. IN THE CASE OF: BOARD DATE: 24 January 2013 DOCKET NUMBER: AR20120010679 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests 2 years of additional constructive service credit for his Masters in Clinical Social Work (MSW). 2. He states: a. he was commissioned as a first lieutenant (1LT)/O-2upon his initial entry onto active duty in the U.S. Air Force (USAF) in April 1999 and he was promoted to captain (CPT)/O-3 shortly after beginning his service. b. he was granted 2 years of constructive service credit based on his MSW from Boston College in accordance with Department of Defense Instruction (DODI) 6000.13 (Medical Manpower and Personnel) and the remaining credit was for time he spent working in the field prior to his commissioning. c. he matriculated at the Uniformed Services University of the Health Sciences (USUHS) in the Summer of 2003 where he was awarded his Doctor of Medicine. He resigned his commission in the USAF and he was commissioned as a second lieutenant (2LT)/O-1 in the Army. He was assured that both his prior service as a Biomedical Sciences Corps officer in the USAF and his MSW would result in constructive service credit. He contacted the Office of the Surgeon General and he was advised to appeal the decision through the Army Board for Correction of Military Records (ABCMR). d. he was surprised to find out he and one of his colleagues, who did not have prior service, were on the same Medical Corps Major (MAJ)'s Board. His colleague was initially denied constructive service credit for his Masters of Science in Psychology, but he appealed to the ABCMR and he was granted 2 years of constructive service credit. 3. He provides: * Email correspondence * Transcript from Boston College * License in Social Work * Certification in Clinical Social Work * Diploma of Doctor of Medicine from the USUHS * License as a Physician * Appointment in the USAF * DD Form 214 (Certificate of Release or Discharge from Active Duty) * Active duty orders * Promotion orders to CPT * ABCMR Record of Proceedings of another Soldier with 7 attachments * Two letters of support * Officer Record Brief CONSIDERATION OF EVIDENCE: 1. The applicant is currently serving on active duty in the rank/grade of major (MAJ)/O-4. He is assigned to the Walter Reed National Military Medical Center. 2. The applicant was awarded an MSW from Boston College on 22 May 1995. 3. He served on active duty with the U.S. Air Force Reserve from June 1999 to June 2003. 4. He was certified in Clinical Social Work on 9 November 2001. 5. Orders a-06-392754, issued by the U.S. Total Army Personnel Command (currently known as U.S. Army Human Resources Command), dated 5 June 2003, ordered him to active duty at the USUHS with a reporting date of 11 August 2003. 6. The applicant was appointed as a U.S. Army Reserve commissioned officer on 10 June 2003 in the rank of 2LT. 7. His service record does not contain a DA Form 5074-R (Record of Award of Entry Grade Credit (Medical and Dental Officers)). 8. He was awarded a Doctor of Medicine from the USUHS on 19 May 2007 and was appointed as a CPT, Medical Corps, with a date of rank of 2 June 2005. 9. He was promoted to MAJ on 2 June 2011. 10. He provided letters of support from two Staff Psychiatrists: a. Dr. C.A.C. stated she supervised the applicant during a rotation on the Inpatient Psychiatry Service at Walter Reed Army Medical Center (WRAMC). She further stated the applicant: (1) completed his MSW prior to attending medical school and had been certified as a Licensed Independent Clinical Social Worker (LICSW) in Massachusetts. (2) worked previously as a civilian with troubled adolescents in residential treatment facilities and he had been involved in case management as well as providing several modalities of therapy. (3) also worked with offenders at the Navy brig at Miramar. b. Dr. R.M.P., Jr. stated he supervised the applicant during two rotations with the Psychiatry Consult Liaison Service at WRAMC and he had been the applicant's instructor as part of the formal didactic training for his residency. Dr. R.M.P. reiterated the applicant's work history as a Social Worker. His observation is that the applicant's previous training and experiences have allowed him to step into many aspects of his role as a Psychiatry Resident faster than other incoming residents he has worked with on the Psychiatry Consult Liaison Service. 11. In the processing of this case, on 29 August 2012, an advisory opinion was obtained from the Program Manager, Graduate Medical Education, Office of the Surgeon General. The advisory official stated: a. the applicant was originally selected for and completed a PGY1 (Post Graduate Year One) in Family Medicine from 1 July 2007 to 30 June 2008. At that time his degree and prior service were reviewed for constructive service credit. b. it was determined that the applicant would be given credit for his prior service; however, he would not receive credit for the Master's degree because per DODI 6000.13, paragraph 6.1.2.2.3, "The additional degree must add adjunctive skills to the primary specialty and must contribute directly to performance in the anticipated position in the Military Service concerned." The Social Work degree did not add adjunctive skills to his specialty of Family Medicine. c. the applicant subsequently applied for and he was selected for a residency in Psychiatry and began training in July 2010. However, constructive service credit is only reviewed upon entry on to active duty and it was not reviewed again. d. the applicant referenced a colleague who received constructive service credit for his Master's degree in Psychology. This colleague began his residency in Psychiatry at the PGY 1 level upon coming on active duty. At that time, the reviewer determined the Psychology degree was relevant to the specialty of Psychiatry and granted credit. e. the applicant was not chosen ahead of his peers for the Child/Adolescent Fellowship as he stated. The Army provides a track for all general Psychiatry residents to apply for and be selected for this track where they begin the Child/Adolescent fellowship while completing their 4th year of General Psychiatry residency. f. this office recommended denial of the applicant's request to grant additional constructive service credit for his MSW. 12. A copy of the advisory opinion was forwarded to the applicant for information and to allow him the opportunity to submit comments or a rebuttal. On 26 September 2012, the applicant submitted a rebuttal to the advisory opinion with a letter of support and a Mental Health Care Services by Family Physicians Position Paper. (He indicated he provided a letter from Dr. S.A.; however, this letter is not available for review). a. He contends the statement from Ms. R. in her opinion that the "Social Work degree did not add adjunctive skills to his specialty of Family Medicine…" represented an antiquated perspective that was not supported by professional guidelines or by currently practicing Family Medicine physicians. b. He referenced the AAFP (American Association of Family Practitioners) Mental Health Position Paper that states the comfort of diagnosing and treating mental health issues is an essential skill for a Family Physician. Throughout his medical school clerkships and Family Medicine Internship it was stressed that a huge portion of the patient problems seen in primary care settings are caused or exacerbated by psychosocial factors. c. He quotes statements made by Dr. B.K.U. and Dr. S.A. d. He states his personal experience during his time as a Battalion Flight Surgeon during the 2 years after his Family Medicine internship also supports this position. He believes it is quite evident his degree both adds adjunctive skills and contributes directly to performance as required by DODI 6000.13 in order for constructive service credit to be awarded. 13. He also provided a letter of support from Dr. B.K.U., Colonel, Medical Corps, U.S. Army, Associate Professor of Family Medicine. Dr. B.K.U. stated he has been a family medicine educator for the past 21 years, served as faculty at five residency programs, and served as residency director at two programs from 1995 to 2002. He is an associate professor of Family Medicine and Geriatrics at the USUHS. He stated: a. the applicant was a graduate of the USUHS and he became acquainted with the applicant when he was applying for Family Medicine Residency training. b. Behavioral Health Specialists are required to be faculty for Family Medicine residency programs to instruct and consult with other clinicians to meet the behavioral health needs of patients, trainees, and fellow faculty. c. Military Family Medicine is moving towards embedding mental health providers within primary care clinics. These providers provide immediate consultation and care, often in moments of crisis. Behavioral health providers also train physicians on how to meet the uncomplicated mental health needs of their patients. Individuals who possess the applicant's training are instrumental for the military to deliver world class health care. 14. Army Regulation 135-101 (Appointment of Reserve Commissioned Officers for Assignment to Army Medical Department Branches) prescribes policy, procedures and eligibility criteria for appointment in the Reserve Components of the Army in the six branches of the Army Medical Department. Table 3-1, paragraph 6, states that additional credit may be granted in unusual cases based on special education or professional experience in the specialty in which assigned when experience is accrued after qualifying degree and licensure, if applicable. Unusual case determination will be made by The Surgeon General or designee. 15. DODI 6000.13 is the governing directive in granting constructive service credit. a. Paragraph 6.1.2. states that constructive service credit provides a person who begins commissioned service after obtaining the additional education, training, or experience required for appointment, designation, or assignment as an officer in a health profession, with a grade and date of rank comparable to that attained by officers who begin commissioned service after getting a baccalaureate degree and serve for the period of time it would take to obtain the additional education. b. Paragraph 6.1.2.2.2. states credit for master's and doctorate degrees in a health profession other than medicine and dentistry, whether it is the primary degree or an additional advanced degree, shall be awarded based on actual full-time equivalent education up to 2 years for a master's degree and up to 4 years for a doctorate. c. Paragraph 6.1.2.2.3. states that the additional degree must add adjunctive skills to the primary specialty and must contribute directly to performance in the anticipated position in the Military Service concerned. DISCUSSION AND CONCLUSIONS: 1. The applicant's contentions regarding his entitlement to 2 years of constructive service credit have been considered. However, his service record does not indicate an error or injustice exists in this case. 2. The evidence of record shows the applicant was awarded an MSW on 22 May 1995. 3. The applicant was appointed in the U.S. Army Reserve on 10 June 2003 in the rank of 2LT. 4. The advisory opinion indicates he was granted 2 years constructive service credit for his prior service in Family Medicine; however, he was not granted any constructive service credit for his MSW. 5. Based on paragraph 6.1.2.2.3 of DODI 6000.13, the additional degree must add adjunctive skills to the primary specialty and must contribute directly to performance in the anticipated position in the Military Service concerned. His MSW did not meet this requirement; therefore, he is not eligible for additional credit for this master’s degree. There is a reluctance for the Board to substitute its judgment for The Surgeon General, who is responsible for managing the officers of the Army Medical Department. 6. The applicant contends the ABCMR has granted relief to one of his colleagues who was awarded additional constructive service credit for a Master of Science Degree in Psychology. In that case, that officer began his residency in Psychiatry upon coming active duty. The applicant began his residence as a Family Medicine officer. The ABCMR reviews each case individually and it is presented before the Board based on its own merit and evidence. There are no cases that set the standards on how the Board should always vote. 7. There is no apparent error or injustice that exists in this case regarding the applicant’s current DOR to 2LT or constructive service credit awarded to him. 8. In view of the foregoing, there is an insufficient evidentiary basis for granting the applicant's requested relief. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ___X___ ___X____ ___X____ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ___________X____________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ABCMR Record of Proceedings (cont) AR20120010679 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20120010679 7 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1