"Physician Opportunities to Make a Difference in US Government” Officer name Recruitment Physician Professional Advisory Subcommittee US Public Health Service

Special Credits to the Following Officers for Contributing to this Presentation LCDR Deborah S. Belsky, MD MPH LCDR Matt Daab, MD CDR Sara E. Luckhaupt, MD MPH CDR Sylvie Cohen, MD, MPH CDR Dorothy Sanderson, MD CAPT Paul Kitsutani, MD CAPT Ha C. Tang, DO

Objectives Why consider service in the US Government? Why consider service in the US Government? Appreciate the wide range of opportunities to impact change in Federal Government Appreciate the wide range of opportunities to impact change in Federal Government Recognize the range of career options Recognize the range of career options What are the professional and personal challenges? What are the professional and personal challenges?

What are reasonable career goals? Making an impact on what scale? Making an impact on what scale? Reasonable living standard Reasonable living standard Opportunity for advancement Opportunity for advancement Opportunity for lateral moves Opportunity for lateral moves

What are reasonable career goals? Avoid malpractice Avoid malpractice Good place to raise a family Good place to raise a family Retirement benefits Retirement benefits Hopefully happiness Hopefully happiness

What is your primary interest? Domestic vs global focus Domestic vs global focus Clinical, administrative(policy), Research Clinical, administrative(policy), Research Underserved populations? Underserved populations? Operational medicine Operational medicine Preventive medicine Preventive medicine Disaster response Disaster response Academic? Academic?

What are some of the many options in Federal Government? ? Department of Homeland Security Department of Homeland Security United States Coast Guard (USCG)United States Coast Guard (USCG) Immigration and Customs Enforcement (ICE)Immigration and Customs Enforcement (ICE)

What are some of the many options in Federal Government? ? Centers for Medicaid and Medicare Services (CMS) Centers for Medicaid and Medicare Services (CMS) Dept of Justice, Bureau of Prisons (BOP) Dept of Justice, Bureau of Prisons (BOP) Department of Defense Department of Defense VA VA Department of State Department of State White House White House

Department of Health and Human Services IHS, FDA, NIH and CDC IHS, FDA, NIH and CDC Health Resources and Services Administration (HRSA) Health Resources and Services Administration (HRSA) Office of the Assistant Secretary for Preparedness and Response(ASPR) Office of the Assistant Secretary for Preparedness and Response(ASPR) US Public Health Service US Public Health Service

History of U.S. Coast Guard Est. 1790, world’s 12 th largest naval force, one of 5 U.S. armed services, one of 7 uniformed services. Est. 1790, world’s 12 th largest naval force, one of 5 U.S. armed services, one of 7 uniformed services. Only military branch outside DoD (falls under US Dept of Homeland Security but can transfer to Navy in times of war). Only military branch outside DoD (falls under US Dept of Homeland Security but can transfer to Navy in times of war). 42,000 on active duty 42,000 on active duty

USCG Mission Ports, waterways, and coastal security Ports, waterways, and coastal security Drug interdiction Drug interdiction Aids to navigation Aids to navigation Search and rescue Search and rescue Living marine resources Living marine resources Defense readiness Defense readiness Migrant interdiction Migrant interdiction Marine environmental protection Marine environmental protection Ice operations Ice operations Other law enforcement Other law enforcement

An average Coast Guard day An average Coast Guard day -We save 15 lives -Assist 114 people in distress -Conduct 82 search and rescues -202 law enforcement boardings -Service 40 aids to navigation -23 waterfront facility safety inspections -Interdict 26 illegal migrants at sea -Seize $12.4 million worth of illegal drugs -Protects $4.9 million in property, and provides 4 cutters in support of Theatre Security Operations.

PHS role in USCG PHS officers wear the CG uniform and are subject to UCMJ regulations PHS officers wear the CG uniform and are subject to UCMJ regulations Provide primary care and are responsible for ensuring Coast Guardsmen meet required physical standards for military service and rate specific requirements (e.g., flight status). Provide primary care and are responsible for ensuring Coast Guardsmen meet required physical standards for military service and rate specific requirements (e.g., flight status). If PHS officer meets physical requirements, may apply and train to become USCG flight surgeon with special capabilities and requirements (monthly flying in CG aircraft among others). If PHS officer meets physical requirements, may apply and train to become USCG flight surgeon with special capabilities and requirements (monthly flying in CG aircraft among others). Only 63 PHS physicians are assigned to USCG Only 63 PHS physicians are assigned to USCG

= location, location, location

Immigration and Customs Enforcement (ICE) Immigration enforcement Preventing terrorism and Combating the illegal movement of people and trade.

ICE Health Service Corps staff >900 USPHS officers, federal civil servants and contract support staff. Direct care to 15,000 detainees housed at 21 designated facilities throughout the nation. Oversees medical care provided to an additional 17,000 detainees housed at non-ICE Health Service Corps staffed detention facilities

Centers for Medicaid and Medicare Services (CMS) Administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards. Administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards.MedicareMedicaidState Children's Health Insurance Programhealth insuranceMedicareMedicaidState Children's Health Insurance Programhealth insurance

CMS Indirect Medical Education(IME) Indirect Medical Education(IME) Partly based upon residents to bed ratio Partly based upon residents to bed ratio Part of $30 Billion Dollars the US Government pays for residency training in the US. Part of $30 Billion Dollars the US Government pays for residency training in the US.

Census on US Veterans 19.6 millions 19.6 millions 1.6 millions are females 1.6 millions are females 3.6 millions with service connected disabilities 3.6 millions with service connected disabilities Veterans represent 11% of the adult civilian population, but 26% of the homeless population, according to the Homeless Research Institute (2007). Veterans represent 11% of the adult civilian population, but 26% of the homeless population, according to the Homeless Research Institute (2007).

NYT Report Three months ago, Mr. McDonald took control of a demoralized and dysfunctional 330,000-employee agency buffeted by crisis, with problems ranging from outdated software to what even the White House described as a “corrosive” and retaliatory culture.“corrosive” Seeks to recruit 28,000 staff

Mission: Mission: Shape and sustain a peaceful, prosperous, just, and democratic world andShape and sustain a peaceful, prosperous, just, and democratic world and Foster conditions for stability and progress for the benefit of the American people and people everywhere.Foster conditions for stability and progress for the benefit of the American people and people everywhere. This mission is shared with the USAID, ensuring we have a common path forward in partnership as we invest in the shared security and prosperity that will ultimately better prepare us for the challenges of tomorrow. (U.S. Department of State website)This mission is shared with the USAID, ensuring we have a common path forward in partnership as we invest in the shared security and prosperity that will ultimately better prepare us for the challenges of tomorrow. (U.S. Department of State website)

U.S. Department of State Physician Opportunities Foreign Service Specialist Foreign Service Specialist Provide important healthcare service at one of over 270 posts overseas, in Washington, D.C., or elsewhere in the U.S.Provide important healthcare service at one of over 270 posts overseas, in Washington, D.C., or elsewhere in the U.S. Access position openings from State Department website or USAJobsAccess position openings from State Department website or USAJobs