Promotion 2005: Physicians’ Benchmarks and Proposed Revisions Physicians’ Professional Advisory Committee (PPAC) Promotion Benchmarks Committee, Nov 2004 v.7May05 Prepared by CDR Jeffrey Kopp, MD

PPAC Benchmarks Subcomittee 2004 CAPT Sarah Linde-Feucht, FDA and CDR Jeffrey Kopp, NIH, Co-Chairs CDR Mike Boquard, USCGCDR Naryan Nair, FDA CAPT Lynn Bosco, AHRRCAPT Richard Niska, CDC CDR Michael Carome, OSOPHS LCDR Rochelle Nolte, USCG Christine Casey, FDACDR Monica Parise, CDC CDR David Frucht, FDACDR Andrew Pelletier, Maine Health Dept CAPT Sharon Ludwig, USCGCAPT Nancy Rosenstein, CDC CAPT Susan Molchan, NIHCAPT Steven Rosenthal, FDA CAPT Vern Maas, HRSACDR Ann Schwarz, FDA CDR Robert Miller, USCG

Background  Promotion precepts 2 and 3 are prepared by PPAC  Precepts 1 and 4 are prepared by the Chief Professional Officer/PAC Chair committee (CPO committee)  Precept 5 (Readiness) is prepared by Office of Force Readiness and Deployment  Each precept contains multiple factors (elements)  Benchmark revision process - prepared by PPAC subcommittee - approved by full PPAC - approved by the CPO committee - approved by Asst Sec Health (pending) in consultation with Surgeon General

#PreceptWeight 1Performance40% 2Education, training, and professional development 15% 3Career progression and potential25% 4Professional contributions and service to PHS 15% 5Response readiness5% 100% Note: relative weights are determined by CPO committee and are identical across categories

Performance (Precept 1) FactorO4O5O6 COER,attachments (past 3 yr) Primary focus on narrative CC Honor awardsContinuum of awards at the Achievement medal level and below Continuum of awards at the Commendation medal level and below Continuum of awards at the Outstanding Service medal level and below Non-corps awardsValue added Reviewing official’s assessment 1. Promotion readinessYes 2. LeadershipContributes as a member of a formal task force at branch or higher level Contributes as a member of a formal task force at division or higher level Leadership role in a formal task force at the agency or higher level 3. Mission contributionAssignedSeeks outside activities that contribute to mission Career (duties and outside activities) contribute to mission IntegrityUnquestioned

Education, training, and development (Precept 2) FactorO4O5O6 DegreesMD or DO Certification/ Credentials Board eligibleBoard eligible or board certified Board certified LicensureCompliant CME≥50 hrs/licensing interval, if required by state Public Health Training/Experience Additional coursework in public health and emergency preparedness; CCRF modules; other training related to agency mission Completion of CCRF modules; work experience on a leading public health initiative Completion of CCRF modules; leadership role and work experience on a leading public health initiative

Career progression and potential (Precept 3) FactorO4O5O6 BilletO3 or aboveO4 or aboveO5 or above AssignmentsPotential for increasing levels of responsibility; emerging leadership potential. Increasing level of independence, responsibility, and accountability Full level of independence, responsibility, and accountability Mobility≥1 geographic or programmatic move ≥2 geographic or programmatic moves ≥3 geographic or programmatic moves; may consider fewer moves for a generalist AssimilationNot requiredValue added Collateral duties: Agency mission related duties that are not in billet Local, expected; service as team member Regional, national; service as team leader National, service as team leader, creator of activity

Characteristics and Service to Corps (Precept 4) FactorO4O5O6 PAC/Advisory groupsVolunteer or elected member Elected member, chair task force or subcommittee Elected member, Chair or Vice-Chair Associate RecruiterYes MentoringValue addedLeadership, recognition BOTC/IOTCYesWith ribbon Professional organizationsMemberCommittee or subcommittee service Chair or Vice-Chair or other leadership or board member Service awards: NEPA, Crisis Resp, Spec Assign, Isolated Hardship, Hazard Duty, Foreign Duty ≥1≥2≥3 Daily wear of uniformYes Other PHS activities: Honor Guard, Color Guard, PHS Ensemble, Aide-de-Camp Yes

Precepts 5 and 6  Readiness (precept 5), PY 2005: Details pending from OCCFM  Assignment (precept 6), PY 2006: Recognizes and rewards isolated/hardship positions and similar positions, details pending from OCCFM

Proposed revisions to Physicians’ benchmarks  Revised cover letter and revised benchmarks (presented on the following 14 slides) were generated by PPAC Benchmarks subcommittee  Approved by the full PPAC Nov 2004  Submitted to the CPO committee Nov 2004  Response was that changes for the category- specific precepts 2 and 3 were likely to approved for PY05  As of May 2005, the PHS website provides only the PY04 Benchmarks

Cover letter: comments proposed by the PPAC for the PY05 benchmarks  Four factors are denoted “required’: promotion readiness, integrity/duty, professional degree, state medical licensure  For all other factors, the descriptions of activities are examples of excellence and are not to be construed as requirements

 The promotion board may identify similar activities that completely fulfill a given factor  The promotion board may deem other activities to be lesser in quality or quantity and to constitute partial fulfillment of the factor  The term value added should be dropped, since all but the required factors may be partially or completely fulfilled (partial fulfillment resulting in reduced precept score) Cover letter: comments proposed by the PPAC for the PY05 benchmarks

 The relative weighting among the factors in determining the score for a precept is left to the discretion of the promotion board  There is no time limit on performance of activities that fulfill a factor (e.g. activities from 5, 10, or 15 years ago are eligible for consideration) Cover letter: comments proposed by the PPAC for the PY05 benchmarks

The promotion board is urged to consider  Existence of diverse career tracks, including clinicians, epidemiologists, researchers, regulatory officers, policy makers, and administrators  Individuals in different career tracks will achieve excellence in different ways Cover letter: comments proposed by the PPAC for the PY05 benchmarks

The promotion board is urged to consider conflicting goals inherent in the promotion process  Promote diversity of achievement : PHS needs individuals with diverse education, training, skills, and achievement and PHS needs to elicit excellence from officers in diverse ways  Ensure equality of opportunity: achieving the highest level of performance for some factors may be a challenge for officers who face limitations due to agency mission or geographic location The promotion board is asked to take into account the officers’ assignments, past and present Cover letter: comments proposed by the PPAC for the PY05 benchmarks

Performance (Precept 1): Proposed FactorO4O5O6 COER,attachments (past 3 yr) Primary focus on narrative CC Honor awardsAchievement medal and below Assessed qualitatively and not quantitatively to equalize inter-agency differences Commendation medal and below Assessed qualitatively and not quantitatively to equalize inter- agency differences Outstanding Service medal and below Assessed qualitatively and not quantitatively to equalize inter-agency differences Non-corps awardsDivision, Institute, and Agency awards and professional organization awards and recognition such as letters of appreciation

Performance (Precept 1): Proposed FactorO4O5O6 Reviewing official’s assessment 1. Promotion readiness Yes 2. LeadershipContributes A) As a member of a task force or similar group at the Branch, Institute, Division, Agency, or CC level or local, regional, national, or international level AND/OR B) Through publications or other written communication Contributes and exhibits leadership A) As a member of a task force or similar group at the Branch, Institute, Division, Agency, or CC level or local, regional, national, or international level AND/OR B) Through publications or other written communication Leads A) As a member of a task force or similar group at the Branch, Institute, Division, Agency, or CC level or local, regional, national, or international level AND/OR B) Through publications or other written communication

Performance (Precept 1): Proposed FactorO4O5O6 Reviewing official’s assessment 3. Mission contributionPerforms duties assigned by supervisor Performs duties assigned by supervisor; seeks outside activities that contribute to PHS mission Compelling evidence that career duties and outside activities have contributed and will contribute to PHS mission IntegrityUnquestioned

Education, training, and development (Precept 2): Proposed FactorO4O5O6 DegreesMD or DO Certification/ Credentials Board eligibleBoard eligible or board certified Board certified LicensureCurrent CMEAs required by State Licensure Board (annual summary of CME for most recent 3 yr) OR Officer provides letter in OPF stating CME not required for licensure Note: consideration is being given to requiring CME 25 hr/yr, so officers should plan accordingly As O4

Education, training, and development (Precept 2): Proposed FactorO4O5O6 Public Health Training/Experience Additional coursework in public health, emergency preparedness, and other training related to agency mission. This might include bioethics, epidemiology, public health policy, research, and regulatory affairs. As O4 Work experience or committee service on a local, regional, national, or international public health activity or initiative As O4 Leadership role on a a local, regional, national, or international public health activity or initiative Additional degreesMPH, MHSc, PhD or other degree relevant to agency mission As O4

Career progression and potential (Precept 3): Proposed FactorO4O5O6 BilletO3 or aboveO4 or aboveO5 or above AssignmentsPotential for increasing levels of responsibility: emerging leadership potential. Increasing level of independence, responsibility, and accountability MobilityGeneralist track: 1 geographic or programmatic move Specialist track: increasing responsibility and leadership Generalist track: ≥2 geographic or programmatic moves Specialist track: increasing responsibility and leadership Generalist track: ≥3 geographic or programmatic move Specialist track: increasing responsibility and leadership

Career progression and potential (Precept 3): Proposed FactorO4O5O6 AssimilationIf eligibleYes Collateral dutiesMission related duties that are not included in the billet description. Involvement is local and as a team member Mission related duties that are not included in the billet description Involvement is regional or national and officer serves in a leadership role Mission related duties that are not included in the billet description Involvement is regional or national and officer serves in a leadership role Officer has initiated the activity.

Characteristics and Service to Corps (Precept 4): Proposed FactorO4O5O6 Daily wear of uniform Yes BOTC/IOTCYes OR PHS Orientation course prior to BOTC PAC/Advisory groups Volunteer or elected member Volunteer or elected member who demonstrates leadership as Chair or Vice-Chair or leads committees or subcommittees. Associate RecruiterYes MentoringInformal mentoring Informal mentoring. Serves as mentoring contact within Division or Agency. Informal mentoring. Serves as mentoring contact within Division or Agency.

Characteristics and Service to Corps (Precept 4): Proposed FactorO4O5O6 PHS service awardsYes Other CC activitiesHonor Guard, Color Guard, PHS Ensemble, Aide-de- Camp, appointment boards, assimilation boards, DMAT As O4 Professional organizations - Medical and specialty organizations, at the regional, national, and international levels (to promote visibility as PHS officer) - COA MemberMember of committee or subcommittee Chair or other leadership role on governing board or on committees or with local chapter

Some issues for discussion  Can leadership be demonstrated only by committee service or can it be demonstrated also by written communications?  Should CME be required for all officers, even if their state (e.g. New York) does not require it for licensure? What should the minimum number of hours be? How many years of documentation should be required? When can we reasonably impose a new requirement that requires documentation of past CME?  Should there be formal tracks within the physician category? How might they be structured? - Clinician, researcher, regulator, manager - Generalist, specialist  Should BOTC/IOTC be the only orientation course fulfilling the factor or should prior PHS orientation courses be acceptable?

More information PPAC home page  2004 Benchmarks  Draft of PPAC proposal for 2005 benchmarks  Tips for success with promotion boards  Preparation of CV and sample CV from promoted officers Comments on benchmarks should be addressed to LCDR Rochelle Nolte -

Jefferson Memorial – at Dusk