RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        12 July 2007
      DOCKET NUMBER:  AR20070002211


      I certify that hereinafter is recorded the true and complete record
of the proceedings of the Army Board for Correction of Military Records in
the case of the above-named individual.

|     |Ms. Catherine C. Mitrano          |     |Director             |
|     |Mrs. Nancy L. Amos                |     |Analyst              |


      The following members, a quorum, were present:

|     |Mr. James E. Anderholm            |     |Chairperson          |
|     |Mr. Jose A. Martinez              |     |Member               |
|     |Mr. William F. Crain              |     |Member               |

      The Board considered the following evidence:

      Exhibit A - Application for correction of military records.

      Exhibit B - Military Personnel Records (including advisory opinion,
if any).

THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests two years of additional constructive credit for
obtaining her Masters degree in Business Administration (MBA) in Health
Care Leadership.

2.  The applicant states that although her medical degree and MBA were
awarded on the same day, they were achieved at two separate, accredited,
 full-time graduate-level institutions and should be considered as such.
Having her MBA in Health Care Leadership directly affects the quality of
health care she delivers to the Soldiers, retirees, and dependents that she
sees as patients.  Constructive credit would allow her to be promoted
faster and start to use the skills she possesses in leadership positions.

3.  The applicant provides her Officer Record Brief; transcripts from
Rockhurst University, Kansas City, MO for her MBA with a major in Health
Care Leadership, awarded on 16 May 2004; her MBA diploma; an MBA in Health
Care Leadership for Physicians Program Description; Frequently Asked
Questions regarding the MBA in Health Care Leadership for Physicians
program; seven pages of slides on the MBA in Health Care Leadership for
Physicians program; her active duty orders; an appointment memorandum,
dated 2 August 2001; and her USAREC Form 1131 (Department of the Army
Service Agreement F. Edward Hebert Armed Forces Health Professions
Scholarship Program (AFHPSP)), dated           2 August 2001.

CONSIDERATION OF EVIDENCE:

1.  The applicant has served in Operation Iraqi Freedom.

2.  On 2 August 2001, the applicant was appointed a second lieutenant in
the    U. S. Army Reserve while she was obtaining her medical degree in
osteopathy from the University of Missouri under AFHPSP.

3.  At the same time, from Summer of 2001 through Spring of 2004, the
applicant attended Rockhurst University, Kansas City, MO to obtain her MBA
in Health Care Leadership.  She was awarded her MBA on 16 May 2004.

4.  Apparently in May 2004, the applicant was awarded her medical degree.

5.  The applicant entered active duty on 2 June 2004 in the rank of
captain, O-3 in specialty 62B (Field Surgeon).  She was awarded 4 years of
constructive credit for her medical degree.

6.  The applicant’s officer evaluation reports show she was initially
assigned to William Beaumont Army Medical Center, El Paso, TX as a general
surgery intern (where her duties included being responsible for the in-
patient management and out-patient treatment plans of all surgical patients
on their respective surgical team and to provide initial as well as pre-
and post-operative care of routine, emergent, and traumatic surgical
patients).  She was then assigned to Fort Wainwright, AK as a brigade
surgeon (where her duties included providing direct care and coordination
for Soldiers medically returned from Operation Iraqi Freedom, determining
medical fitness of those Soldiers, and managing their progression through
the physical disability system), and she served as a battalion surgeon in
Iraq (where her duties included being responsible for the clinical
supervision and leadership of the battalion aid station direct support to
over 5,500 deployed Soldiers and area support level II combat health
support to over 7,000 tenants on Forward Operating Base Marez).

7.  In the processing of this case, an advisory opinion was obtained from
the Office of The Surgeon General (OTSG).  OTSG noted that Department of
Defense Directive (sic) 6000.13, paragraph 6.1.2.2.3 states an 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.  OTSG noted that, as a general medical officer,
the applicant’s advanced degree in Health Management does not contribute
directly to her performance in this area of concentration.  OTSG noted that
paragraph 6.1.2.2.2 states “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 a both a master’s and a doctorate degree may not
exceed the maximum allowed for a doctorate.”  OTSG recommended the
applicant not be granted additional credit.

8.  A copy of the advisory opinion was provided to the applicant for
comment or rebuttal.  The applicant responded by stating that her MBA
directly affects her practice as a military physician.  She stated that
military medicine is a business and as such requires physician leaders to
run health care delivery.  At every level of practice military physicians
are expected to be leaders and oversee a piece of the Army Medicine budget
(over $9.7 billion), personnel (over 100,000 Soldiers and civilians), and
customer service (over 5 million beneficiaries).  Business and management
skills are not included in a medical education.  It is erroneous to
encourage military physicians to learn business leadership skills on the
job.  Department of the Army Pamphlet 600-4 specifically encourages an
advanced degree in public health or business administration.

9.  The applicant stated that as a brigade surgeon, she relied heavily on
her business skills to improve the health care she delivered to her
Soldiers.  She had the foresight to see the problems with their medical
system and the skills to correct the problems.  As any physician who
deploys with an operational unit would tell you, you are expected to
deliver health care from start to finish.  A physician in combat must have
the skills necessary to organize a practice, maintain records, order and
secure medical supplies, communicate effectively, teach and manage medics,
and track the movements of injured Soldiers.  That job is best served by
someone with business management skills in the medical field, a physician-
manager or physician-executive.

10.  The applicant stated that the policy not to award additional credit
for more than one advanced degree in a single field, or closely related
field, is simply not relevant to medicine and business.  A medical degree
and MBA are not a single field or a closely-related field.  The policy to
only allow a maximum constructive credit for a doctorate is outdated.  The
Army needs to reward Soldiers who improve themselves and their job
qualifications by attaining advanced degrees.

11.  Department of Defense Instructive (DODI) 6000.13 (Medical Manpower and
Personnel) implements policy, assigns responsibilities, and prescribes
procedures to carry out medical manpower and personnel programs.  Paragraph
6.1. states the entry grade credit to be awarded shall equal the sum of
constructive service credit and prior commissioned service (as outlined in
the DODI) credit except in cases where the total exceeds the maximum credit
allowed.  A period of time shall be counted only once when computing entry
grade credit.

12.  DODI 6000.13, paragraph 6.1.2.2.1. states four years of constructive
service credit shall be granted for completion of first professional
degrees that include medical (M.D.), osteopathy (D.O.), dental (D.D.S. or
D.M.D.), optometry (O.D.), podiatry (Pod.D. or D.P), veterinary (D.V.M.)
and pharmacy (Ph.D.).

13.  DoDI 6000.13, 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 two years for
a master's degree and up to four years for a doctorate.  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.

14.  Department of the Army Pamphlet 600-4 (Army Medical Department Officer
Development and Career Management), paragraph 4-4 (Civilian education)
states the long-term health education and training [programs] provide
opportunities for select Army Medical Department (AMEDD) officers to obtain
master’s and doctoral degrees from civilian institutions.  Under the
Advanced Degree Program, selected active component officers are placed in
post-baccalaureate training to meet validated position requirements for
AMEDD incumbents possessing graduate or doctoral degrees.  The Degree
Completion Program is designed to raise the educational level of AMEDD
officers through full-funded baccalaureate or graduate study in a subject
area of functional importance to the Army.  The Training with Industry
(TWI) Program was initiated in response to the Army’s critical need for
officers with state-of-the-art skills in industrial practices and
procedures not available through military or civil education programs.
Once the TWI student is integrated back into an Army organization, he or
she can use this information to improve the Army’s ability to interact and
conduct business with industry.

15.  Department of the Army Pamphlet 600-4, paragraph 4-5 states the
Interagency Institute for Federal Health Care Executives is offered to
senior leaders of the five Federal health services to provide an
opportunity for seasoned, practicing Federal health care executives to
examine current issues in health policy and management, and to explore
their potential impact on the Federal health care systems.

16.  Department of the Army Pamphlet 600-4 describes the duties of
specialty 62B (Field Surgeon) in part as “Performs the basic and
fundamental duties of a physician.  Examine, diagnose, resuscitative and
definitive care for injured and wounded Soldiers within the capabilities of
the unit’s organic or attached medical element.  When assigned to a
maneuver unit, serves as the principle advisor to the commander regarding
medical forces protection and the maintenance of the health of the unit.”

17.  Department of the Army Pamphlet 600-4 describes the duties of
specialty 70A (Health Care Administration) in part as “Plans, directs,
manages, administers, and participates in the functioning of health care
facilities and organizations, coordinates care delivered by the health care
consortium through DVA/DOD sharing, civilian contractors …advises
commanders at all levels on health care delivery and the management of
health care facilities.”

DISCUSSION AND CONCLUSIONS:

1.  All of the applicant’s contentions, in her application and in her
rebuttal to the advisory opinion, have been carefully considered.

2.  The Army does not just encourage military physicians to learn business
leadership skills on the job.  The Army has specific civilian education
programs to teach its AMEDD officers those skills.  Those programs (e.g.,
the Interagency Institute for Federal Health Care Executives Course) appear
to be geared toward its senior leaders or toward those officers for whom an
advanced degree would benefit the Army in a subject area of functional
importance to the Army.  There does not appear to be anything in Department
of the Army Pamphlet 600-4, and certainly nothing in paragraph 4-4, that
encourages the ordinary AMEDD officer to have an advanced degree in public
health or business administration.

3.  As a junior AMEDD officer in specialty 62B, the applicant’s
responsibilities appear to be primarily concerned with the basic duties of
a physician.  Even her two officer evaluation reports where she performed
duties as a brigade and battalion surgeon indicate she performed more the
basic duties of a physician rather than those health care duties envisioned
for more senior AMEDD officers. If the applicant had been assigned to a 70A
position, her MBA in Health Care Leadership could more readily be seen as
adding adjunctive skills and contributing directly to her performance of
duty.  However, the applicant was not assigned to a 70A position.

4.  The applicant stated that constructive credit would allow her to be
promoted faster and start to use the skills she possesses in leadership
positions.  This appears to be an acknowledgement that she is not yet using
those skills despite her contentions in her rebuttal to the advisory
opinion.

5.  In addition, DODI 6000.13 states a period of time shall be counted only
once when computing entry grade credit.  The applicant acknowledges she
obtained her MBA at the same time she was attending medical school.  She
has already been awarded 4 years of credit for her basic medical degree.
The DODI does not provide an exception to that rule by reason of the
degrees being obtained from different schools.

6.  There is insufficient evidence that would warrant granting the relief
requested.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

__jea___  __jam___  __wfc___  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.




                                  __James E. Anderholm__
                                            CHAIRPERSON



                                    INDEX

|CASE ID                 |AR20070002211                           |
|SUFFIX                  |                                        |
|RECON                   |                                        |
|DATE BOARDED            |20070712                                |
|TYPE OF DISCHARGE       |                                        |
|DATE OF DISCHARGE       |                                        |
|DISCHARGE AUTHORITY     |                                        |
|DISCHARGE REASON        |                                        |
|BOARD DECISION          |DENY                                    |
|REVIEW AUTHORITY        |Ms. Mitrano                             |
|ISSUES         1.       |102.08                                  |
|2.                      |                                        |
|3.                      |                                        |
|4.                      |                                        |
|5.                      |                                        |
|6.                      |                                        |


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