Code repository for the article,

Attitudes Regarding the Position Assignment Process Among Active-Duty Navy Physicians

Richard Childers, MD¹, Joel Schofer, MD MBA, CAPT MC USN², Nanette Rollene, MD, CAPT MC USN³, Alicea Mingo, MD MPH, CDR MC USN⁴, Gary M. Vilke, MD¹, & William H. Beasley, PhD⁵

Abstract The process of assigning positions to officers in the military is complex. While general guidance is available, there is no prescribed formalized decision-making process when making assignments. We completed a survey of the Navy Medical Corps to obtain baseline perceptions about the assignment process prior to initiating a quality improvement project. On a five-point Likert scale, with 5 being the most satisfied, the mean for overall satisfaction with the assignment process for the entire cohort, weighted for specialty, was 3.4. In regression analysis, physician specialty, current billet, and rank were found to predict overall satisfaction. The highest priority positions to fill in the Navy are overseas and with operational units, yet these are the least popular among Navy physicians. This survey provides a baseline measure which can be used for comparison after future interventions and provides descriptive insight into attitudes among officers into the assignment system.

Organizations:

1. Department of Emergency Medicine, University of California, San Diego Health, San Diego, CA
2. Bureau of Medicine and Surgery, United States Navy, Falls Church, VA
3. Walter Reed National Military Medical Center, Bethesda, MD
4. Bureau of Naval Personnel, Millington, TN
5. Biomedical & Behavioral Methodology Core, University of Oklahoma College of Medicine, Oklahoma City, OK.

Figure 1

Figure 2

Correlation among Outcomes

Additional Resources

• The entire analysis report, which includes additional graphs and model diagnostics that didn't fit in the article.

• The survey questionnaire, including the responses and response rates for the following items:

  1. What is your primary specialty?
  2. What is your rank?
  3. What year did you execute orders for your current billet? (Consider retour orders the same as a PCS set of orders.)
  4. How would you describe your current billet?
  5. For your last set of orders, how many months prior to your move were your orders released? That is, how many months did you have to prepare for your PCS?
  6. On a scale of 1 to 5, with 1 being not transparent and 5 being very transparent, how would you rate the transparency of your detailing experience for your last set of orders?
  7. On a scale of 1 to 5, with 1 being unsatisfied and 5 being very satisfied, how would you rate your overall detailing experience for your last set of orders?
  8. On a scale of 1 to 5, with 1 representing a significant problem and 5 being not a problem at all, how would you rank the problem of favoritism in the billet assignment process?
  9. Describe your current assignment:
  10. Please rank your desired billet locations with the top level being the most desireable, and the bottom being the least desireable. [Ranking 1, 2, ..., 9]
  11. Which career path do you want to pursue in the next 5-10 years?
  12. Neither the Army nor the Air Force have physicians in the detailer role. Instead, they have nurses or medical administrators work with specialty leaders to determine assignments. This is different from the current Navy Medical Corps billet assignment process where the detailer is a physician*. Would you approve if the detailer position was filled by a non-physician?
  13. How long should an individual be allowed to remain at one command?
  14. Do you think that there is a problem in the Medical Corps with members not moving? That is, are there too many physicians who get to stay in one place too long?
  15. Civilian medical residency positions are assigned using the National Residency Match Program where members submit a preference list, residency directors submit a preference list, and a computer algorithm optimizes a match. This is different from the current Navy Medical Corps billet assignment process where the detailer and specialty leader take input from medical officers and then make a decision. Of these two options, which would you prefer for your military billet assignment?
  16. The later the match day, the more information one has before creating their rank list. The earlier the match day, the sooner one can have certainty and prepare. Assuming your were scheduled to execute new orders in July of 2017, what month would you want the match to occur in?
  17. Do you think members who are coming from operational or OCONUS assignments should be given preference in billet assignment?
  18. Do you think members with more seniority (as defined by time in service or rank) should be given preference in billet assignment?
  19. Any last thoughts or input regarding the billet assignment process?