Brigade Surgeon Life

Introduction

I spent my first two years post-residency as a Battalion Surgeon for a BSB. Around that time, my Brigade Surgeon left for greener pastures. Her replacement was substantially less experienced than myself, so Division made the decision that I was to take over as the Brigade Surgeon and my predecessor's replacement would take over my BSB gig. Stuff like this happens ALL. THE. TIME. There is always a chance you will end your time at a duty station with a different title from the one you started with, but I digress...

Despite the similar name, this job is entirely different from the Battalion counterpart. It is substantially more filled with administrative work with far less direct patient care. I was originally dreading this "promotion," but it has had a number of perks that I have been enjoying.

Job description

You are the supervising physician of your brigade. There may be any number of physicians and PAs staffing the respective battalions that fall within your Brigade, and you are responsible for them (to a degree). You are not their "boss," but you kinda are. Their Battalion XO is their main boss. The XO is their rater on their OER and their Battalion Commander is the Senior Rater. The Battalion controls when they go to the field or do a PT test. Your leadership is a bit less direct: you are their intermediate rater on their OER (they need some sort of medical person in their rating chain). You don't control when they come to work, but you do control medical policy across the Brigade. If you want everyone with a musculoskeletal injury to have an x-ray completed within 30 days of initial presentation, that will become Brigade policy, and the Battalion Surgeons will follow it. I work very hard to stay friends with the Battalion providers while maintaining a boss-like persona. 

You are the medical expert of the Brigade. Leadership from across the Brigade at all levels will have your phone number and call you at any time with medical and medical policy questions. You will sit in meetings with Brigade staff and go over profiles to weigh in on the prognosis and return-to-duty timeline. You will be asked questions about policy from pregnancy to vaccines, to transition surgery, and so on. 

You will be expected to keep higher command updated on the medical readiness of the Brigade. Technically, readiness is the responsibility of the Battalion staff, but even still, the buck will at least start with you. You need to take control of the situation and push the right people to make the right decisions.

There are a bunch of other smaller hats you get to wear as well (managing medical training across the Brigade, advising on medical logistics for battle strategy, etc). 

Beyond all of this, you are special staff. You have a unique position from which you can touch every aspect of leadership. You can walk into the COL's office and he will be happy to see you. You get a seat at the big kid's table during meetings. You can walk into most offices in Brigade HQ on your journey to achieve some goal and people will listen and help you without question.  

Day-to-day

Here is where it gets interesting. I have three, one-hour, regular meetings per week. That is it. That is my entire regular schedule. Sure there is the occasional extra meeting here or there, but on the whole, that is it. Freedom of schedule is the biggest difference I have noticed from Battalion to Brigade life. As they say, with great power comes great responsibility... I could absolutely just milk this like crazy and barely ever show up. As it stands, I have found a happy medium in this cornucopia of choice. I have a program to run an Army virtual desktop on my personal5 computer and an app to run an Army virtual phone on my phone. I am plugged in 24/7 - I answer emails and phone calls all day and night. I don't mean I am constantly looking at a screen, but I am able to get work notifications as they pop up and am extremely prompt with responses. To balance this out, I leave my house way later or whenever I'd like to. I get to have breakfast with my kids and work out after the sun rises. 

I am entirely in control of my patient schedule. Technically, I believe the Brigade Surgeon has a 0.1 FTE. I haven't had a need to pay attention to this. I only see the patients I want to see. This has led me to predominantly treat higher-level staff and do a LOT of procedures. I have even had time to get a Vasectomy clinic going.  I really thought I would have skill atrophy without seeing as much clinic, but I quickly realized that the majority of what I was seeing was very repetitive, non-cognitively stimulating common complaints (flu, knee pain, back pain, headaches, etc.). 

Another interesting perk of this position is your staff. Yes, I said YOUR staff. The Brigade Surgeon leads what is known as the Surgeon Cell (or Surgeon staff if you want to be boring). I work with a medical operations officer (the Brigade "MEDO") and a senior medic. You provide the expertise, the MEDO is the planner, and the senior medic is the do-er. Your MEDO will handle medical logistics across the Brigade (ordering supplies, planning meetings, etc.) and will go to a bunch of meetings your probably don't want to go to. Your Senior Medic will get things done. They will make sure your vehicles are working, picks up and stores supplies, and otherwise executes the plans put together by the MEDO. They will consistently be hitting you up for your opinion and advice on all things medical. A great or terrible MEDO/Medic will make or break your Surgeon cell. 

Other responsibilities

Being in charge, you ultimately need to make sure that things get done. A good number of times, I ended up just doing it myself. If the Battalion PA hasn't submitted the profile reviews for the COL on time, I guess I'm staying up late tonight. I step in and help out in the clinic when PAs are on leave or a TDY.  

Deployment

In theater JAN2025. (didja get the joke?)

I know I will have lot more to add to this page when the prep work for our rotation in Europe comes up.

• Soldier Readiness Processing (SRP)

  • Everyone's favorite process in which every single member of your unit must be screened for readiness and remedied if not up to date. 

  • It includes various administrative checks from other offices like S1, finance, etc, but you get to manage the medical!

  • Apart from the usual readiness metrics (PHA, DHA, HIV, vision, hearing, etc), you get to screen everyone for a deployment-limiting condition/medication. This will vary by your theater of operation and there is a pre-established memo that lays out what conditions/medications are permitted and those that will require a waiver to allow deployment.

    • The waiver is a form you complete to state that you understand they have this condition and explain how they will still be good to deploy. Certain conditions need an additional memo from the Battalion commander (stating they accept responsibility for this individual's medical wellbeing).

    • This is an extensive effort and will require significant coordination with your various Battalion medical providers