IN THE CASE OF: BOARD DATE: 2 February 2010 DOCKET NUMBER: AR20090003932 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, in effect, reconsideration of his request that his grade of entry on active duty be changed from major (MAJ) to lieutenant colonel (LTC). 2. The applicant states that he is entitled to additional constructive service credit for his education and professional experience. He argues that the Board did not fully consider all of the evidence submitted regarding the computation of the proper constructive service credit. He believes the Board simply relied on the findings contained in the advisory opinion from the Program Manager, Medical Corps, Health Services Directorate from the U.S. Army Recruiting Command (USAREC) rather than reviewing the evidence presented. Moreover, he does not believe USAREC correctly analyzed the evidence regarding his case. 3. The applicant emphasizes several points in which he alleges the Board did not consider in the previous decision. First, he alleges that the Board did not properly credit his medical education in Pakistan. He states he was awarded a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree from Allama Igbal Medical College in Pakistan on 30 September 1986. The applicant points out that the medical college in Pakistan consists of five years followed by one year of house training. He believes that he should be given credit for all six years or as a minimum, the extra two years of medical college should be counted as one year in accordance with Department of Defense Instruction (DODI) 6000.13, paragraph 6.1.2.2.5. He also references DODI 6000.13, paragraph 6.1.2.2.1. and Army Regulation 135-101 (Appointment of Reserve Commissioned Officers for Assignment to Army Medical Department Branches), paragraph 3-1(a)(1). 4. Secondly, the applicant alleges that the Board omitted significant periods of his medical education and professional experience. He states he originally gave a complete chronological order of his postgraduate training to his Medical Services Officer recruiter as an amendment to his application process. Unfortunately, the constructive service credit assessment that was performed and recorded on the DA Form 5074-R (Record of Award of Entry Grade Credit (Medical and Dental Officers)) was incorrect. He lists his periods of training as a house officer, medical officer, staff fellow, and attending physician/consultant. He states he attended classes at Hood College Graduate School [Frederick, MD] toward a Master of Science Degree from July to December 1991. 5. Thirdly, the applicant alleges that the Board did not properly compute the constructive service credit for his post-graduate medical and surgical training. He contends that his job as a house officer should have been included on the DA Form 5074-R as residency training and he should be entitled to an additional 1 year, 6 months, and 20 days of constructive service credit. He states he worked as a medical officer at BHU [Banaras Hindu University] Department of Health from June 1988 to April 1990 and at Services Hospital from April 1990 to June 1991. He contends that these periods of professional experience were also not included on the DA Form 5074-R. The applicant references page 3, paragraph 8 [advisory opinion] of the previous Record of Proceedings. He states that the Board is trying to insinuate his residency training in Pakistan should not be given constructive service credit because it predates his receipt of certification. The applicant references DODI 6000.13, paragraphs 6.1.2.2.5. and 6.1.2.2.4. 6. The applicant further alleges that the Board misconstrued the date he completed his residency training in the United States and did not properly compute his fellowship with the Food and Drug Administration. He again references page 3, paragraph 8 [advisory opinion] of the previous Record of Proceedings, which states "The applicant completed his residency training as a 61F, Internist, in July 1999; therefore, any professional experience that predates July 1999 does not count toward constructive credit." He contends that he completed 3 years of internal medicine residency training from 1 July 1994 to 30 June 1997. He also was a staff fellow with the Food and Drug Administration from 7 July 1997 to 7 July 1999, which should count as professional experience. 7. Additionally, the applicant alleges that the Board did not recognize the professional training he received through externship nor did the Board calculate his work experience as a consultant with the Department of Veterans Affairs (VA) Medical Center. He states that he completed an externship at Providence Hospital from August 1993 to June 1994; however, this period of training was not included on the memorandum from the U.S. Army Medical and Dental Activity, Fort Polk, LA and neither did the Board or USAREC note it in their analyses. The applicant alleges that he should have received 11 months of constructive service credit for this formal professional training in accordance with DODI 6000.13, paragraph 6.1.2.2.4. He states he worked as a consultant at William Jennings Bryan Dorn VA Medical Center [Columbia, SC] and he should be given the proper constructive credit for this professional experience in accordance with DODI 6000.13, paragraph 6.1.2.2.5. 8. Lastly, the applicant alleges that the Board should have awarded him constructive service credit for his graduate medical education. He states he attended classes at Hood College Graduate School in the Master of Science Biomedical Science Program from July 1991 to December 1991 and he should have been granted 6 months of constructive service credit for his education at Hood College Graduate School. In conclusion, he contends that serious inequities would arise if he did not receive proper credit for his extensive education and professional experience. 9. The applicant provides the following documents in support of his request for reconsideration: a. a memorandum, subject: Entry Grade Credit, RE: MAJ N----, S---, MC, xxx-xx-xxxx, dated 10 August 2007; b. five letters of support; c. two Service Certificates; d. a Certificate of Medical Registration; e. a Certificate of Internal Medicine Residency; f. a Transcript/Statement of Federal Service; g. a letter from Providence Hospital, dated 28 June 2007; h. a letter from Department of VA Medical Center, dated 18 October 2006; i. a. letter from Hood College, dated 28 June 2007; and j. a DA Form 5074-R, dated 27 February 2002. 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 AR20070017299 on 25 March 2008. 2. The applicant provides new arguments, letters, certificates, and a Transcript/ Statement of Federal Service that were not previously considered by the Board, and, therefore, warrants consideration by the Board. 3. At the time the applicant submitted his request for reconsideration, he was serving on active duty as an Army Medical Corps officer in the rank of MAJ. 4. The applicant's DA Form-5074-R, dated 10 August 2006, shows he was granted 13 years of total constructive credit in specialty 61F (internist). This form shows he was awarded the following credit for his basic qualifying degree, internship, and graduate professional education: Doctor of Medicine (MD) 04-00-00 September 1986 Georgetown University 01.00-00 1 July 1994-1 July 1995 Internal Medicine (resident) 02-00-00 1 July 1995-1 July 1997 Fellow 06-00-00 1 July 1999-1 July 2005 5. The applicant was appointed in the Regular Army (RA) on 29 September 2006 as a MAJ in the Army Medical Corps. U.S. Army Human Resources Command (USAHRC), Alexandria, VA, published orders on 7 June 2007 which adjusted his date of rank to MAJ from 29 September 2006 to 29 September 2003. 6. The applicant's Certificate of Medical Registration shows he was registered to practice medicine, surgery, obstetrics, and gynecology on 20 October 1986. 7. The applicant provided four letters of support from the Medical Superintendent, Services Hospital Lahore [Pakistan] attesting to the fact that he had worked as an additional house surgeon in the Surgical Specialist Unit of the hospital during the periods 11 November 1986 to 10 May 1987, 11 May 1987 to 30 September 1987, and 1 May 1988 to 31 May 1988, and as a regular house physician from 1 October 1987 to 30 April 1988. In these letters, the Services Hospital was described as a teaching hospital attached to Allama Igbal Medical College, Lahore. 8. The applicant provided a letter, dated 10 February 1998, from the principal of Allama Iqbal Medical College. The principal stated the applicant "was admitted in 1st year MBBS Class during the session 1979-80 commencing from 1 July 1980 and graduated on 30 September 1986 from this college." 9. The applicant also provided two Service Certificates which indicate he worked as a medical officer from 18 June 1988 to 23 January 1989 and from 25 April 1990 to 21 June 1991. 10. The applicant's certificate from the George Washington University Medical Center (Department of Internal Medicine) and Providence Hospital [Washington, DC] show he served as an internal medicine resident from 1 July 1994 to 30 June 1997. 11. The applicant's Transcript/Statement of Federal Service shows he served as a staff fellow at the Department of Health and Human Services, Washington, DC from 7 July 1997 to 7 July 1999. 12. In an 18 October 2006 letter, a Medical Staff Coordinator stated the applicant held clinical care privileges at the DVA Medical Center, Columbia, SC as an associate member of the medical staff in the Primary Care and Subspecialty Medicine Section from February 2006 to September 2006. 13. In a 28 June 2007 letter, a Clinical Professor of Medicine at George Washington University indicated the applicant did an externship at Providence Hospital from August 1993 to June 1994. The letter also indicated the applicant completed 3 months in the office and 8 months in Providence Hospital doing ward rounds, intensive care unit, and coronary care unit. The letter further indicated the applicant was accepted into the residency program in which he completed in 1997. 14. The applicant provided a letter, dated 28 June 2007, from Hood College Graduate School, which stated he attended classes at this college from July 1991 to December 1991 in the Master of Science Biomedical Science program. 15. The applicant provided a copy of a fellow officer's DA Form 5074-R, dated 27 February 2002, which shows the officer was granted 2 years of credit for graduate professional education. 16. In the processing of this case, on 15 October 2009, a second advisory opinion was obtained from the Medical Corps Program Manager, U.S. Army Recruiting Command, Fort Knox, KY. The advisory official stated the applicant was not due any constructive credit in accordance with DODI 6000.13. The opinion cited DODI 6000.13, paragraph 6.1.2.2.1. and indicated that the applicant was only entitled to the maximum of four years of constructive service credit for his foreign medical professional education even though it may have taken him 6 years to complete his education. The opinion also cited DODI 6000.13, paragraph 6.1.2.2.5. and emphasized the following: a. The applicant completed residency training as 61F in July 1999 and any professional experience that predates July 1999 does not count toward constructive service credit. Therefore, the applicant’s work experience as a House Officer from November 1986 through July 1999 does not count toward determining his entry grade credit; b. The applicant indicated he completed his post-graduate training in surgery and medicine from November 1986 to May 1988 in a teaching hospital affiliated with Allama Iqbal Medical College in Pakistan. Unfortunately, foreign post-graduate training does not qualify for awarding constructive service credit, only graduate medical education given for training recognized in the United States, District of Columbia, Puerto Rico, or U.S. territories; c. The applicant’s curriculum vitae did not state any professional work experience after his fellowship in July 2005; therefore, no credit was given as experience in health profession when his constructive credit was calculated in August 2006; and d. The applicant’s record shows he attended classes at Hood College Graduate School from July 1991 to December 1991. However, his record does not show he was awarded any graduate degree. If the applicant can produce records to verify additional graduate degrees, it is possible for him to receive some credit based on the length of the program. 17. The opinion further cited DODI 6000.13, paragraph 6.1.2.2.4. and outlined the applicant’s constructive service credit he received for his internship at Georgetown University (July 1994 to July 1995) - one year; residency at Providence Hospital (Georgetown University) (July 1995 to July 1997) - 2 years, and fellowship (July 1999 to July 2005) - 6 years. However, correction needs to be made on the applicant’s Health Professions Pay Entry Date (HPPED) to show 9 years. The previous Record of Proceedings granted the applicant 9 years of HHPED credit. 18. A copy of the advisory opinion was forwarded to the applicant for information and to allow him the opportunity to provide comments or a rebuttal. On 1 December 2009, the applicant submitted a rebuttal to the advisory opinion and he reemphasized the following: a. It would be a serious inequity not to count his entire medical education in formulating his entry grade in accordance with Army Regulation 135-101, paragraph 3-1(a)(1) and (2); b. His experience as a Medical Officer at BHU Department of Health and with Services Hospital should qualify as creditable service credit in accordance with DODI 6000.13, paragraph 6.1.2.2.5. He also alleged that this experience has contributed to his medical training that he uses in his current medical practice and should qualify under DODI 6000.13, paragraph 6.1.2.2.6. and Army Regulation 135-101; c. His post-graduate training in surgery and medicine from November 1986 to May 1988 should qualify for constructive service credit in accordance with DODI 6000.13, paragraph 6.1.2.2.5.; d. He was a Staff Fellow with the Food and Drug Administration from July 1997 to July 1999 and he alleged that he should be assessed year for year credit for this period of time in accordance with DODI 6000.13, paragraph 6.1.2.2.5.; e. He worked as a consultant at William Jennings Bryan Dorn VA Medical Center from February 2006 to September 2006 and he gave his experience to his medical recruiter prior to August 2006. He alleged that he was not awarded constructive service credit for this experience and he should be given the proper constructive service credit in accordance with DODI 6000.13, paragraph 6.1.2.2.5.; f. The applicant cited an email from a sergeant first class regarding his work at VA Medical Center; g. He should receive 11 months of constructive service credit for his externship at Providence Hospital in accordance with DODI 6000.13, paragraph 6.1.2.2.4.; and h. He should be granted 6 months of constructive service credit for his education at Hood College Graduate School in accordance with DODI 6000.13, paragraph 6.1.2.2.6. 19. DODI 6000.13 is the governing directive in granting constructive service credit. Paragraph 6.1.2. states that this 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. 20. DODI 6000.13, paragraph 6.1.2.2.1. states that 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.). 21. DODI 6000.13, paragraph 6.1.2.2.2. states that no additional credit may be given for more than one advanced degree in a single field or closely related field. 22. DODI 6000.13, paragraph 6.1.2.2.4. states that year-for-year credit shall be granted for the successful completion of internship, residency, fellowship or equivalent graduate medical, dental, or other formal professional training (i.e., clinical psychology internship or dietetic internship, etc.) required by the Military Service concerned. Training must be approved by the appropriate accrediting agency, and may not exceed that required for certification in the specialty. Day-for-day credit shall be awarded for approved programs of less than one year in duration. 23. DODI 6000.13, paragraph 6.1.2.2.5. states that credit of one-half year for each year of experience, up to a maximum of three years of constructive credit, may be granted for experience in a health profession, if such experience is directly used by the Military Service concerned. Creditable experience cannot predate the receipt of licensure, registration, or certification. Accordingly, volunteer, or student status cannot be credited. 24. DODI 6000.13, paragraph 6.1.2.2.6. states that 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 for appointment as commissioned officers. The amount of credit shall be one year for each year of special education or experience. Maximum credit under subparagraph 6.1.2.2.5., above, must be earned before earning any experience credit under this paragraph. DISCUSSION AND CONCLUSIONS: 1. The applicant contends that he did not receive proper credit for his medical education in Pakistan. Although the applicant states the medical college in Pakistan consists of five years and one year of house training, he was granted the maximum of 4 years of constructive service credit for his MBBS degree allowed by DODI 6000.13., paragraph 6.1.2.2.1. Therefore, he is not authorized additional constructive service credit for his medical education in Pakistan. 2. The applicant contends that significant periods of his medical education and professional experience were omitted from his DA Form 5074-R. He also contends that he gave a complete chronological order of his postgraduate training to his Medical Services Officer recruiter as an amendment to his application process. However, the evidence of record shows that the applicant was awarded the appropriate constructive service credit based on the information available at the time when his DA Form 5074-R was prepared. In the absence of evidence to the contrary, it cannot be determined whether his medical education and professional experience were available to his Medical Services Officer recruiter at the time his application was processed. Therefore, he is not authorized any additional constructive service credit for his medical education and professional experience. 3. The applicant contends that the Board did not properly compute the constructive service credit for his post-graduate medical and surgical training and his periods of professional experience were not included on the DA Form 5074-R. However, the evidence of record shows the applicant completed his residency training as an internist in July 1999. Based on DODI 6000.13, paragraph 6.1.2.2.5., creditable experience cannot predate the receipt of licensure, registration, or certification. There is no evidence which confirms he was granted additional constructive service credit by the Secretary of a Military Department as indicated in DODI 6000.13, paragraph 6.1.2.2.6. Therefore, the applicant’s post-graduate medical and surgical training and professional experience are not creditable towards determining his entry grade credit. 4. The applicant contends that the Board misconstrued the date he completed his residency training in the United States and it did not properly compute his fellowship with the Food and Drug Administration. However, there is insufficient evidence which confirms that his residency training and fellowship were not properly considered when his constructive service credit was calculated in August 2006. 5. The applicant contends the Board did not recognize the professional training he received through externship nor did the Board calculate his work experience as a consultant with the VA Medical Center. However, there are no evaluations or any other documents to confirm the applicant's duty performance as a consultant. Although the applicant provided an email and letter regarding his work at the VA Medical Center, this evidence alone is insufficient on which to grant him additional constructive service credit for this work experience. 6. The applicant contends that the Board should have awarded him constructive service credit for his graduate medical education. Although the applicant attended classes at Hood College Graduate School from July 1991 to December 1991, there is no evidence which shows he was awarded a graduate degree. Therefore, he is not authorized additional constructive service credit for the courses he completed at Hood College Graduate School. 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 to amend the decision of the ABCMR set forth in Docket Number AR20070017299 dated 25 March 2008. ___________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) AR20090003932 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20090003932 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1