IN THE CASE OF: BOARD DATE: 20 November 2012 DOCKET NUMBER: AR20120014966 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 he be given constructive service credit (CSC) for his master's degree in physical therapy vice the prior service credit he received. 2. The applicant states: a. He had asked for the prior commissioned service credit he accrued during his time at physical therapy school. He now wants that dropped and asks that the time be counted as CSC instead. This would prevent his time from counting twice and give him 1 for 1 [credit] as opposed to 1/2 to 1. It would contribute an additional 9 months and 8 days toward his date of rank (DOR). A second option would be to excuse the time he was in physical therapy school and add 2 years of CSC for his master of physical therapy degree. b. His total time at physical therapy school was 1 year, 6 months, and 17 days, well below the maximum of 2 years for a master's degree. He is not asking for any CSC for his additional doctorate degree in physical therapy because this school was started and completed during his medical school. He is currently an orthopedic surgery resident at San Antonio Military Medical Center (SAMMC), Fort Sam Houston, TX. He uses his physical therapy education every day and is frequently asked to instruct patients in physical therapy principles since access to the physical therapy clinic may take weeks. c. Less than 5 percent of all physical therapists in the U.S. are credentialed as an orthopaedic certified specialist as he is. He obtained this credential during his time as an Army physical therapist. This further illustrates his physical therapy experience was based in orthopaedics and is directly beneficial to his patient population 3. The applicant provides: * DD Form 214 (Certificate of Release or Discharge from Active Duty) * DA Form 5074-R (Record of Award of Entry Grade Credit (Medical and Dental Officers)) * DA Form 71 (Oath of Office - Military Personnel), dated 3 August 2006 * a college transcript, issued 29 July 2009 * four certificates * two orders, dated 8 April 2010 and 18 June 2010 * a printout titled Medical Operational Data System (MODS), dated 8 September 2010 * a letter, dated 20 September 2010 * two statements of support CONSIDERATION OF EVIDENCE: 1. The applicant's records show he was awarded a Bachelor of Science degree from The Citadel, Charleston, SC, on 13 May 2000. His major field of study was biology. 2. Having had prior enlisted Reserve service, he was appointed as a second lieutenant (2LT) Reserve officer and executed an oath of office on 13 May 2000. He entered active duty on 9 September 2000. 3. He attended and successfully completed the Army Medical Department (AMEDD) Officer Basic Course from 25 September to 26 November 2000 at the Academy of Health Sciences, Fort Sam Houston, TX, and he was awarded specialty 65B (Physical Therapist). 4. He attended and successfully completed the Baylor University Graduate Program in Physical Therapy from 27 November 2000 to 12 June 2002 at the Academy of Health Sciences, Fort Sam Houston, TX. He was awarded a Master of Physical Therapy on 12 June 2002 from Baylor University. 5. He attained the rank of CPT in the Regular Army on 1 February 2004. 6. He was honorably discharged on 2 August 2006. The DD Form 214 he was issued shows he completed 5 years, 10 months, and 24 days of net active service during this period of service. 7. He was appointed as a 2LT Medical Services Corps Regular Army officer and executed an oath of office on 3 August 2006 with a concurrent call to active duty. 8. He was assigned as a medical student to the Uniformed Services University of Health Services, School of Medicine, Bethesda, MD, from 7 August 2006 to 15 May 2010. He was awarded a Doctor of Physical Therapy degree from Baylor University on 17 May 2008. He was awarded a Doctor of Medicine degree from the Uniformed Services University on 15 May 2010. 9. A DA Form 5074-R, dated 15 March 2010, shows he was appointed as an Army Medical Corps (MC) doctor in the specialty of orthopaedics and was granted 4 years of CSC for his medical degree and 2 years, 11 months, and 12 days of CSC for his Army service from 9 September 2000 to 2 August 2006. This form also shows he was not granted CSC for his Master of Physical Therapy or Doctor of Physical Therapy degrees. 10. On 18 June 2010, he was promoted to the rank of CPT, MC, with a DOR of 27 June 2007. 11. On 20 September 2010, he was selected for Army Graduate Medical Education training in orthopaedics at the Brooke Army Medical Center, Fort Sam Houston, TX, with a start date of 1 July 2011 and a scheduled completion date of 30 June 2015. 12. In the processing of this case an advisory opinion, dated 1 October 2012, was obtained from the Program Manager, Graduate Medical Education Division, Office of the Surgeon General. The advisory official recommended denial of the applicant's request to replace the prior service credit he was granted with CSC for a master's degree in physical therapy and stated that the applicant had been given 2 years, 11 months, and 12 days credit for prior service. a. Department of Defense Directive (DODI) 6000.13 (Medical Manpower and Personnel) is the governing directive in granting entry grade prior service credit and CSC. Paragraph 6.1.1.3 of the directive states constructive credit may be awarded only if such advanced education or advanced degree is required as a prerequisite for original appointment as a commissioned officer in a particular officer category. The master's degree in physical therapy was not a prerequisite for his medical degree nor for his appointment to the MC. Therefore, only half credit was awarded for prior service. b. Paragraph 6.1.2.2.3 states the additional degree must add adjunctive skills to the primary specialty and must contribute directly to performance in the anticipated position of the Military Service concerned. The applicant's degree in physical therapy was not required for appointment to the MC and will not add adjunctive skills to his specialty as an Orthopaedic Surgeon. 13. In a response to the advisory opinion, dated 10 October 2012, that applicant stated DODI 6000.13: a. Paragraph 6.1.1.3 pertains to his medical degree which was a prerequisite for commissioning into the MC. He received 4 years of CSC for this and it is correct. His original appointment was in the MC and this paragraph does not describe CSC for an additional advanced degree. 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 of up to 2 years for a master's degree and up to 4 years for a doctorate. His Master of Physical Therapy degree is an additional advanced degree. c. Paragraph 6.1.2.2.3 states 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 primary specialty is orthopaedic surgery. His training as a physical therapist has empowered him to initiate early rehabilitation protocols for patients that are weeks from their initial physical therapy appointment. His training in nonsurgical management enables him to maximize conservative measures before surgery is indicated. This approach prevents unnecessary surgery but more important less surgical complications and overall patient safety. d. Paragraph 6.1.2.2.6 states additional credit in unusual cases, based on special education or experience, can be granted by the Secretary of a Military Department, or designee. As determined by Service needs, the additional credit applies to individuals with unique qualifications that are beyond normal requirements of appointment as commissioned officers. The amount of credit shall be one year for each year of special education or experience. This directive is less relevant than the other paragraphs he cited but may apply if the other statements are not supported by the Board. He is asking for 1 for 1 CSC during his training for the Master of Physical Therapy degree (or 2 years for the master's degree) but only 1/2 for 1 CSC for his previous commissioned experience. e. The 2 years, 11 months, and 12 days cited in the advisory opinion was solely for prior commissioned service credit with no additional credit for his additional advanced degree. The credit he was granted for the time he served on active duty while not in physical therapy school was correctly granted. 14. The applicant provides a statement of support, dated 9 October 2012, wherein Colonel (COL) JF, Chairman, Department of Orthopaedics & Rehabilitation, Orthopaedic Consultant, U.S. Army Surgeon General, SAMMC, Fort Sam Houston, TX, stated: a. The applicant should be awarded 2 years of CSC for his Master of Physical Therapy degree as it provides adjunctive skills to his primary specialty and contributes directly to his performance in orthopaedic surgery. He (the applicant) has been involved in orthopaedic care since 2000 and COL JF personally instructed him during his master's training. This program was constantly ranked in the top five physical therapy programs in the United States. The skills and knowledge he obtained while in the training directly contribute to his orthopaedic surgery practice. b. Physical therapy has been proven to maximize functional outcomes in most orthopaedic patients. Failure of physical therapy is often an indication for surgical intervention for many orthopaedic conditions. The applicant understands this extremely well due to his experience as a physical therapist. Patients who require physical therapy often wait several weeks before their physical therapy appointment so he (the applicant) is frequently sought out in the clinic setting to instruct patients on rehabilitation exercises and principles during orthopaedic surgery appointments. c. His ability to initiate rehabilitation management of operative and non-operative conditions improves patient care substantially and is a valuable extension of his skill as a physician. He is a leader and professional. His maturity, combined with the skills and knowledge of a therapist makes his seniority extremely valuable as an orthopaedic surgeon. 15. The applicant provides a second statement of support, dated 24 October 2012, wherein COL TG, Director, Department of Orthopaedics and Rehabilitation- Orthopaedic Surgery Residency, SAMMC, Fort Sam Houston, TX, stated: a. It was his professional opinion that the training the applicant received while earning his Master of Physical Therapy degree will add adjunctive skills to his primary specialty and contribute directly to the performance of his duties as an orthopaedic surgeon and he should be given full credit for his time served earning the degree. b. The American Board of Orthopaedic Surgery requires education in rehabilitation, illustrating the emphasis on education in physical therapy. The Accreditation Council of Graduate Medical Education also emphasizes the need for training in therapy topics to become a qualified orthopaedic surgeon. A master's degree in physical therapy requires a greater degree of training in rehabilitation than orthopaedic surgery residency and clearly adds adjunctive skills. 16. DODI 6000.13 implements policy, assigns responsibilities, and prescribes procedures to carry out medical manpower and personnel programs. a. Paragraph 6.1.2 (CSC) states CSC 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. CSC shall be determined according to the following guidelines: b. Paragraph 6.1.2.1 states periods of time spent on active duty or in an active status as a commissioned officer may not be counted when computing constructive service credit c. Paragraph 6.1.2.2.1 states 4 years of CSC credit shall be granted for completion of first professional degrees that include medical, osteopathy, dental, optometry, podiatry, veterinary, and pharmacy. d. 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 of up to 2 years for a master's degree and up to 4 years for a doctorate. Credit may not include time spent in attainment of baccalaureate or other lower degrees. No additional credit may be given for more than one advanced degree in a single field or closely-related field. The total credit allowed for having both a master's and a doctorate degree may not exceed the maximum allowed for a doctorate. e. Paragraph 6.1.2.2.3 states 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 contends he should receive CSC for his Master of Physical Therapy degree in lieu of the prior service credit he received while in the physical therapy school. 2. He stated his training as a physical therapist has empowered him to initiation physical therapy protocols for patients and to maximize conservative measures before surgery is indicated. COL JF stated the applicant's training/experience as a physical therapist contributes directly to his performance in orthopaedic surgery as he is frequently sought out in the clinic setting to instruct patients on rehabilitation exercises and principles. COL TG stated that it was his professional opinion that the training the applicant received while earning his master's degree will add adjunctive skills to his primary specialty and contribute directly to the performance of his duties as an orthopaedic surgeon 3. Notwithstanding the applicant's contention or the professional opinions of COL JF and COL TG, while his experience as a physical therapist may be beneficial at times and utilized due to the delay of physical therapy appointments, the evidence of record confirms he was appropriately granted prior service credit for his almost 6 years of active duty service as an Army physical therapist. He has not provided any conclusive evidence that shows his master's degree has added adjunctive skills to his specialty as an orthopaedic surgeon. 4. OTSG sets the standards and guidelines for what is deemed an adjunctive skill set. In the applicant's case, OTSG recommended the request be denied because, in the opinion of OTSG – the proponent of the regulation involved, his master's degree did not add adjunctive skills to his current specialty and, more importantly, it was not required for his appointment as a MC commissioned officer. 5. Further, constructive service credit is intended for a person who begins commissioned service. The applicant was not beginning commissioned service. 6. In view of the foregoing, he is not entitled to the 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) AR20120014966 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20120014966 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1