Flight Path
The guide for our structure
and the development of our AFMS disciplines

Maj. Gen. Melissa A. Rank

By Maj. Gen. Melissa A. Rank
Assistant AF Surgeon General for Medical Force Development, and Nursing Services

Exciting times continue to challenge our Air Force Medical Service. We can be proud of our successful transition to an expeditionary mission and the deliberate preparation of our Airmen for this mission through aggressive force development policies and programs. Yet, our work is not done.

In 1993, the implementation of the Objective Medical Group (OMG) represented a revolutionary organizational change to the AFMS. The structure provided many benefits to our medics and our patients: command and control mirrored the line construct; medics were at the table on equal ground with Line counterparts; and the "dual profession nature" of military medicine was recognized.

The OMG created a "product line" focus with designation of medical operations; aerospace medicine; dental; and medical support squadrons. This structure fostered team building at the tactical level, facilitated accountability in the provision of care, and enabled the patients to more easily navigate the system during an episode of care. Like all dynamic organizations, our AFMS must continue to respond to the ever-changing environment.

Re-evaluation of the OMG construct was a logical step in this quest for excellence.

In 2004, former Air Force Chief of Staff Gen. John P. Jumper tasked the Air Force surgeon general -- in a letter "Developing Expeditionary Medics - A Flight Path" -- to "complete a comprehensive review of the medical group structure for our garrisoned and expeditionary medical groups."

We have since developed a new "Flight Path" to guide our organizational structure and the development of our AFMS disciplines.

The overall goal of the "Flight Path" is to develop a streamlined, consistent medical group structure from clinic to medical center that provides a ready and fit force for the Air Expeditionary Force. It also rewards military and functional competence; provides a medical power projection platform to deploy medics forward and delivers high quality, cost effective care.

The "Flight Path" fosters corps-specific force development; requirements-driven leadership opportunities, balanced leadership teams within the MTF; compliance with military and civilian certification requirements; and cost-effective mission support at home and when deployed.

Many of the successful attributes of the OMG have been retained while specific changes include:

• highlighting functional expertise (SGH, SGN, SGA, SGP, SGB and group superintendent)
• limiting group command to one 3-year tour
• limiting command of medical centers to medical corps (MC) only
• linking command opportunity to senior leadership requirements
• deactivating squadrons and activating divisions in those MTFs with fewer than 300 authorizations, and
• designating medical group, squadron commander, and division chief positions by corps

There are four MTF organizational models in the AFMS "Flight Path": medical wing, hospital/medical center, clinic with squadrons, and clinic without squadrons. Clinic without squadrons will have product-line divisions: medical operations, aerospace medicine, and dental. Education and training will align under SGN, while readiness and support functions will align under SGA.

As the original OMG was relatively "transparent" to the line and beneficiaries, these improvements should be "invisible" to the outside community. The new structure reduces the amount of manpower dedicated to administrative duties and retains the product-line delivery to our customers. The two- to four-year implementation period provides ample time to accomplish these changes and minimizes any potentially negative effects on the professional lives of our people.

The overarching goal of the "Flight Path" is to guide more deliberate development for AFMS officers and senior enlisted, placing the member in the right job at the right time and setting them up for career success and personal satisfaction while maintaining expertise at the frontlines of patient care. It is an exciting time to be in our AFMS and, at the same time, one with a future that promises many challenging opportunities.