Be very, very careful about joining the Commissioned Corps of the United States Public Health Service (USPHS). It sounds good, especially if you have active duty time and you are dreaming of possibly getting your "20" without ever having to run PT, go to the range or deploy, ever again.
Some people do make it and retire, it can happen, however, this is a service that does not have clear cut personnel procedures, it is a 'uniformed service', they have 'navy ranks and navy uniforms' (they have USPHS ranks, but even they don't know what they are, so they call each other by navy ranks- the uniform is the same as the navy with a different 'patch'), so they like to throw around military sounding jargon-but they have not the slightest idea of what this 'jargon' might have originally meant. This is a service which is basically run by pharmacists. Generally the higher ranking persons who 'run the show' are pharmacists who are now in an office job making administrative decisions which will affect your life and career.
If you are accused of making a mistake, you will be 'written up' by whoever your boss is, or which ever co-worker is out to get you.
Just like the judicial system, little to no evidence is needed to 'accuse' someone of something, you just 'write them up'. In the USPHS the 'write up' is the proof of your guilt, the higher up or more important the person is who 'wrote you up' the more guilty you are. Yes, you are allowed to defend yourself-on the back side of this fear-generating piece of paper, the 'write up', you will be allowed to write your version of the event in question. Also, you can be 'written up' for anything, ( an example from my experience-not reattaching a 'TKO' IV disconnected from a healthy person scheduled for discharge because they wanted to walk to the bathroom). Even if you are following clinic or hospital rules, if you displease a member of one of the groups the USPHS serves and they complain about you, guess what-you have now been 'written up!'
The complaints against you will then be consolidated and sent to the USPHS 'adverse actions' officer. This person (a pharmacist at this time, previously it was a nurse), will decide your sentence, you will not be asked how you plea because you, dear, powerless USPHS Officer, are already considered guilty, there is no JAG office for you!
After going through an experience like this (as I am sure you have already figured out-it happened to me), you long for the honesty and directness of a good old fashion 'court marshal'.
You are not told this by anyone after the USPHS has found you "guilty" and has sent you orders kicking you out, but if you are really persistent you will discover that there does exist a "Commissioned Corps Board of Correction of Records". You can write to this 'Board', if you can somehow find their phone number and address. This Board is composed of a rotating list of retired USPHS civilians who were in a rank structure above "Civil Service", something like a 'managerial service' pay grade structure.
You will spend over a year, possibly several years, writing to this 'Board' trying to defend yourself. The 'Division of Commissioned Personnel' of the USPHS will reply each time you write the 'Board', then you reply to this and so on. The 'Division of Commissioned Personnel' people who are responding to you are on active duty salary, they have paid secretarial support and the support of the legal division of the Department of Health and Human Services, what kind of chance do you think you realistically have? Forget guilt or innocence-you are a pawn in a political game, no one cares. In the words of one of the 'Adverse Actions Officers "you can fight if you want to but remember what they say,you can't fight city hall"!
In the unlikely event that you win the 'Board' ( I did-it took me three years and every dime of my life savings-by the way my case was # 00225, in case anyone thinks I am making this up), your case will then be reviewed by the "Director of the Program Support Center", which somehow is a "private management company", headed by the direct designee of the Secretary of the Department of Health and Human Services and paid for by you and me dear taxpayer. This political appointee, who is 'biding time' until they can get a better appointment,(they are never there long), may then 'non-concure' with the USPHS Board for Correction of Records decision, for any indecipherable reason he dreams up, and then guess what-you may be innocent and you may have fought for years and won battle after battle but you have now lost the war!
This was my experience with the USPHS Commissioned Corps upper management.
I was with this service (USPHS) in the early 80es, transfered to the Army, and then went back to the USPHS, because, just like all the services you meet interesting people, you get to work with people and in places that you may not otherwise get to know, and you may, if you can stick it out, end up with a retirement. From this point of view, interesting people and varied duty, I recommend any and all of the services.
It is my hope that someday the USPHS Commissioned Corps will clean up their act. There is an enormous potential to do a lot of good locked up in this service, with the right leadership and a unified vision of what health care could be like in the United States.
For now though it is a hodge podge of conflicting political interests tied to huge amounts of money in a field with an unlimited capacity to generate funds. As a Commissioned Corps Officer providing care to patients you are a 'pawn' in somebody's high stakes game. You may have no interest in playing politics but you get caught up in these games just because you exist in that system.
For me, the ordeal I had to live through with the USPHS still haunts me. After all I went through with my fight before this 'Board', losing everything I had, and lived for over three years thinking I was a 'dishonorably discharged' Officer from the service of my country, I discovered that I was still in the Army! One morning I got a phone call, "Ma' am, no one in this Unit knows who you are but you need to know that you have been activated in support of Operation Iraqi Freedom and you have 24 hours to report to duty." I could not believe what I was hearing! The USPHS had never gotten a release form the Army for my Commission, I was a 'non-drilling' Army Reserve this entire time! I dug out my boots, dog tags and uniform, reported in, passed the PT test, learned how to put on the new beret, tried to explain my story to a Sargent who was trying to SRP troops to get them ready to deploy ( "yes ma' am, whatever you say ma'am, now would you please get in line for your shots"), tried to explain my story to JAG (ma'am, whenever we have these massive call ups we have people coming in here telling us we made a mistake and they are not really in the Army, you do have a pretty good story but I hate to tell you, if you are putting on the uniform every day, and going to work every day and getting paid, YOU are in the Army now!")
Because of the experience I went through with the USPHS I will probably never get a retirement, ( I have 3 years of Active Duty service with the USPHS which I cannot get into my records because "you can only hold one Commission in one service at a time") my age is working against me, but I am so thankful that I got to do some Active Duty tours with the Army. I was able to get my own self respect back. Yes, I had to get up at "O dark thirty",and yes I had to work those 15 to 20 hour days (and nights), and there were times when I felt like it was all just too much, but I was able to again interact with all the people from all over the country who serve, I saw the good and the bad and did what I could to make it better, I saw the "new" young soldiers and, dirt bags excepted, most of them made me feel proud to be associated with them. I saw all the improvements the military has put in with electronic career management and I am heartened that, although it is not perfect, the military personnel departments are trying hard.
What I went through really, really hurt me a lot. The USPHS did, and still does treat things like this as a joke, they think it's funny to see someone emotionally bleeding to death. Slam me with an M16 round any day compared to this treatment. At least you will be evacuated and someone will take care of you before they start to call you an idiot for being in the wrong place a the wrong time!
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Re: US Public Health Service Commissioned Corps
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, I know who you are, and even though we will never see each other again-Thank You 
), and also to 'set me up' for phony AWOL charges- they told me to just 'put your leave slip in the box, someone will sign it, the bosses are all gone now', after I had been put on the schedule for approved leave. How stupid of me, but this is "how they always" did leave. I had gotten chewed out by them six months earlier because I had insisted that leave papers should be signed before an officer physically went on leave, just like the Reg says. I had over 55 days of unused leave. I had never taken a sick day. I have an OER from the Army mentioning my work ethic and the fact that I had never missed a day of work in over three years at an especially difficult duty station in a hard job. Why in the world would a person like that go AWOL, I asked the USPHS. No answer, just boom, over a thousand dollars deducted from my pay.
