Believe it or not, there are two organizations in the US that can offer you a career as a commissioned officer without actually joining the military. I'll let Phaedra Trethan over at About.com's US Government Info site describe the National Oceanic and Atmospheric Administration, while I confine my attention here to healthcare careers in the US Public Health Service (USPHS) Commissioned Corps.
Serving under the Department of Health and Human Services, USPHS officers serve in a variety of health-related professions around the nation, cooperating with government agencies including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH) to promote the health and wellbeing of American citizens. Though not members of the Armed Forces, the Commissioned Corps website points out that its officers "[s]erve [their] country in uniform . . . protecting our Nation's public health . . . [and] assist in public health responses to man-made and natural disasters."
Back in the good old days of the Republic, before we were inconvenienced by the complexities of modern medicine -- before health insurance, the CDC, or pesky debates about healthcare reform -- Congress employed doctors in the Marine Hospital Service to take care of ill and injured sailors.
Fast forward to 1871 on the USPHS's Commissioned Corps Timeline. In just under a century, America had become a complex place, and so too did it become more difficult to administer healthcare to the Navy. The country's first surgeon general decided to simplify the equation by imposing military discipline on doctors of the Marine Hospital Service, setting them up with naval ranks and uniforms. Eventually the growing needs of the nation led to greater responsibilities for the corps, which provided services to the general public including the control and prevention of disease. (The CDC wouldn't be conceived until 1946.)
By 1912 its expanded scope earned the Marine Hospital Service the more apt title of "Public Health Service," though to this day its Commissioned Corps remains grounded in its naval roots as one of the two uniformed services that are not technically in the US military.
The two greatest requirements for service with the USPHS are education and licensure. Like the Armed Forces' direct commissioning programs for medical professionals, USPHS doesn't take raw recruits -- they look for those who have already invested in an advanced education and established themselves as civilian professionals. Here's a complete list of career fields in the Commissioned Corps, but a few highlights are:
- Registered Nurses (with bachelor's or master's degree only)
- Social workers
- Psychiatrists and psychologists
- Dietitians (bachelor's to doctorate)
- Allied professions, such as dental hygienists and physician assistants
Opportunities to join USPHS in one of these professions may wax and wane from year to year depending on the Corps' needs, of course. Nurses, for example, are out of luck as of January 2012, since the Corps is still buried in a backlog of applications.
Potential USPHS officers must also be citizens of the United States under the age of 44, and pass medical and physical examinations. Though recruited as civilian professionals, hopefuls must also be prepared to conform to height, weight, and grooming standards similar to the Armed Forces.
Getting a Leg Up
Unlike an enlistment in the military, the Commissioned Corps isn't something you can jump into right out of high school. But don't despair: There are a few opportunities to start a career with the USPHS for those who need a helping hand.
Those already serving in the military may be able to transition to a career with USPHS through one of two educational programs that allow them to earn an advanced degree on the government's dime, while receiving their pay and benefits. Aspiring physical therapists with a bachelor's degree can apply to attend a doctoral program offered jointly by at the Army and Baylor University in Waco, Texas. There's also the Interservice Physician Assistant Program, which also caters to the Public Health Service.
As for civilians, students on their way to earning an appropriate degree can apply to serve as interns during school breaks, earning ensign (O1) pay and points toward promotion and retirement they can take with them if hired after graduation.