CMSgt Charlie Cole                 CMSgt Enrique Henson            CMSgt Robert Bradley

CMSgt Joe Potts                      SMSgt Dave Nordel                 SMSgt Bobbie Gilbar              

SMSgt Manfred Glas                MSgt Daniel Arnold                  MSgt Don Mabee       

MSgt Lisa Richards                 

      As expected the conversion of the IDMTs from a Special Identifier (SEI) to a shred of 4N0X1C has not gone as smoothly as we hoped.  Less than 50% of our IDMTs have been converted.  I am working with the MAJCOM Functionals and SMSgt Mogle at AFPC to get the conversions done in a timely manner.  Another change is both SMSgts and CMSgts will carry the 496 SEI.  Initially the plan was SMSgts would carry the shred, but somehow that was changed in the classification update.  I decided the SMSgt’s would go ahead and carry the SEI instead of the shred.  The IDMT career path ladder is being developed for the new 4N0X1C Shred.  Your MAJCOM Functionals and I will review the proposed career path in April at our Functional Manager’s Meeting at Sheppard.

     The last IDMT issue I need to discuss is promotion testing.  IDMTs will test (PFE/SKT) in 05 with the rest of the 4N0 career field.  In 06 IDMTs will be competing against only those within the C shred out.  The WAPS Catalog will be updated in August 05 to reflect the required study references.  IDMTs actually played a part in the development of this new SKT.

Webmaster's note: The questions below are the two most received by the IDMTAssociation.org website. They were forwarded to Chief Lewis who replies as follows: 

Q: Where is 44-103?

A: As stated in my Nightingale Newsletter, I expect to see the IDMT AFI out in the field NLT June 05.  It has made its final rounds here at Air Staff, we now just need the final sign off by AF/SG.

Q: Why is it that even though CMSgt Harms said we're (the IDMTs) going to be seeing patients in-garrison, we're still being told by the Med Groups that IDMTs can only see patients while deployed?  

A: IDMTs may see patients in-garrison but only under the provision of sustaimnet training.  The new AFI will require the IDMT to see a minimum of 48 patients annually.  An IDMT may see more patients than this, but 48 is the minimum number.  A physician will lay eyes on the patient before the patient departs the MTF.  SME/MMU IDMTs will not see patients in their squadrons/units.  All patient care while in garrison will be done in the MTF. 

 DAVID W. LEWIS
4N0X1/B/C Career Field Manager
HQ USAF/SGCN Office of the Surgeon General

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Good morning...

            I need to get you up to speed on what is happening with the IDMTs and what you can expect as far as an impact to your facility.

            - On 1 Nov, the management of IDMTs will move from SEI to shred of the 4N0 AFSC...4N0X1C.  As such we will no longer have IDMTs in facilities that do not have IDMT requirements either in the facilities or at SMEs (requirements were worked by the MAJCOMs earlier this year). All SME 4N0 positions will be IDMTs.  This may take us a year of so to get to and as such, we know we may have 4N0s sitting in 4N0X1C SME billets until such a time as AFPC has an IDMT to fill the requirement.  All 4N0X1s with the 496 SEI will automatically convert to 4N0X1C on 1 Nov.

            - AFPC will be doing all the assignment actions in order to balance the commands in percent of staffing with IDMTs.  As is standard practice, PACAF and USAFE will be staffed to a higher percent than CONUS.  It will take a few months to get individuals moved to valid positions as well as identify individuals to backfill the facilities. 

            ROES:

            Since this is a force shaping initiative, almost all the pcsing rules can be ignored....such as time on station etc...

            Since Feb 04, AFPC has hand matched IDMTs returning from overseas into bases that have IDMT requirements.  This may cause an overage at some locations and may then cause the highest time on station IDMT to move.

            IDMTs who are overseas and have more than one year remaining on their DEROS can be moved to a valid assignment within the command to finish off their tour of duty or returned stateside.  If they have less than one year remaining, they will be PCSd.

            IDMTs who are serving at a remote assignment as a 4N0 will finish their tour and then be moved as an IDMT.  AFPC will try to match them to their BOP however this may not happen in all cases.

            We have a larger number of 7-level than requirements so we recognize that we will have 7 levels filling 5-level requirements until we balance out.  This is why we only have SrA and SSgt for retraining in to the IDMT course.

            Individuals who already have an IDMT class slot will continue to go to school.  When the AFSC awarding course is on the books, AFPC will give the attendees a new TLN for the J3ALN4N051C course.  The MAJCOMs have been slotting folks into the course so we may not have to have 60 retrainees this year, but next year we will need 90.  Entrance into the IDMT world will now be through retraining and CAREERs.

            IDMTs will be seeing patients in garrison with their preceptor available.  SME/MMU IDMTs will not see patients down in their squadrons/units.  All patient care while in garrison will be done in the MTF (exception would be mass immunizations as coordinated with the immunization clinic).  They can have patients scheduled for them, but not more than 2 - 3 per hour.  The patient count will go to the preceptor as will the RVUs.  IDMTs will only be allowed to see active duty patients.  IDMTs will be required to complete an annual training program as well as be IBTs and maintain the currency requirements.  Most of the in-garrison IDMTs will be assigned to the Flight Medicine Clinic.

            AFI 44-103 and the IDMT protocols are being updated as I write this and it is planned that they will be published before the 1st of Nov.

            For CY 05, IDMTs will promotion test (PFE and SKT) with the slick 4N0s, but be selected for promotion as a 4N0X1C.

            Obviously there is alot of work going on in the background, but hopefully this message helped fill in some knowledge gaps.  If you need additional information, contact the 4N0 MAJCOM Functional.

Sincerely,
Ellen K. Harms, CMSgt, USAF
Aerospace Medical Service CFM                                                                                                                           Superintendent, Med Ops Policy Div

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Greetings from Washington DC, 

      I have been asked by members of the association to give you an update on where we are with moving the IDMT management from SEI to AFSC.  This has been a long well thought out process that has involved the 4N0 MAJCOM Functionals, schoolhouse, IDMT consultants, AFPC, AETC, SG JAG, SGD (MG Brannon), SGO (MG Kelly), and the SG (LTG Taylor).  If after reading this letter, you still have questions, please contact your senior 4N0 or MAJCOM Functional for clarification.

     The classification change request has been approved by AFPC and is in the implementation stage that will activate the 4N0X1C AFSC on 1 Nov 04. 

     The 4N0 MAJCOM Functionals worked with their command manpower and readiness personnel to lay in the IDMT requirements by unit.  Many of the IDMT positions are in Flight Medicine to support the operational component of their mission to include the Mission Essential Task List (METL).  We will have IDMTs in the Squadron Medical Element (SME) positions as well as in other locations in the MTF as needed to support UTC and backfill requirements.

     We meticulously completed a review of all individuals who hold the 496 SEI and compared that to the schoolhouse class graduation rosters.  We identified individuals who never completed the course who had the SEI--AFPC removed the SEI; conversely, we found individuals who graduated from the course who did not have the SEI and we worked with the units to correct that.  To this end, at midnight, 31 Oct 04, all individuals who have the 496 SEI will convert to 4N0X1C effective 1 Nov.

     Knowing the requirements and where the individuals are, SMSgt Cole from assignments was then able to determine how many individuals will be moved into valid IDMT authorizations after 1 Nov 04.  There are some ROEs as well…individuals who are doing a remote assignment will continue to complete the tour of duty and to the best of our ability allow them to proceed on to their Follow On Assignment.  If the Follow On Assignment does not have an IDMT requirement, assignments will work with the individual to meet his/her preferences as well as that of the Air Force.  We also looked at individuals who are stationed OCONUS and their status, requirements of their current duty location and the requirements of the MAJCOM.  Some of these individuals will remain in place and complete their DEROS; others may have to move.  IDMTs stateside will relocate to valid IDMT positions either at their current duty location or PCS/PCA to valid IDMT positions.  All the moves will not happen overnight.  Assignments will work the moves and back fills. 

     Promotion testing for CY 05.  IDMTs will compete for promotion with all eligible 4N0s.  There was not enough time to put together a promotion test writing team and get the tests published.  Also, the MAJCOM Functionals and I did not want to have the IDMT’s WAPS study material to be various AFIs, CDCs, and reference manuals.  The decision was made to do an exception to policy and have the 4N0X1C AFSC compete with the 4N0s.  In CY 06, unless otherwise determined by the MAJCOM Functionals and the new CFM, the IDMTs will compete for promotion within the 4N0X1C AFSC.

     Retraining.  After 1 Nov, IDMTs will enter the AFSC through the retraining process.  Because of our current numbers vs. requirements, it will be predominantly retraining for SrA and SSgts.  We built in some safeguards to facilitate getting the right person into the IDMT AFSC.  They must have 4 years experience as a 4N0 and a minimum of 2 years experience in direct patient care. (this means that first term airmen who enlisted for 4 years will not be able to retrain into IDMT until they have the 4 years experience as a 4N0--it takes approximately 9-10 months to get from BMT to their first duty assignment. 4N0s who are 6-year enlistees will have the opportunity for retraining at their first re-enlistment point).   We also kept the requirement to have the individual cleared for duty in remote isolated environments IAW 48-123.  To this end, we need to really develop our SrA and SSgts for the rigors of the IDMT course (our upcoming 7-level CDC will be a key component in this)…especially getting their clinical skills up.  The mandatory 4N0 mentoring PPT has sparked lots and lots of interest in our SrA and SSgt.  We need to help them prepare for the school and assist with the completion of the retraining package.  I set the requirement that the IDMT course be a 5-level awarding course.  Individuals who complete the course after 1 Nov will enter into upgrade training for 6-months to get back to the 7-skill level (as applicable).  Rationale:  The AOR commanders and the remote/isolated site commanders prefer to not have 3-levels.  IDMTs are skilled 4N05/71s that have received additional training that expands their skills and knowledge while adding in new ones.  I did not feel that having folks graduate as 4N031Cs was the right way to go, hence the requirement for this to be a 5-level awarding course.  AETC along with the schoolhouse is working to change the course number and rework the lesson plans to meet the requirements.  The plan is to have the course certified later this summer and ready to go before the implementation date of 1 Nov.

     Immunization Back-Up Technician (IBTs).  All IDMTs will have to be IBTs.  It will be a pre-requisite for submitting a retraining package and a required skill set for all IDMTs.  Rationale:  The after action reports showed that many individuals required immunizations after they arrived at their deployed location or we were continuing immunization series such as anthrax or initiating an immunization such as influenza.  By having all IDMTs with this skill set, the AFMS can provide this vital Force Protection to our forces.

     AFI 44-103.  We are in the final stages of the draft of 44-103 that incorporates the wording to allow IDMTs to practice in-garrison.  The AFI also contains wording about how the IDMT is to maintain the full spectrum of their skill set to include Public Health, Bio, dental, etc.  The AFI is due out for internal review early July.  I am hoping to have it published by 31 Aug.

     Special Duty Assignment Pay (SDAP).  A package was submitted for IDMTs to receive SDAP.  The package will meet a board in July and the board will determine if all, none, or some of the IDMTs will receive this pay. 

     IDMT Annual Award.  The 4N0 MAJCOM Functionals and I agreed to develop an annual IDMT AFMS award.  The criteria has to be sorted out and added to the AFI.  Be aware through, IDMTs are strong candidates for the Olsen-Wegner award (this was the prior 4F0 annual award). 

     I hope I have addressed some of your concerns on where we are heading with the conversion to the 4N0X1C AFSC.  SMSgt Cole has developed a talking paper that further addresses the assignment process for getting our IDMTs in to valid IDMT positions.  Again, if you have questions/concerns or are hearing rumors and need the facts, please address them to your senior 4N0 and/or MAJCOM Functional.

Sincerely,
Ellen K. Harms, CMSgt, USAF
Aerospace Medical Service CFM    

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Greetings Fellow IDMTs, 

     I wish to apologize for the lengthy hiatus from taking keyboard to fingers and typing to help keep you abreast on things affecting us within the Air Force Medical Service (AFMS). We have had many changes take place since I last sent out any messages to the field and I would like to help dispel any rumors or misinterpretations on what the future holds in store for the IDMT. To do this I contacted CMSgt (Sel) Charlie Cole to put together a talking paper that has since been posted on the IDMT Home Page.  As you all know for many years we have sought to find our own identity within the AFMS and it has been an uphill battle. The IDMT has played an integral role in AFMS since our inception and today we remain the only enlisted proponent of the physician extender. The AFMS and our superiors rely heavily on our ability to fit into any model being touted or implemented as roles and missions change. This goes across the board in the medical community but it is critical that we can adjust and meet the need to support our line counterparts from any platform. The responsibility afforded the IDMT is not one you will find given to any other enlisted and our value has been proven over and over again not only in the success of our actions but the continual creation of new IDMT billets.

     As a founding member of the IDMT Association I have seen where we have helped influence these changes in both small and large leaps. I can remember back in the early 90’s when the IDMT world was dictated by one or two folks; they made all the decisions across the board and the only time the IDMT in the field knew what was happening was after it had been implemented. I’m not the only dinosaur out here still, so I know some of you can vividly recall what I’m talking about.  We were very fortunate to have innovators and supporters in the early formation like CMSgt’s Bob Loftus, Chris Williams, Mary Hale, Tony Kolodgy, Herm Hertog, Richard Preheim, Mike Miraglia, John Salone to name a few (this listing is not all inclusive) to not loose track of from where they came and help pull us together as a group by encouraging/supporting the development of the association.  Since this time we have gained an active voice in helping set policies which affect us and have been sought out by the MAJCOM Chief Medical Enlisted Issues (CMEIs) and AF Career Field Manager (AFCFM) to help improve the process from the field. We also gained recognition as an echelon of health care a few years back, (referenced as a first responder) although the nomenclature did not meet with great approval it was a small victory towards some independence. We went to standardized AF Protocols, which eliminated a major training curve from one assignment or deployment to the next. Our available medication list has grown immensely affording us a greater opportunity to provide care to our patients from a worldwide platform. We have IDMTs gaining advanced level training/certifications and are embedding them with the unit’s who need them most. This is all as a result of what we had accomplished previously, collectively and the input we have been able to share upward. The IDMT will only continue to gain the recognition we have hoped for with the transition to the new Air Force Specialty Code (AFSC) and along with that will be some added responsibility.

     I will be the first to admit we have not achieved 100% of the goals I would have hoped by now but the “writing is on the wall” that we’re still moving in the right direction to reach them. It is going to be a slow process but as we continue to demonstrate that we can provide “total health care in one package” our position will only strengthen. You each need to stay engaged with your MAJCOM CMEI to help ensure that information is being flowed both up and down the chain. There are many steps being finalized yet, so until the fluidity stops the information being posted should come from the subject matter experts or their point of contacts. I again think this identifies why each MAJCOM needs to have a MAJCOM IDMT focal point (additional duty position) appointed by the CMEI for the others to go through to help prevent misinformation. There are many other things being worked currently behind the scenes by Chief Harms, which fall in line with our association’s goals that she will address in the near future as they solidify the final initiatives/push for the IDMT.

     I have read many of your concerns in regards to the new process of selecting IDMTs from the field and would like to briefly share some thoughts on this. We have all seen major changes throughout our military careers and will continue to do so if we stay long enough. The taking from one AFSC and having individuals retrain in to another is nothing new, as the military will always have a spot for a good Airman…it just might not always be in the job they chose. Some of us that are medical now did not start that way when we first came on active duty, there are others who were persuaded (strongly) to take on SEIs that have proven successful, and then we will always have those who set the bar high and want to take on the challenges. The senior 4Ns at facilities will have a major role in the recommendation process still, which means where in the past those we thought would have made a great IDMT now will get an opportunity to excel. I will be the first to say being an IDMT is a calling, but sometimes folks need that little push to realize the voices they hear aren’t in their head…this will afford that opportunity. What I’m trying to say is we are diverse across all AFSC the outcome and our success is determined by individual desire, which means we will still only graduate those qualified from our IDMT programs.

     All of us know some Airman in our career that was just a total screw up in certain work environments, but with realignment to a new position/challenge they became the complete opposite. We have also found some that were the exception who showed chinks in the armor after being challenged, of which many went back and improved to pursue their goal of IDMT and attended a second time. I know quite a few of these folks I just referenced above and they are nothing less than stellar as IDMTs in today’s AFMS. We have also blocked retraining in the past to limited AFSCs for our 4Ns as the need arose; the results of these programs have proven successful to meet the AFMS mission needs. Any other alternative or initiative would require a waiting period to grow our own replacements, this is something we as NCOs/IDMTs should be working on all the time…so therefore those being selected should have already been prepped and had exposure at some point. If not, now is the time for us to sell the IDMT and help better educate those that may become potential candidates. I encourage each IDMT at facilities to work with the senior 4N to help identify individuals they feel fit our mold and become recruiters versus nay-sayers.

     I am not taking the company stand on this issue but speaking from my personal perspective as to how I view the implementation of this program from a positive perspective. The new change will afford some relief to many IDMTs spending excessive deployment time on the road at locations/units that are under manned with IDMTs. We will gain more individuality to help push for the incentives we desire (badge, SDP, funded IDMT Symposiums, etc..). There will be greater opportunity to move around and still be able to practice as an IDMT despite whether you are located at MTF, GSU, MMU, or remote site. This process will ensure we place IDMTs where they are required and that they are utilized to the extent of their training. Our promotion testing will place IDMT against IDMT in the out years (exempt first time), removing us from the large pool of 4Ns in the AFMS, yet overall promotion percentage per ASFC will remain (could be good for some and not for others…really no change in that philosophy from our current situation it all depends on what we do to prepare ourselves).  As far as moving to the ranks of SMSgt and CMSgt the path will not change much but where it does that will require the senior 4Ns at the facilities to help guide and mentor those as they come back in to the medical facilities. In some cases many of our MSgts will become more promotable as they can still come out of the field and practice as an IDMT, therefore those who did not want to remove themselves from the hands-on aspect of IDMT will not have to sacrifice for the opportunity of increased rank (we all know there are some IDMTs who have done this in the past).

     As far as fear on competency goes there are several safeguards in place just like we have now: (1) Must meet minimum requirements to get accepted  (2) Has to pass course curriculum standards   (3) Has to complete 3 week HMTF orientation and gain SGH certification  (4) Must maintain skill currency quarterly  (5) Required to recertify annually over 2 week period and be recertified by SGH  At any point along this process should their skills be questionable they can be evaluated. There are ways to implement remedial training or recommend removal from AFSC through the MAJCOM/SG if findings should warrant. Bottom line if they can get through the school we will hold them to our standards and not a lower one because they didn’t volunteer, patient care will not be compromised. From the 4N perspective we have managed the removal of the “A” shred and the merger of the 4F in our career field, with only small ripple effects. This will be one more pebble thrown in the water, and we will have to ride the ripple (maybe just a larger and longer ride) until it becomes the norm. Our job in the mean time is to help maneuver through the growing pains by taking an active role and talking with our senior enlisted leadership, as well as those who would be desirable candidates.  I honestly believe many of you will be pleased with the projected changes and pushes once all is said and done, not a 100%…as change affects everyone differently. 

     If you have any other issues or areas you would like the association to weigh-in on or to provide assistance/information gathering let us know. The association is a tool for all IDMTs to use; together we speak louder as one voice and can make a difference. I appreciate all the honesty, candor and open discussions on many of the subjects on the Forum; it is through discussion/open communication we can gain insight and strength. As always you can contact me direct @ DSN 246-2553 or by e-mail joseph.potts@kirtland.af.mil.  

                                     Respectfully Yours,

                                                                     Joe Potts

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TALKING PAPER ON ASSIGNMENTS FOR IDMTS POST SEI 496 CONVERSION TO AFSC 4N0X1C

The purpose of this TP is to discuss assignment processes for IDMTs after the conversion from SEI 496 to 4N0X1C on 1 Nov 04 - During Feb/Mar 04, AFPC and MAJCOMs performed a scrub of all 4N0X1, X4N0X1, T4N0X1, J4N0X1 who hold the SEI 496 due to: -- Erroneous updates of SEI 496 due to mbr’s sitting in SEI coded UMD positions who are not IDMTs -- MILDPS only captures those IDMTs who are sitting in SEI coded UMD positions as assigned --- After validation we verified there are 495 SSgt thru MSgt IDMTs, however a large number of these are not in IDMT positions - MAJCOMs also validated projected increased IDMT authorizations for FY 04/05 -- FY 05 we will have 695 IDMT authorizations --- Most increases are at SrA/SSgt due to requirement for all Squadron Medical Element positions to be IDMTs - With the conversion, 4N0s will enter 4N0X1C AFSC thru Retraining instead of volunteering thru MTF for MAJCOM slot or thru volunteering for Equal Plus position and then sent by gaining MAJCOM.

The great majority of IDMTs are TSgt/MSgts so retraining will be targeted primarily at SrA/SSgt volunteers. 4N0X1 SrA/SSgts can anticipate being restricted for retraining into only 4N0X1B/C shreds. As the 4N0X1C numbers stabilize over the course of next few years, Retraining Out at 7 level may be offered with any other AFSC. --- Retraining requirements are almost identical to what they are now as an SEI ---- Retrainees will be required to have 4 years experience as a 4N0 and 2 years experience in direct patient care. ----- This means a FTA with a 4 year enlistment won’t be able to retrain into IDMT until they have 4 years as a 4N0X1—FTA with 6 year enlistments will be able to retrain into IDMT when they reach 4 years and 2 years direct patient care experience. It does not mean they have to have worked ED or inpatient unit, PCO/PCE is direct patient care also.

Assignment Processes (Short Term) -- To distribute IDMT resources to fill IDMT authorizations, IDMTs who are not in valid or projected authorizations will be given IDMT assignments with reporting 4 – 12 months after the conversion. Time on Station (TOS) rules will not apply due to AFSC reclassification. --- IDMTs who are OS and not in valid authorizations will be offered a Continuation of Tour assignment within the same OS theater if they meet eligibility rules --- IDMTs who are OS and do not meet eligibility or do not desire a Continuation of Tour will be returned to CONUS to an IDMT authorization -- Equal Plus OS IDMT assignments will continue to be advertised until Jul - Aug 05 reporting cycle (the OS/OS Return process can’t be built until the AFSC exists) - Assignment Processes (Long Term) -- Equal Plus IDMT advertisements will be at a minimum, for example only those positions requiring a skill set above and beyond normal IDMT, i.e., instructor duty, AFSOC, all J coded (Parachuting) duty. All Equal Plus advertised positions will require volunteers to already possess 4N0X1C AFSC. -- 4N0X1C OS and OS Return assignments will be posted on Equal OS and OS just like every other AFSC -- OS IDMTs will be able to compete for Consecutive OS Tour IDMT assignments posted in their DEROS cycle -- IDMTs going on Short Tours will be able to apply for Follow On/Home Basing assignments as IDMTs -- CONUS IDMTs will be able to apply for the same voluntary assignment programs available to every other AFSC --- Base of Preference, Swap, Permissive, etc --- The tool on AMS that shows what AFSCs are authorized at what bases will be updated to include 4N0X1C (completion date undetermined), however it will not be able to show whether the position is an MTF or SME) –

IDMT Release from AFSC -- Due to the huge gap between 695 authorizations and 495 actual IDMTs, I have not recommended approval for any requests for release from AFSC to special duty, retraining, etc, since the classification change was submitted. As the AFPC Functional Manager this is my responsibility to maintain the health of the AFSC so that unit’s have resources to fulfill vital IDMT functions. There are 3 levels of AFPC approval authority who also make a recommendation with final determination resting with AFPC/DPAA. - With change there is always confusion and misinformation. Please contact your senior 4N0, MAJCOM Functional Manager, myself or my replacement SMSgt Mogle, if you have any questions.

SMSgt Cole/AFPC/DPAAD2/3 Jun 04/DSN 665-4115 ext 2.

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