Assignment

Assignment to a facility outside the continental United States or to foreign shores can be a very rewarding and culturally rich experience. Preparation for transfer to such a duty assignment is critical and should not be taken lightly. Unfortunately, one of the most important and overlooked procedures is the medical overseas suitability screen.

Military treatment facilities (MTF)

Military treatment facilities located overseas often have limited medical capabilities and do not have certain medical specialties. Assignment of active duty military personnel or their family members with chronic or acute medical conditions places an extreme hardship on the receiving command, his or her fellow shipmates, and the actual family. Absence from duty and early return to the United States cause unplanned expenditures on both the Government and the active duty families. Additionally, overseas commands are burdened by the marginal performance and increased demands of those members who should not have been assigned overseas. When an early return becomes necessary this unplanned loss creates a gap and replacement does not normally take place for at least 6 to 8 months.

Medical suitability screening

Medical suitability screening for service members and family members should be thorough. Conduct a complete interview with each family member and review of health records with emphasis on the following conditions:

• Chronic and acute medical and dental conditions including complete HIV testing. Although some medical treatment facilities do not have certain specialties care may be reasonably available through a partnership or preferred health care provider program. The Overseas Suitability Screening Coordinator or patient administration officer has the capability of obtaining this information by communicating with the appropriate MTF.
  
  
• Mental health or psychiatric disorders.
  
  
• Past drug abuse. Current or past alcohol abuse. Assignment to overseas locations after completion of a rehabilitation program is discouraged, unless an After Care Program is available at the gaining command.
  
  
• Pregnancy. Travel and assignment restrictions are relevant factors. Those service members and dependents with history of complicated deliveries should be carefully screened. Most overseas commands have limited OB/GYN and neonatal pediatric capabilities.
  
  
• Obesity and Physical Readiness Test (PRT) performance (active duty members only). Active duty personnel identified as out of standards two separate times may not be transferred to an overseas location.
  
  
• Exceptional Family Member Program (EFMP). The availability of medical and other services necessary to support dependents with a physical, emotional, or learning disability must be considered in the screening process. Referral to the patient administration officer for members in this category should be completed prior to final action on an overseas screening authorization. If family members are enrolled during the overseas screening the pending transfer shall be held in abeyance until their enrollment application have been processed.
  
  
• Other individual or family characteristics which would preclude them from completing an overseas tour.
  
  
• Overseas suitability screening will be valid for 1 year from the date of initial screening completion unless changes in the conditions affecting suitability occur

NOTE: BUMED is in the process of revising the overseas suitability screening instruction to include operational and remote duty suitability screening.

Reviewed by LCDR Robert A. Rahal, MSC, USN, Assistant Specialty Leader for Patient Administration, Bureau of Medicine and Surgery, Washington, D.C. (1999).

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