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DEPARTMENT OF THE NAVY COMMANDER NAVAL SURFACE RESERVE FORCE 4400 DAUPHINE STREET NEW ORLEANS, LOUISIANA 70146-5100 COMNAVSURFRESFORINST 1570.4B N9 COMNAVSURFRESFOR INSTRUCTION 1570.4B Subj: PHYSICIAN RESERVIST IN MEDICAL UNIVERSITIES AND SCHOOLS (PRIMUS) PROGRAM Ref: Encl: (a) (b) (c) (d) (e) (f) (g) (h) (i) (1) COMNAVRESFORINST 1570.13A COMNAVRESFORINST 1001.5C BUPERSINST 1001.39C OPNAVINST 6110.1E NAVMED P-117 (Manual of the Medical Department) COMNAVRESFORINST 1571.17D BUMEDINST 6320.66B BUPERSINST 1610.10 BUMEDINST 6230.15 PRIMUS Description and Administrative Procedures 1. Purpose. To issue policy and procedures for the administration of the PRIMUS Program available to medical department personnel throughout the Naval Reserve per reference (a). This instruction has major revisions and should be read in its entirety. 2. Cancellation. COMNAVSURFRESFORINST 1570.4A 3. Action a. Commander, Naval Surface Reserve Force (COMNAVSURFRESFOR) is responsible for administrative oversight of the PRIMUS Detachments (DETs) assigned to the respective programs. Enclosure (1) of this instruction provides specific descriptions and administrative procedures for the program. b. Naval Reserve Readiness Commands (NAVRESREDCOMs) and Naval Reserve Fleet Hospitals (NRFHs) will: (1) Perform duties described in this instruction. (2) Conduct PRIMUS DET audits during the triennial command inspection. Review eligibility, assignment and participation requirements, and IDT administration and accounting procedures under the provisions of this instruction. (3) Assign personnel no longer meeting the eligibility requirements to the appropriate program within the Naval Reserve Readiness Commands (NAVRESREDCOMs ). (e.g., If the member was in a NRFH PRIMUS DET, then that individual would be moved to a regular Fleet Hospital (FLTHOSP DET).) c. Supporting Naval Reserve Centers (RESCEN) Commanding Officers (CO) will: (1) Perform duties per this instruction.

(2) Provide administrative support to the PRIMUS DETs, and ensure compliance with all guidance contained within this instruction and references (a) through (i). (3) Approve PRIMUS DET Officer in Charge (OIC) IDT schedule. d. PRIMUS Det OICs will: (1) Verify/authorize Inactive Duty Training (IDTs) for the personnel assigned to their DET. (2) Verify/approve Annual Training (AT) Active Duty Training (ADT) applications for personnel assigned to their DET. (3) Verify eligibility of unit participants annually. (4) Submit officer fitness reports on members assigned to their DET per reference (h). 4. Forms a. The following forms are used in this program and are available upon request from your local NAVRESREDCOM. (1) Individual Monthly Drill Performance Report (NAVRES 1570/16). (2) Request for Approval of CME or other Activity as Drill Credit (NAVRES 1570/19). b. The Naval Reserve Qualification Questionnaire For Inactive Duty Personnel (NRPC 1200/1) is mailed annually from the Naval Reserve Personnel Center to individuals. If not received contact the Naval Reserve Personnel Center (N5), 4400 Dauphine Street, New Orleans, LA 70149-7800 for a replacement copy. Distribution: (COMNAVRESFORINST 5218.2B) List A (A3 (N095, N093, N1R), FH1 (BUMED) (MED-07) (3 copies) only) B1 (23C ((N01M) (3 copies)), 26B3, 42RR, FR21 only) B2 (FR9, FR10 (3 copies), FR23 only) E6 (FJB1 only) E9 (24J4, 46B only) Copy to: (COMNAVRESFORINST 5218.2B) List E5 (FA47, FA49, FB58, FB60, FF72, FT108, FW1, FW3 only) SNDL: FH36 (Jacksonville, Norfolk, San Diego) FW4 (Quantico) Stocked by: COMNAVRESFOR (N01A) 2

PRIMUS DESCRIPTION AND ADMINISTRATIVE PROCEDURES 1. Eligibility. officer who will participation is a. Medical, recipients. A PRIMUS participant is a Naval Reserve medical department fill a manpower requirement upon mobilization. PRIMUS limited to: Nurse, and Medical Service Corps Assistant stipend b. Medical, Dental, Nurse, and Medical Service Corps officers in post graduate level training for any of the following Department of Defense (DoD) Reserve Component wartime specialties with critical shortages (subspecialty/navy Occupational Billet Code(NOBC)): General Surgeon (0214) Emergency Medicine (0109) Thoracic Surgeon (0264) Oral Surgeon (0550) Urology (0269) Physician Assistant (0113) Diagnostic Radiology (0131) Critical Care Nurse (0904) Internal Medicine (0101) Family Physician (0108) c. Medical department officers holding critical wartime specialties as defined above and currently employed as full time faculty (receiving primary income) in their primary critical wartime specialty at an accredited medical/dental/nursing school or an affiliated teaching hospital. 2. Assignment a. Each PRIMUS participant will: (1) Request assignment using the letter format in appendix 1 of this enclosure. (2) Validate participation eligibility annually by Administrative Remarks (NAVPERS 1070/613) entry, appendix 2 of this enclosure. b. Medical department officers who are assigned to a structured unit and enter into a university or school in training for a qualifying critical wartime specialty may request transfer to a PRIMUS DET. c. The PRIMUS DET OIC billet will be coded to permit assignment of any medical department officer (i.e., 2XXX). This position will be filled by national board action. This officer is not considered a PRIMUS participant and is not subject to the IDT accounting of this instruction. IDT participation of the incumbent is in direct support of the PRIMUS unit and all participants assigned. IDT will be performed at the Naval Reserve Activity (NRA) or at a location approved by the NRA CO. Support performed at a private residence does not count as IDT. d. NAVRESREDCOMs will assign PRIMUS participants to either Programs 32 or 46 wartime critical NOBC mobilization billets. e. Initial assignment of qualified PRIMUS participants may be to a PRIMUS DET In Assignment Processing (IAP) awaiting a billet. f. Personnel in primary training/residency for a critical wartime NOBC will only be assigned to Program 32 units. Enclosure (1)

g. NOBCs. NAVRESREDCOMs must ensure that all NOBCs are accurately reflected in the Inactive Manpower and Personnel Management Information System (IMAPMIS). Changes in NOBC prioritization should be requested through NRPC (N-512). (1) Physicians in training for a specialty will be assigned a primary NOBC 0106. The secondary NOBC will be the critical wartime specialty for which they are in training (i.e., 0106/0131). (2) When training/residency is complete primary NOBC will be changed to appropriate NOBC. (3) Individuals already having NOBCs will have that NOBC listed primary with the secondary being the one in training. h. PRIMUS DET OICs and NAVRESREDCOMs will monitor participants closely to ensure compliance with proper billet assignments and ensure NOBC requests are submitted per reference (c). 3. Participation a. Minimum participation requirements for PRIMUS are described below. Participants failing to meet these minimum requirements will be transferred to the Individual Ready Reserve (IRR) per reference (b). Members receiving a stipend must meet the requirements of their stipend agreement in addition to those listed below: (1) Participate in and pass the semiannual physical readiness test per reference (d). (2) Participate in random drug urinalysis screening program (if on board a Naval Facility while testing is performed). (3) Complete/update Naval Reserve Qualification Questionnaire for Inactive Duty Personnel (NRPC 1200/1), as required. (4) Health care providers must follow credentialing and privileging requirements of reference (h). (5) Accrue a minimum of 50 retirement points per anniversary year. (6) Obtain current, complete physical examination or annual certification of health status per chapter 15 of reference (e) and obtain required immunizations per reference (i). (7) Complete and submit travel claim reimbursement forms within 10 days of completion. (8) Complete Individual Training Plan (ITP) requirements within the specified time period. (9) Perform AT. Residents and full time students are exempt from the requirement to perform AT. Waiver requests must be submitted per reference (c). New officer affiliates with no prior service will attend the Officer Indoctrination School (OIS) as their first AT. (10) Conform to grooming standards and uniform regulations. (11) Complete service record review as required. Enclosure (1) 2

frame. (12) Respond to all official correspondence within the specified time (13) Members who have received stipend cannot be transferred to the IRR unless one of the two options has been fulfilled: (a) Agree to recall to active duty subsequent to having received stipend benefits. for the time period incurred benefits. (b) Executed a financial agreement for recoupment of stipend 4. IDT Administration a. The PRIMUS program permits 100 percent flexibility in performance of reqular IDT periods. Although each IDT period for pay must total at least four hours of activity, PRIMUS participants may accrue the four hours incrementally on an hour-by-hour basis during one or more days. IDT increments of less than one hour are not creditable. No more than two IDT periods can be performed on one day. b. IDT is authorized at: (1) The assigned mobilization site. (2) Any federal Medical Treatment Facility (MTF)/Dental Treatment Facility (DTF) for the purpose of peacetime contributory support. A memorandum of understanding should-be in place at non-naval MTF/DTFs. (3) to support Any NRA for medical/dental support. All health care providers are health of the force issues such as physical exams. (4) Private residences will not be used as an IDT activity. c. IDT is authorized to include the activities listed below: (1) Attendance at courses in military medicine. (2) Unit administration. Periodic PRIMUS DET meetings. (3) Attendance at civilian Continuing Medical Education (CME) programs professional meetings/seminars, such as medical symposia, workshops, forums, specialty scientific sessions, in-service educational programs, which contribute to mobilization readiness. Continuing education units must be awarded to qualify. (4) Students/residents participating in grand rounds, pre-grand round conferences, patient care conferences or other formal educational conferences and rounds centered on patient care. (5) Graduate level educational courses, which contribute to the clinical/operational enhancement of the medical department, staff member. d. Training via video tapes and satellite link/satellite teleconferences are acceptable for IDT credit provided these activities are part of the overall organized educational program for the member and are held at and monitored by a hospital, medical school, military authority or other educational organization. Individual or unmonitored self-study activities at home or any other location are NOT creditable or authorized. 3 Enclosure (1)

e. PRIMUS participants can complete any of the approved IDT options listed in paragraph (4c) for pay or non-pay and retirement points or for Active Duty Training (ADT) CME credit with or without funding, but NOT for both. Guidelines for requesting ADT for CME are in reference (h). f. Activities not approved for IDT credit include: (1) Hospital medical staff or general staff meetings. (2) Medical society or society committee meetings. (3) Specialty society non-medical/non-scientific sessions. (4) Journal club meetings or reading study groups. (5) Home study courses whether or not approved for CME credit. (6) Courses for which academic credit is awarded. (7) Serving as an instructor for any course. (8) Faculty conducting grand rounds, pre-grand round conferences, patient care conferences or other formal educational conferences in which compensation is already being received. 5. IDT Accounting a. Any specific activity for which PRIMUS participants seek to earn IDT credit or retirement points MUST BE APPROVED IN ADVANCE by the PRIMUS DET OIC. PRIMUS participants will complete the Request for Approval of CME Activity as Drill Credit (NAVRES 1570/19), for approval of recurring or nonrecurring activities, whether CME, contributory support, or other activity. Once approval is obtained for a specific recurring activity, prior approval need not be requested for that same activity again. Requests for approval for nonrecurring activities such as CME courses, symposia, seminars, workshops, or any other activity covering one or more days should be accompanied by an agenda of the sessions. The OIC may approve all or a portion of the hours requested, based on analysis of whether the experience is appropriate for IDT credit. The OIC will sign the form indicating approval or disapproval, retain the signed form, and return a signed copy to the member. b. Completed IDT activity will be reported by the PRIMUS participant on an hour-by hour basis on the Individual Monthly Drill Performance Report form (NAVRES 1570/16). The OIC will review the submitted NAVRES 1570/16 before submission to the NAVRESCEN for processing. IDT performance documentation must be submitted within 30 days of performance to ensure prompt payment of completed IDT periods. A copy of the completed NAVRES 1570/16 and original NAVRES 1570/19 will be retained by the OIC for the establishment of an audit trail. A second copy of the completed NAVRES 1570/16 will be returned to the PRIMUS member. PRIMUS participants are required to submit a 1570/16 for any month having no creditable IDT activity. The form will be annotated, no IDT periods for the month of and will be signed by the member. The 1570/16 should be submitted to and received by the unit/det OIC within 30 days of the IDT periods completed. Enclosure (1) 4

APPENDIX 1 SAMPLE PRIMUS ASSIGNMENT LETTER Date From: Individual requesting assignment to a PRIMUS Detachment To: Commander, Naval Reserve Readiness Command Region Via: (1) Officer In Charge, Naval Reserve PRIMUS Detachment (2) Commanding Officer, Naval Reserve Center Subj: PHYSICIAN RESERVIST IN MEDICAL UNIVERSITIES AND SCHOOLS AFFILIATION/ASSIGNMENT IN CASE OF (RANK/RATE, NAME, CORPS, USNR, SOCIAL SECURITY NUMBER (SSN), DESIGNATOR) Ref: (a) COMNAVSURFRESFORINST 1570.4B 1. Per reference (a), I request assignment to PRIMUS Unit based on the following qualifying criteria. a. Residency/Student or Faculty Status: b. Name of School or University: c. Course of study (specialty), duration, expected graduation: d. Residential address, phone number: e. Designator: f. Navy Officer Billet Classification (NOBC): 2. I have read reference (a) and understand all requirements of the program. Signature FOR OFFICIAL USE ONLY PRIVACY ACT PROTECTED A1-1 Appendix 1 to Enclosure (1)

FIRST ENDORSEMENT From: Officer In Charge, Naval Reserve PRIMUS Detachment To: Commander, Naval Reserve Readiness Command Region Via: Commanding Officer, Naval Reserve Center Subj: PHYSICIAN RESERVIST IN MEDICAL UNIVERSITIES AND SCHOOLS AFFILIATION/ASSIGNMENT IN CASE OF (RANK/RATE, NAME, CORPS, USNR, SSN, DESIGNATOR) 1. Forwarded recommending approval. (Rank/Rate, Name) request has been reviewed and he/she meets all eligibility requirements of the program. 2. I accept responsibility for approval of Inactive Duty Training credit for subject member per reference (a). Signature FOR OFFICIAL USE ONLY - PRIVACY ACT PROTECTED Appendix (1) A1-2 to Enclosure (1)

SECOND ENDORSEMENT From: Commanding Officer, Naval Reserve Center To: Commander, Naval Reserve Readiness Command Region Subj: PHYSICIAN RESERVIST IN MEDICAL UNIVERSITIES AND SCHOOLS AFFILIATION/ASSIGNMENT IN CASE OF (RANK/RATE, NAME, CORPS, USNR, SSN, DESIGNATOR) 1. Forwarded, recommending approval/disapproval. Signature FOR OFFICIAL USE ONLY - PRIVACY ACT PROTECTED Appendix 1 A1-3 to Enclosure (1)

APPENDIX 2 SAMPLE - CERTIFICATION STATEMENT (Date) Ref: : (a) COMNAVSURFRESFORINST 1570.4B PRIMUS PROGRAM 1. I certify that I meet the PRIMUS eligibility requirements to participate per reference (a) based on one of the following criteria: I am a (circle one) stipend recipient. Medical Corps/Nurse Corps/Physician Assistant I am a (circle one) Medical/Dental Oral Surgeon/Nurse Corps (circle one) resident/student in the following critical wartime specialty as specified in enclosure (1) to reference (a): Critical wartime healthcare specialty: I am a medical department officer holding a critical healthcare specialty as specified in reference (a) and I am currently employed full time in this primary critical wartime healthcare specialty at an accredited medical/dental/nursing school or affiliated teaching hospital: Critical wartime healthcare specialty: School or teaching hospital: 2. Documentation necessary to verify above information is attached. 3. I further understand that any change in my eligibility status will be reported to my Detachment Officer In Charge. Signature of Member Unit Commanding Officer/OIC A2 Appendix 2 to Enclosure (1)