RECORD OF PROCEEDINGS


	IN THE CASE OF:	  


	BOARD DATE:	  04 March 2008
	DOCKET NUMBER:  AR20070006236 


	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

Ms. Jeanne Marie Rowan

Analyst


The following members, a quorum, were present:


Mr. James E. Anderholm

Chairperson

Mr. William D. Powers

Member

Mr. Jerome L. Pionk

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 that he be relieved of a $37,000.00 debt for the Army Medical Department (AMEDD) Specialized Training Program Service Agreement (STRAP) for Army physicians. 

2.  The applicant states, in effect, that he proudly serves in the U. S. Army Reserve (USAR) as an Occupational Medicine Doctor, a branch of Preventive Medicine, and his training as an Occupational Medicine Doctor is not a critical Area of Concentration (AOC); therefore, he is not entitled to the STRAP bonus he received for his initial training as a Family Medicine Resident and recoupment of the STRAP bonuses was initiated.  This collection of the STRAP bonus caused a severe financial strain on his already limited family finances.  He further states that there is a shortage of physicians within the Department of the Army (DA) and that based on this known shortage his debt should be waived.

3.  The applicant provides copies of the following documents in support of his application:

     a.  a personal statement dated 24 April 2007;

     b.  a memorandum, dated 3 April 2006, from The Surgeon General, a lieutenant general, which disapproved the applicant's request to receive STRAP stipend payments for a Residency Program in Occupational Medicine;

     c.  a letter, dated 14 April 2006, from the Director of the AMEDD Region for the Human Resources Command (HRC)-St. Louis which notified the applicant that The Surgeon General of the Army disapproved the applicant's request for an exception to policy to remain in the STRAP stipend program;

     d.  an undated memorandum from the commanding general of the USAR Medical Command to the applicant requesting his assistance as a recruiter for the USAR physician and dental programs;

     e.  a Military Leave and Earnings Statement (LES), dated 10 May 2006, which shows the applicant has a cumulative debt of approximately $38,753.48;

     f.  an electronic message dated 15 November 2005 from the applicant's spouse which stated, in effect, that her husband when board certified as an Occupational Medicine Doctor would be a part of the AOC of Preventive Medicine; therefore, he would be eligible for the STRAP stipend program;

     g.  Waiver/Remission of Indebtedness Application (DA Form 2789), dated 22 June 2006, with supporting documents; 

     h.  a memorandum, dated 17 October 2005, which identified the critical medical AOCs that were entitled to the New STRAP stipend bonus which did not include Occupational Medicine; and 

     i.  a blank DA Form 5685 (New Specialized Training Assistance Program Service Agreement) and excerpts from various websites. 

CONSIDERATION OF EVIDENCE:

1.  The applicant has prior service and his records show he was honorably discharged from the U. S. Naval Reserve on 28 September 1996.  He enlisted for six years in the USAR on 24 August 2000 as a specialist/pay grade E-4 in the military occupational specialty (MOS) 91B (Medical Specialist).  On 18 December 2002, he accepted an appointment as a Medical Services Corps (MSC) Army Reserve commissioned officer in the grade of second lieutenant/pay grade O-1.  On 1 August 2002, he accepted a second appointment in the Army Reserve as a MSC commissioned officer in the grade of captain/pay grade O-3.  He currently is a captain and a member of the USAR assigned to a troop program unit (TPU).

2.  On 1 August 2002, the applicant entered into a New STRAP service agreement for a Family Practice Residency Program.  Through his signature on DA Form 5685, he acknowledged that he had been accepted for an approved course of specialized training in the critical medical specialty of Family Medicine at the McGraw Medical Center of Northwestern University, Chicago, Illinois.  He stated he was scheduled to complete his training in Family Medicine on 30 June 2005, and acknowledged that his service obligation would end on 
30 June 2011 and that his statutory military service obligation ended on 
15 September 1996.  A sergeant first class serving in the position of the AMEDD recruiter certified the New STRAP service agreement.

     a.  The applicant acknowledged through his signature that he would be entitled to a monthly stipend during his specialized training program at the rate paid to officers participating in the Health Professions Scholarship Program.  He agreed to serve 2 years in a TPU or as a member of the Individual Mobilization Augmentee Program (IMA) for each year or part thereof during which he received a monthly stipend;

     b.  As a participant in the New STRAP receiving financial assistance, he agreed to comply with and meet all academic, medical, administrative, and other standards and requirements outlined in his specialized training program of Family Medicine;

     c.  He agreed that if he was terminated from the New STRAP he may be ordered to reimburse the U. S. Government in an amount equal to the total amount of the stipend paid to him, including any applicable accrued interest at the current interest rate.  He also agreed to serve on active duty for 1 year for each year or part thereof, for which he received a stipend or in lieu of being ordered to active duty, he could be required to reimburse the U.S. Government for the total amount of the stipend paid to him even though required to remain in the Ready or Selective Reserve.  He further agreed that if terminated from the New STRAP any reimbursement made to the U.S. Government would not reduce or eliminate his obligation to serve in the Ready Reserve for the specified statutory period; and 

     d.  The New STRAP termination policies in effect at the time of the service agreement were that if he failed to successfully complete the specialized training program in Family Medicine, or if he was involuntarily released from the Family Medicine Residency Program, or if he voluntarily stopped training in the Family Medicine Residency Program he could be terminated from the New STRAP program.  

3.  On 26 March 2002, the McGraw Medical Center of Northwestern University Family Practice Program offered the applicant an appointment into their program for postgraduate training.  The applicant accepted this appointment.  The appointment was contingent upon the issuance of a valid Illinois medical license. 

4.  On 23 August 2002, the applicant signed the STRAP Extension Statement to the New STRAP Service Agreement and he stated he understood that his Army military occupation specialty (MOS) was 61H (Family Medicine), which was on the critical specialty shortage list for health professionals.  Through his signature, he indicated he had read and understood the agreement outlined in DA Form 5658 and the amendment supplements of DA Form 5536.

5.  On 3 November 2002, a major serving as the Incentives Program Manager accepted and approved the applicant's participation in the New STRAP stipend incentive program.

6.  On 31 December 2002, a medical doctor serving as the department chief or program director at the McGraw Medical Center of Northwestern University Family Practice Residency Program acknowledged in writing that the applicant enrolled in this program on 1 July 2002 and that the anticipated program completion date was 30 June 2005.

7.  On 2 June 2003, the Family Practice Residency Program at Northwestern University confirmed the applicant's continued enrollment in the Family Practice Residency Program.

8.  On 23 August 2003, the applicant signed DA Form 5536 (Health Professionals Loan Repayment Agreement-HPLR) acknowledging that he would perform as an officer in the Selected Reserve and that he was qualified for service in the critical medical MOS 61H (Family Medicine).  He further acknowledged that his participation in HPLR would be terminated if he transferred to a medical specialty not designated as a critical specialty. 

9.  On 20 January 2004 and again on 16 July 2004, the program director, a medical doctor, at the Bethesda Family Practice Residency Program, Cincinnati, Ohio acknowledged in writing that the applicant enrolled in this program on 20 January 2004 and/or 1 February 2004, and that the anticipated program completion date was 21 January 2007 initially then adjusted to 30 July 2006. 

10.  On 12 September 2005, the University of Cincinnati Medical Center, Department of Environmental Health, offered the applicant a residency position in Occupational Medicine beginning on 21 September 2005 and ending 20 September 2007.  

11.  On 15 September 2005, the director of Occupational Medicine at the University of Cincinnati Residency Training Program acknowledged in writing that the applicant was a resident of the Occupational Medicine program at this university. He stated the applicant started this residency program on 21 September 2005 and that his anticipated completion date was 20 September 2007.

12.  By electronic mail on 15 September 2005, a major at HRC-St. Louis informed the applicant that Occupational Medicine was not on the medical critical shortage list and stated, in effect, that if the applicant was not completing the Family Practice Residency Program per his contract that his New STRAP stipend would be stopped and monies paid recouped.

13.  By letter to The Surgeon General of the Army on 18 September 2005, the applicant requested, in effect, a waiver to his New STRAP contractual requirement to maintain academic standing in the Family Practice AOC.  He requested to continue in the New STRAP stipend program in the Occupational Medicine/Preventive Medicine AOC.  He stated that Occupational Medicine fell under the heading of Preventive Medicine and that these two specialties were identical.  He further stated he was aware that the Army had two different AOCs for Occupational Medicine and Preventive Medicine and that he was prepared for training in either program.  

14.  On 23 December 2005, the Incentive Program Manager at HRC-St. Louis officially terminated the applicant from the New STRAP stipend incentive program with an effective date of 15 September 2005.  The notification stated the applicant failed to successfully complete the specific academic training program (Family Practice), that he failed to maintain eligibility requirements, and that the AOC (Occupational Medicine) was not on the AOC shortage list.  The memorandum further stated that recoupment for all monies paid to the applicant under the New STRAP had been requested through the finance center.  Finally, he was told that any reimbursements made to the government would not reduce his service obligation to serve in the Ready Reserve.

15.  On 3 April 2006, The Surgeon General disapproved the applicant's request to continue with the New STRAP stipend program in the Occupational Medicine Residency Program.  The Surgeon General stated that he had consulted with proponents for the Preventive Medicine and Occupational Medicine MOS and determined that based on the applicant's current level of training, he would be awarded AOC 60D9C (Occupational Medicine).  He further stated that the AOCs of Preventive Medicine and Occupational Medicine are not interchangeable and that Occupational Medicine is not on the Reserve Component Wartime Health Care Specialties with Critical Shortages list. 

16.  On 14 April 2006, a colonel from HRC-St. Louis wrote the applicant and told him that the money he received during his participation in the New STRAP stipend program must be recouped and that the original obligation that he incurred upon signing the New STRAP contract on 1 August 2002 would remain in effect.  The colonel further stated, in effect, that the applicant upon completion of his current residency program in Occupational Medicine could choose to serve on active duty and that the recoupment of the New STRAP stipend would stop if he served his remaining obligation on active duty.  

17.  An advisory opinion was obtained from HRC-St. Louis AMEDD Region, Incentives Management on 13 November 2007.  In the opinion, the Director of the AMEDD Region stated, in effect, that the applicant contracted on 1 August 2002 in the New STRAP stipend bonus program for the critical MOS shortage in Family Medicine and that he agreed to complete a residency program in this AOC.  The applicant then transferred from the Family Medicine Residency Program to the Occupational Medicine Residency Program, which is not listed as a critical wartime shortage AOC.  The director further states that STRAP monies are only payable for training in a specialty that is identified on the Critical Wartime Specialty Shortage List.  When the applicant changed his residency, he broke this STRAP contact and is therefore required to repay the stipend received.

18.  On 6 December 2007, the applicant submitted a rebuttal to the advisory opinion.  In his rebuttal statement, he acknowledged, in pertinent part, that HRC-St. Louis's technical position on his training in Occupational Medicine does not fall within the list of critical wartime AOC shortage specialties.  However, he states that HRC-St. Louis is not addressing the real question of technical credentialing and temporality.  He states he has completed the American Board of Preventive Medical Residency as the Chief Resident at the University of Cincinnati and that he is currently working on his master's thesis.  He states that in a few short months, he will sit for the Preventive Medicine Board, then practice for 9 months and then he will have the Preventive Medicine and Occupational Medicine qualifications.  The applicant argues that he will be qualified in Preventive Medicine upon completion of the required practicum and that HRC-St. Louis is not acknowledging the one-year requirement to wait for board certification.  The applicant provided for the board's review information from The American Board of Preventive Medicine, that once he is certified he will be exactly what the Army has on its wartime critical medical AOC shortage list.  He states his specialty will be Occupational Medicine, which is an area of Preventive Medicine. 

19.  Department of Defense Directive Number 1205.20 (Reserve Component Incentive Programs), dated 8 January 1996, prescribes to DA incentive programs that shall be used to attract and retain individuals possessing or qualifying for training in critical skills and/or critical units needed in wartime, and to sustain membership and maintain readiness in the National Guard and Reserve components.  Each year the Services will provide the Assistant Secretary of Defense for Health Affairs a list of critical skills eligible to participate in the Reserve Component Incentive Program based on their critical needs and anticipated wartime shortages.  The Services will ensure that only those persons who meet established eligibility criteria participate in the incentive program.  In addition, the Services will maintain information on all members who have been paid incentives and who have been determined to have failed to participate satisfactorily in the required training to include the termination of payments and recoupment of funds as appropriate.  

20.  Army Regulation 135-7 (Army National Guard and Army Reserve Incentive Programs) prescribes the policies and procedures for the administration of the Incentive Programs to members in the USAR.  In this regulation it is stated that the New STRAP sets up financial assistance to officers engaged in specialized training in return for their service in the Ready Reserve.  An officer will be terminated and not eligible for payments if he voluntarily stops training in the specialty designated in the participant's New STRAP agreement, transfers to a medical specialty not designated a critical specialty or if he is not licensed or certified in the critical medical specialty designated in the specified written agreement.  Recoupment of funds received upon termination of the service agreement is required.  

21.  Army Regulation 15-185 (Army Board for Correction of Military Records) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the Army Board for Correction of Military Records (ABCMR).  Paragraph 2-9 contains guidance on the burden of proof.  It states, in pertinent part, that the ABCMR begins its consideration of each case with the presumption of administrative regularity, that is that what the Army did was correct.  The ABCMR is not an investigative body and decides cases based on the evidence that is presented in the military records provided and the independent evidence submitted with the application. The applicant has the burden of proving an error or injustice by a preponderance of the evidence.  

DISCUSSION AND CONCLUSIONS:

1.  The applicant entered into a contract with the U. S. Government on 1 August 2002 under the New STRAP incentive program for medical personnel.  He agreed to complete the residency training requirements and meet certification in the AOC critical shortage of Family Medicine.  The applicant's New STRAP contract stated he would attend residency training in Family Medicine at McGraw Medical Center of Northwestern University.  For personal reasons, the applicant changed his residency program after two years from Family Practice to Occupational Medicine when he accepted an appointment to the Occupational Medicine Residency Program at the University of Cincinnati Medical Center on 12 September 2005.  

2.  When the applicant transferred to the residency program in Occupational Medicine he effectively violated his New STRAP contract, which required him to complete his residency in Family Medicine at Northwestern University in Chicago, Illinois.  The applicant acknowledged through his personal correspondence that he did not complete the residency program in Family Medicine to which he was contracted.  As required by law, HRC-St. Louis initiated recoupment of the New STRAP stipend bonus that he had received for two years while in the Family Medicine Residency Program and the STRAP payments ceased.  

3.  The applicant consistently argues throughout his various appeals, that he will be a board certified Occupational Medicine medical doctor under the umbrella of Preventive Medicine and that Preventive Medicine is a critical shortage medical AOC.  He further argued that the Army Reserve is short medical doctors in general; therefore, since he will be a board certified medical doctor his debt should be waived.  The Surgeon General, the proponent for medical personnel management and policies, stated in his memorandum, dated 3 April 2006, that the AOC for Preventive Medicine and Occupational Medicine are not interchangeable.  

4.  The applicant is not entitled to relief of his debt as he knowingly violated the terms for which he personally contracted under the terms and conditions of the New STRAP service agreement.  When he ceased training in the residency program for Family Medicine, he terminated his contract, which required the recoupment of funds paid during his 2 years of residency training.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

__JEA__  __WDP__  __JLP ___  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
AR
SUFFIX

RECON

DATE BOARDED
20080304
TYPE OF DISCHARGE

DATE OF DISCHARGE

DISCHARGE AUTHORITY

DISCHARGE REASON

BOARD DECISION
DENY
REVIEW AUTHORITY

ISSUES         1.

2.

3.

4.

5.

6.