum of 35 years if granted continuation. The statutory limit for Navy RC Commander (O-5) is 28 years of commissioned service with a maximum of 33 years if granted continuation. The statutory limit for Navy RC Lieutenant Commander (O-4) is 20 years, with two failures of selection, with a maximum of 24 years if granted continuation. Limitations based on Age: Varying groups with fundamentally different approaches to retention. (1) Serving beyond 60 years of age. All RC officers need to document their desire to remain in a drilling status beyond 60 years of age. Thus, no officer that requests to remain on the Reserve Active Status List (RASL) beyond 60 years of age will be removed for age consideration alone, provided they are in a billet of the appropriate pay-grade and specialty mix. Upon reaching a secondary limitation, the officer will be reevaluated based on the matrices of skill sets described herein by community. (2) Serving beyond 62 years of age. Section of title 10, U.S. Code, authorizes retention on the RASL of RC Medical Corps, Dental Corps, Nurse Corps, and certain designators of the Medical Service Corps until they reach 68 years of age. Officers from the Long Term RC Critical Wartime Specialty and Manning Difficulty groups will be the primary target for retention beyond 62 years of age. Certain officers will not be continued beyond 62 years of age regardless of YCS. Those specialties will be addressed by the OCM and RAOs on a case by case basis. (3) Initial Military Service Obligation. Officers that have age waivers at accession should not be removed from the Reserve Active Status List during their initial eight year obligation. Documentation can be gathered for the administrative requirement of exceeding 60 years of age; however, the expectation shall be that the officer continues with the obligation, since consideration was already granted for the specialty/skill set during the initial age waiver. Multiple limitations: Unless otherwise stated, each waiver will be limited to the time stated based on the skill set, SSP, or the next statutory limit has been reached whichever occurs first. An expressed waiver release from the latter limit will be required for applicants that hit an additional limit prior to the waiver expiration.

3 Medical Corps Retention Requirements Provide four year waivers for this entire group regardless of rank. Provide two year waivers for this entire group regardless of rank. Current Stable Manning (or No Need) for the Skill Set: Some waivers may be provided for up to two years for this group depending on a variety of skill sets and other manning considerations. Automatic Waiver for Current Mobilization: Provide a two waiver to take effect at the completion of the mobilization. Applicant must be deployed on mobilization orders. ADSW and Recall orders do not count for an automatic two year extension. A waiver should be requested during the recall application process, if applicable. Two year waiver will be rescinded if member is demobilized early for lack of license/privileging/confidence. No waiver should be less than a current serving recall for the previously retained and continued. 15B0 15C0 15D0/15D1 15H0 15A0/15A1 15B1 15C1 (AQDs: 6CD/6CE/6CJ, others ask) 15F0 15G0 15H1 15I0 15J1 15K2 15L0/15L1 16Q0/16Q1 (w/ AQD 62G) 16R0 16R1 (auto 2 year for all AQDs) 16P0/16P1 16X0/16X1 16Y0/16Y1/16Y2 Anesthesia, General Surgery, General Neurological Surgery, General Orthopedic Surgery, General Aerospace Medicine (15A as primary specialty and in paid status ONLY) Anesthesia, Subspecialty Surgery, Subspecialty General Medicine (15F as primary and in paid status ONLY) Ophthalmology, General Orthopedic Surgery, Subspecialty Otolaryngology, General Urology, Subspecialty Occupational Medicine, General Physical Medicine & Rehabilitation, General / Subspecialty Family Medicine, General (Sports Medicine Subspecialty) Internal Medicine, General Internal Medicine Subspecialty Emergency Medicine, General (Subspecialty) Psychiatry, General Diagnostic Radiology/ Radiology, Subspecialty/ Radiology Oncology Current Stable Manning (or No Need) for the Skill Set: 15E0/15E1 15G1 15I1 15K1 15M0/15M1 16N0/16N1 16Q1 (other than AQD 62G) 16T0/16T1 16U0/16U1 16V0 16V1 Obstetrics/Gynecology, General / Subspecialty Ophthalmology, Subspecialty Otolaryngology, Subspecialty Preventative Medicine, Subspecialty Pathology, General / Pathology, Subspecialty Dermatology, General / Dermatology, Subspecialty Family Medicine, Subspecialties other than Sports Medicine Neurology, General / Neurology Subspecialty Undersea Medicine, General/ Undersea Medicine, Subspecialty Pediatrics, General (likely approved for operational med orders, if eligible) Pediatrics, Subspecialty

4 Dental Corps Retention Requirements Provide four year waivers for this entire group regardless of rank. Provide two year waivers, provided they are serving in a paid billet. Current Stable Manning (or No Need) for the Skill Set: Very few waivers will be provided for this group. Special Needs: Some waivers may be given for those participating in the VTU due to special humanitarian missions or Active Duty needs, despite the lack of a funded SELRES billets Oral Surgery 1725 Comprehensive Dentistry (military only residency, no NOBC awards only SSP) 1760 Periodontics Current Stable Manning (or No Need) for the Skill Set: 1700 Dentistry, General 1710 Endodontics 1720 Dental Education Programs 1730 Maxillofacial Prosthetics 1735 Orthodontics 1740 Operative Dentistry 1745 Oral Medicine/Oral Diagnosis 1769 Prosthodontics 1775 Public Health Dentistry 1780 Oral Pathology 1785 Orofacial Pain 1790 Dental Science and Research Special Needs: 1724 Advanced Clinical Programs (ACP in General Dentistry) 1749 Advanced Clinical Programs (ACP in Exodontia) 1795 Pediatric Dentistry

5 Medical Service Corps Current Retention Requirements Possible four year waivers for this group, provided the officer serves in an Apply POMI Billet Some waivers may be provided to serve out Apply board awarded billet and will generally be given only to those in a paid status. Current Stable Manning: Very few waivers will be provided. While unlikely, there are occasional needs dependent upon the combination of secondary or tertiary skill sets. No Further Need Anticipated for the Skill Set: Almost no waivers are likely (dependent upon the combination of secondary or tertiary skill sets). Special Needs: Close consideration of the health of specialties with small billet bases or no billet base need to be considered. Some waivers may be granted waivers for those in IRR, dependent upon the need for special mobilization requests or humanitarian assistance missions Plans, Operations, and Medical Intelligence (POMI) (NAVET only specialty) Current Stable Manning Skill Sets: 1800 Health Care Administration (identified by combination with other SSPs) 1801 Patient Administration (NAVET only specialty) 1802 Medical Logistics Administration (NAVET only specialty) 1804 Health Facility Planning and Projects (NAVET only specialty) 1836 Aerospace and Operational Physiology (due to extremely small billet base ~4) Entomology Environmental Health Industrial Hygiene Medical Technology 1873 Physical Therapy 1876 Dietetics 1878 Pharmacists 1880 Optometry 1892 Podiatry 1893 Physician Assistant No Further Need Anticipated for the Skill Set: 1803 Medical Data Services Administration 1810 / 1815 Biochemistry / Microbiology 1825 Radiation Health 1835 / 1841/ 1842 / 1843 / 1844 / 1845 Physiology / Child Psychology / Neuropsychology / Medical Psychology / Aerospace Experimental Psychology / Research Psychology 1862 Audiology 1870 Social Work 1874 Occupational Therapy Special Needs: 1840 Clinical Psychology (due to emphasis on mental health for HA)

6 Nurse Corps Current Retention Requirements Possible four year waivers for this group, provided the officer serves in an Apply Billet (for O-5s & above) and meets program authorization requirements (i.e. possesses a Bachelor of Science of Nursing (BSN) degree for 1950). Some waivers may be given, provided the officer occupies a paid billet and a senior officer billet is awarded via Apply board process. Expect a two year waiver, if granted. Current Stable Manning (or No Need) for the Skill Set: Very few waivers may be provided. While unlikely, there are occasional needs dependent upon secondary or tertiary skill sets. No Further Need Anticipated for the Skill Set: Almost no waivers are likely (dependent upon the combination of secondary or tertiary skill sets). Special Needs: None at this time Preoperative Nursing (some were previously assessed without a BSN) 1910 Medical/Surgical Nursing 1960 Critical Care Nursing 1974 Pediatric Nurse Practitioner 1981 Nurse Midwife Current Stable Manning Skill Set: 1900 Professional Nursing 1903 Nursing Education 1920 Maternal and Infant Health Nursing 1922 Pediatric Nursing 1930 Psychiatric/Nursing 1945 Emergency Trauma Nursing 1964 Neonatal Intensive Care Nursing 1972 Certified Registered Nurse Anesthetist (CRNA) 1973 Psychiatric Mental Health Nurse Practitioner 1976 Family Nurse Practitioner (will upgrade if GMO billet conversion occurs) 1980 Women s Health Nurse Practitioner No Further Need Anticipated for the Skill Set: 1901 Nursing Administration 1940 Public Health Nursing

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