IN THE CASE OF:	  

		BOARD DATE:	  4 October 2012

		DOCKET NUMBER:  AR20120009360 


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 reconsideration of her earlier request to be granted 2 additional years of constructive service credit for her master's degree in physiology and biophysics.

2.  The applicant states she received a Master of Science degree from Georgetown University in 2003.  She and a colleague were both recruited from this graduate program and told they would be granted 2 years of constructive service credit.  She and her colleague were both commissioned in May of 2003 and graduated from Georgetown University with Masters of Science degrees in physiology and biophysics in August 2003.  They went to different medical schools and both graduated in June 2007.  They both applied for constructive service credit for their masters' degrees.  Her request was denied and her colleague's request was approved.

3.  She further states she supplied records to the Office of the Surgeon General (OTSG) requesting an adjusted date of rank (DOR) on a DA Form 5074-R (Record of Award of Entry Grade Credit (Medical and Dental Officers )) which was informally denied.  She states, "No credit was granted from the advisory opinion from OTSG on 26 May 2008, citing that credit would only be given for a Doctorate of Physiology and not a [m]aster's degree, and that [b]iophysics would not incur credit."  However, Army Regulation 135-101 (Appointment of Reserve Commissioned Officers for Assignment to Army Medical Department Branches), table 3-3, provides that nuclear medical science confers 2 years of constructive service credit for a master's degree.  Footnote 5 states this "includes degrees in health physics, radiobiology, radiological physics, nuclear physics, and biophysics."  OTSG determined there was no basis to grant additional constructive credit and to do so would afford her a benefit others in similar circumstances were not afforded.  However, on 24 September 2010, her classmate and colleague, Major (MAJ) B____ M____, received a reconstructed record of award of entry grade credit for the same degree signed by Ms. S____R____, Program Manager, Graduate Medical Education Division, OTSG.  MAJ B____ M____'s DOR was then adjusted by 2 years on 24 September 2010 for the same degree for which she is being denied credit.

4.  The applicant provides:

* her Officer Record Brief (ORB)
* MAJ B____ M____'s ORB
* MAJ B____ M____'s Order Number 267-001, dated 24 September 2010
* MAJ B____ M____'s DA Form 5074-R, dated 9 September 2010
* Three letters of support

CONSIDERATION OF EVIDENCE:

1.  Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20080002867 on 23 September 2008.

2.  The applicant submitted two ORB's, orders, a DA Form 5074-R, and three letters of support.  This evidence was not previously considered.  Therefore, it is considered new evidence and as such warrants consideration by the Board.

3.  On 29 May 2003, she was appointed as a Reserve commissioned officer of the Army without a branch designation and signed a U.S. Army Recruiting Command Form 1131 (Department of the Army Service Agreement – F. Edward Herbert Armed Forces Health Professions Scholarship Program) wherein she agreed to serve 4 years on extended active duty and 4 years in the Individual Ready Reserve in exchange for a scholarship to medical school.  In paragraph 27 of the agreement she acknowledged she understood the contract was between herself and the U.S Army and there were no oral or other agreements, understandings, or representations made which were not contained in the agreement.

4.  On 21 March 2007, orders were published by the U.S. Army Human Resources Command (HRC), St. Louis, MO, which ordered her to active duty in the rank of captain (CPT) effective 11 June 2007.  The orders specified that her appointment was effective the date she entered active duty and her DOR would be adjusted based on constructive service credit of 4 years.

5.  Her record contains a DA Form 71 (Oath of Office), dated 1 June 2007, showing she was appointed as an Army Medical Corps (MC) officer in the Regular Army in the rank/grade of CPT/O-3.

6.  On 6 September 2007, HRC published orders adjusting her DOR to 11 June 2007, the date she entered active duty.

7.  On 22 October 2007, she signed a training agreement for Graduate Medical Education (GME) in Family Medicine at DeWitt Army Community Hospital, Fort Belvoir, VA, beginning on or about 1 July 2008 and scheduled to be completed on 30 June 2010, wherein she acknowledged for a second time that the agreement constituted the entire contract between herself and the U.S. Army and there were no oral or other agreements, understandings, or representations.

8.  In the processing of the previous Record of Proceedings an advisory opinion was obtained from Ms. S____ R____, Program Manager, Graduate Medical Education Division, OTSG.  Her transcripts from Georgetown University were provided for review.  OTSG opined that the applicant's advanced degree in physiology and biophysics did not tangibly add any value to her primary specialty of family medicine, did not contribute directly to performance of skills as a family medicine resident, nor did it reduce the expected length of training to meet specialty board requirements.  OTSG recommended that no additional credit be granted.

9.  The applicant replied to this advisory opinion stating her degree in physiology and biophysics does add adjunctive skills to her primary specialty of family medicine and contributes to performance in her anticipated position of family medicine physician in several ways.

	a.  Her master's degree in physiology and biophysics added training in mechanisms of human training and performance, risk-factors related to overuse injuries and recovery time, physiologic responses to training at altitude and with diving, nutrition and supplements as they impact human performance, metabolic responses to physical and mental stress, and complementary and alternative medicine.  These areas were not covered in medical school and are directly applicable to practicing military medicine.

	b.  While her additional degree does not reduce the expected length of training to meet specialty requirements for family medicine, her studies will better prepare her for military operational medicine which she anticipates practicing after completion of her residency in family medicine.  In addition, the degree is applicable in current clinical and basic research projects which the military supports through the Human Performance Laboratory and it is her goal to be involved with some protocols through that laboratory.

	c.  She further stated she was in her master's program when she was recruited for the HPSP and was specifically told by two officials that her degree would confer constructive service credit.  It is a misrepresentation to deny the credit when it was specifically stated that it would be granted.

10.  She provided two ORB's, one belonging to her and the other belonging to her colleague MAJ B____ M____.  She highlighted both ORB's to show she and MAJ B____ M____ graduated from Georgetown University in 2003 with a master's degree in physiology.

11.  She provided a copy of MAJ B____ M____'s DA Form 5074-R, dated 24 September 2010, wherein he was given 2 years of constructive credit for his master's degree in physiology.  The approving official on this form is listed as Ms. S____ R____, the same OTSG advisory official.  His ORB shows his area of concentration as 62B (Field Surgeon) and 61J (General Surgeon).

12.  She provided Order Number 267-001, HRC, dated 24 September 2010, pertaining to MAJ B____ M____ which shows his DOR was adjusted from 5 June 2007 to 5 June 2005.

13.  She provided three letters in support of granting her 2 years of constructive credit for her advanced degree:

	a.  In a memorandum, dated 16 July 2012, Colonel (COL) F____ G. O____, Professor, Military and Emergency Medicine, and Medical Director, Consortium for Health and Military Performance Uniform Services University of Health Sciences, Bethesda, MD, stated, "[The applicant] is currently serving as the Army World Class Athlete Program (WCAP) team physician.  Her background in [p]hysiology and [b]iophysics directly aids her in this position, which is usually filled by a fellowship-trained physician in [s]ports [m]edicine.  Specifically, her degree has provided her a background in the physiologic response to training at altitude which serves her well with both [o]perational [m]edicine and [s]ports [m]edicine at the elevation of 6,000+ feet above sea level in Colorado Springs.  In addition, her degree provided education on mechanisms of human training and performance, nutrition and supplements as they impact human performance, and complementary and alternative medicine, all of which directly build adjunct skills 

upon the [f]amily [m]edicine base and contribute to her current practice.  Additionally, this degree prepared [the applicant] to be involved with academic medicine, and to that end, she has co-authored an article on concussion which was published this year and has two pending publications on exercise-induced bronchoconstriction testing, topics with direct physiology and biophysics relevance."

	b.  In a memorandum, dated 19 July 2012, COL K____ d_ W____, the Program Director, Sports Medicine Fellowship, Uniformed Services University of Health Sciences, Bethesda, MD, stated, "There are currently no board-certified sports medicine physicians stationed at Evans Army Community Hospital to care for the Army WCAP, a group supporting elite active duty military athletes who train in Olympic sports.  [The applicant] has filled this gap well.  Her background in [p]hysiology and [b]iophysics has given her a high level of [s]ports [m]edicine knowledge that has prepared her to competently address the needs of elite athletes such as physiological response to weight-cutting in wrestlers, effects of nutrition and supplements on performance and injury recovery, and risk factors related to overuse injuries….[The applicant's] [p]hysiology and [b]iophysics degree also provided the foundation for clinically and operationally important research that she has been involved with on Functional Movement Screening (FMS).  She is also involved with the application of FMS to injury prevention programs in [b]rigade [c]ombat [t]eams at Fort Carson, CO.  In these academic and operational domains, her advanced degree has directly contributed to productive work that benefits Soldiers….While her degree does not reduce the length of training needed to meet board requirements, it certainly has added tangible value to her impressive service as an academically-savvy and operational focused [f]amily [m]edicine physician."

	c.  In a memorandum, dated 26 July 2012, COL M____ R____, an Army Family Medicine Consultant at Headquarters, U.S. Army Medical Command, Fort Sam Houston, TX, stated, "The criteria for constructive credit as cited in [Army Regulation] 135-101 and [Department of Defense (DOD) Instruction (DODI)] 6000.13 are:  1) '…additional degree must add adjunctive stills to the primary specialty,' and 2) 'must contribute directly to performance in the anticipated position in the Military Service concerned.  These references also specify year for year credit.  [The applicant's] [m]aster's program added the following adjunctive skills:  1) physical training and performance optimization, 2) prevention of overuse injuries, 3) decreasing post training and injury recovery time, 4) management of unique hyper- and hypo-baric physiological response, 5) evidence based incorporation and risk reduction through appropriate use of nutrition and supplements, [and] 6) utilization of complementary and alternative 

medicine.[The applicant] is clearly performing at a much higher level as an Army family physician…for the Army WCAP, excelled while filling an O-5 [c]ommand [s]urgeon position during a deployment to Operation Iraqi Freedom, and is excelling as an officer in charge for a large [f]amily [m]edicine clinic providing comprehensive care for approximately 10,000 Soldiers, [f]amily [m]embers, and retirees….although this training did not shorten the length of training to meet specialty board requirements, it certainly has shortened the time for her to achieve significant success and to be selected to serve and lead in positions of advanced responsibility.[The applicant's] [m]aster's program developed expertise in human performance optimization in general and specifically in austere, physiologically unique environments which is frequently required for Army family physicians but seldom available without fellowship or other post-residency specialized training.it is abundantly clear that 'adjunctive skills' were 'added to the primary specialty' and that they have 'contributed directly to performance in her positions of Military Service.'"

14.  An advisory opinion, dated 18 June 2012, was obtained from Ms. S____ R____, Program Manager, Graduate Medical Education Division, OTSG, in the processing of this case.  Ms. S____ R____ stated, "[The applicant] is once again requesting constructive credit for a [Master of Science] [d]egree in [p]hysiology and [b]iophysics.  DOD policy under DOD Directive 6000.13 is the governing directive in granting entry grade credit.  In accordance with this directive, 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.  As a trainee in the specialty of [f]amily [m]edicine, [the applicant's] advanced degree in [p]hysiology and [b]iophysics does not tangibly add any value to her primary specialty of [f]amily [m]edicine, contribute directly to performance of skills as a family medicine resident, nor reduce the expected length of training to meet specialty board requirements.  Therefore, the recommendation continues to not grant additional credit….[The applicant] cites constructive credit was given to one of her classmates, [MAJ B____ M____], for the same [m]aster's [d]egree in which she is requesting credit.  The reconstructed DA Form 5074-R for [MAJ B____ M____] grants credit for a [m]aster's [d]egree.  The reconstruction was completed using a copy of [MAJ B____ M____'s] orders which gave him 2 years of constructive credit, there was no explanation of what the credit was for and was assumed to be for the [m]aster's [d]egree.  The individual who awarded the constructive credit for the Class of 2007 is no longer available, nor are the records.  It is [Ms. S____ R____'s] belief that the constructive credit awarded to [MAJ B____ M____] was in error; however, it cannot be taken back now.  [OTSG] has been consistent for the past several 

years on not awarding constructive credit for additional advanced degrees and remains firm in our decision for [the applicant] in this opinion."

	a.  The applicant replied to this advisory opinion on 15 July 2012 stating, "[her] [m]aster's degree in [p]hysiology and [b]iophysics did not shorten the training required for a residency in [f]amily [m]edicine.  It did however prepare [her] to not only succeed, but to excel in residency training where [she] was selected to be a [c]hief [r]esident.  [She] was selected for the 'Outstanding Intern Award' as well as the 'Outstanding Graduating Resident Award.'  [Her] [o]fficer [e]valuation [r]eports since entering [a]ctive [d]uty [in] 2007 include [the statements], 'she is in the top 1% of all captains I have worked with in my 19 year Army [c]areer and is the standard for which I will judge all physicians leaving residency,' 'the applicant] is absolutely the best [b]attalion [s]urgeon I have ever worked with during my 17 years of military service,' and '[the applicant] is inarguably one of the best, most well-rounded physicians that I have worked with in my 17-year military career.'"

	b.  She also stated, "In Iraq, [she] was able to fill the billet of a [l]ieutenant [c]olonel (LTC) due to [her] experience as a leader and had to work on field sanitation as well as preventative and community medicine topics which [she] was better prepared for due to the research skills [she] learned from [her] advanced degree.  [She is] currently serving in a position usually held by a [b]oard [c]ertified [s]ports [m]edicine LTC and [she feels] that [she has] been able to do these roles successfully as a CPT without fellowship training due to [her] background in [p]hysiology and [b]iophysics."

	c.  She further stated, "Army Regulation 135-101 provides in [t]able 3-3 that Nuclear Medicine Science confers 2 years of constructive service credit for a [m]aster's degree.  Footnote 5 states that this 'includes degrees in health physics, radiobiology, radiological physics, nuclear physics, and biophysics.'"

	d.  She concluded, "Lastly, there appears to be internal unpublished guidelines regarding granting credit which are not applied consistently.  The informal 'standard' applied at the GME office is not consistent as her colleague received this credit as did another colleague (see [ABCMR Board Docket AR20060005666, dated 6  February 2007]).  It was mentioned that to give [her] credit would be to 'afford [her] a benefit others in similar circumstances are not afforded.'  However, in the aforementioned case and the case of MAJ M____, it is clear that other physicians with a [Master of Science] in [p]hysiology and [b]iophysics from Georgetown University have successfully been granted 2 years of credit.  While [she] cannot help that the records from MAJ M____'s case have 

been lost, a review of his ORB shows the same degree that we shared as classmates and the [DA Form] 5074-R in blocks 17-20 show 2 years of constructive credit was awarded for his [Master of Science from Georgetown University] 2001-2003."

15.  Army Regulation 135-101, paragraph 1-3 (Personnel Eligible and Grade on Appointment) states commissioned officers of any Reserve Component of the Army who have served satisfactorily in the specialty for which they are applying may be appointed and/or called to active duty under either (1) or (2), whichever selection would result in a higher grade or greater promotion service on the date of appointment:  (1) in the grade currently held if serving in the specialty for which applying or (2) in the highest grade for which they can fully qualify by education and experience, gained after becoming professionally qualified.

	a.  Table 3-1 states credit for additional advanced degrees must add adjunctive skills to the primary specialty and must contribute directly to performance in the anticipated duty position.  Credit is awarded based on full-time equivalent education up to 24 months for a master's degree or up to 36 months for a doctorate.  The additional degree must not have been earned concurrently with the primary credential.  Credit includes time spent in attainment of a lower degree.  No additional credit will be given for more than one degree in a single field.

	b.  Table 3-3 states a degree in nuclear medical science, which includes degrees in health physics, radiology, radiological physics, nuclear physics, and biophysics, addressed under note 5 of this table, are granted 2 years of constructive credit at the master's degree level.  However, advanced degrees in physiology only receive constructive credit at the doctorate level.

16.  DODI 6000.13 (Medical Manpower and Personnel) implements policy, assigns responsibilities, and prescribes procedures to carry out medical manpower and personnel programs.

	a.  Paragraph 6.1.2 (Constructive Service Credit) states 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.  Constructive service credit shall be determined according to the following guidelines:

	b.  Paragraph 6.1.2.2.1 states 4 years of constructive service credit shall be granted for completion of first professional degrees that include medical, osteopathy, dental, optometry, podiatry, veterinary, and pharmacy.

	c.  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.

	d.  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's initial request to be granted 2 additional years of constructive credit for her Master of Science degree in physiology and biophysics from Georgetown University was denied on 23 September 2008 in ABCMR Docket Number AR20080002867 on 23 September 2008.

2.  The advisory opinion in the original case did not deem the applicant's discipline warranted an exception for constructive credit.  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 on two separate occasions because, in the opinion of OTSG – the proponent of the regulation involved, the training did not add adjunctive skills to her current specialty.

3.  The applicant argued that OTSG and the ABCMR have previously granted constructive credit for Soldiers in similar situations; however, it should be noted that the ABCMR does not operate on or establish precedents.  Each case is individually decided based upon the merits of the evidence presented.  Further, the OTSG advisory opinion states the constructive credit granted to the applicant's peer was in error.  To repeat that error in the applicant's case would eviscerate OTSG's policy-making discretion in this area and is therefore inappropriate.

4.  She has not conclusively shown that her master's degree has added adjunctive skill to her current specialty.  Therefore, based on the evidence presented and the OTSG advisory opinion, the requested relief is denied.

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 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.

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ABCMR Record of Proceedings (cont)                                         AR20120009360



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