Complete Story
05/11/2024
The “Invisible Corps” - Being Active Duty with the US Public Health Service
Paul Roszko, MD, FAEMS FACEP
Knowing that all active duty military physicians will eventually leave their Services, GSACEP wants to help its members understand their career options, so they can make informed decisions on how they can make a smooth transition out of the armed forces. Whether you are early in your career and plan to remain in the military for a decade or longer, or are about to leave the Service in the upcoming year, planning for this transition period is critical.
At this year’s Government Services Symposium, I had the pleasure of participating in a panel discussion on career opportunities for medical officers after they separate or retire from active duty service. The panel discussed opportunities working with the Department of Veterans Affairs, joining the National Guard, the Navy Reserves, and the United States Public Health Service (USPHS) Commissioned Corps. I talked about the USPHS and my recent experiences with completing an inter-service transfer from the US Navy, and in this article wanted to share some additional details about what it is like to be an active duty physician in the USPHS.
The USPHS is one of our country’s 8 uniformed services (Army, Marine Corps, Navy, Air Force, Space Force, Coast Guard, and NOAA round out the list) and traces its roots back to 1798 with the passage of the Act for the Relief of Sick and Disabled Seamen. Given the importance of maritime trade and commerce on the economic success and national security of a young nation, the Act provided for a way to collect monies to go into the Department of the Treasury to fund medical care for seamen and to build hospitals at ports to provide their care. In 1870, the Marine Hospital Service was created (putting the nation’s network of maritime hospitals under a single service) and established the position of a supervising surgeon, filled by Dr. John Maynard Woodworth, who was the precursor of today’s US Surgeon General. As a prior Union Army physician, Woodworth organized the Marine Hospital Service as a uniformed service, which screened for and prevented the spread of global endemic disease such as smallpox, yellow fever, and malaria. In 1889, President Grover Cleveland signed legislation formally creating the Commissioned Corps of the US Public Health Service, including establishing military pay grades and a rank structure. Today, the USPHS is 5,300 officers strong across 11 professional disciplines, with a mission to “Protect, promote, and advance the health and safety of the nation.” Within the past decade, USPHS officers have served the country by responding to numerous health emergencies, including: the Flint, MI water crisis, Hurricane Maria, COVID-19 (which included cruise ship passenger quarantine; U.S. citizen repatriation; backfilling civilian hospitals, long-term care facilities; and supporting COVID-19 testing and vaccinations); Operation Allies Welcome, and the Maui Wildfire.
The USPHS is part of the Department of Health and Human Services (HHS) under the command of the Assistant Secretary of Health (ASH), Admiral Rachel Levine, and the US Surgeon General, Vice Admiral Vivek Murthy. USPHS officers work in any number of federal agencies - a full list can be found here - and includes the numerous agencies under the Department of Health & Human Services to include the Indian Health Service, the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention among others, the US Coast Guard, the Bureau of Prisons, the Department of Veterans Affairs, the Defense Health Agency, and the National Park Service. USPHS officers, as active duty uniformed service members, enjoy many of the same benefits as their military colleagues, including:
- Active duty years toward retirement in either the High-3 (legacy) or Blended Retirement System (20-year minimum active duty years, with at least 10 years in the USPHS)
- Same military pay tables for grade and years of service
- Similar incentive pay and board-certification pay, including comparable retention bonuses up to 4-years
- Post 911 GI Bill benefits (including transfer of education benefits to family members)
- Tricare health insurance and access to healthcare at Military Treatment Facilities
- SGLI for life insurance
- Access to commissaries, MWRs, and Military Exchanges
- Qualification for most military discount benefits (e.g. free checked luggage on select airline carriers)
USPHS officers, similar to military officers, are required to maintain a basic level of readiness to deploy and respond to disasters or health emergencies that threaten the health security of the United States. This includes completing an annual periodic health update (including maintaining retention weight standards), passing an annual fitness test (with similar standards to the US Navy PFT), maintaining licensure and certification requirements, passing a Tier III background check, and staying up to date on all required vaccinations. Officers are placed on a rotating call schedule for deployments, and if deployed, can anticipate deploying for up to 4 weeks in most circumstances.
Unlike the military services, the USPHS does not employ detailers or career managers to assign their officers to billets. USPHS officers actively seek out positions with an agency and go through a hiring process before being offered a job. If accepted, the officer will receive active duty orders to that agency from USPHS headquarters, Commissioned Corps Headquarters. The officer may have a minimum time obligation to work at the agency (usually two-years) but has more flexibility than the military services if they wish to remain in their position and duty location beyond this time. Permanent Change of Station (PCS) requests are also treated differently. An officer can PCS from one agency to another without having to move geographically, which can provide greater stability to families and officers with working spouses.
For current active duty military medical officers, there are two potential paths to joining the USPHS. You could complete your service obligation and then choose to join the Commissioned Corps as a new accession. This would require an officer to meet new accession standards found here. The other option is to complete an interservice transfer from a military service, which is treated similarly to changing services from the Navy to Air Force or Army to Navy. You need to get a DD368 form signed by the losing service and gaining service (note that each military branch has its own policies and processes for completing inter-service transfers). Both of these pathways into the USPHS Commissioned Corps can take up to a year, so if you are considering an interservice transfer, be sure to start the process early so you do not have a gap in service. Applicants with greater than 8 years of active duty service will require a waiver to join the USPHS and those with over 15 years of service are ineligible to transfer.
For those who are considering if the USPHS is right for them, talk to current and former USPHS officers early and often. They can help answer questions about the application process, how to find job openings, and share what it was like to work with different agencies. Commissioned Corps officers serve in a wide range of agencies and geographic locations, and no two careers will look the same. This can be daunting for individuals who are used to being told where to go, what to do, and for how long; however, it also means USPHS officers have more control and input into what their career looks like. They can seek out billets with agencies that match their personal interests (love the great outdoors? Work as a medical director for the National Park Service! Want to do research? Work for the National Institutes of Health!) and choose where they live and for how long, all while continuing service to their country.
If any of this sounds like a career option you would be interested in and want to learn more about, please reach out and contact me! I am happy to share my experience regarding interservice transfers, finding a job, and how my time in the USPHS compares to being in the Navy. You can contact me at paul.roszko@va.gov
