This is a good discussion. I can give you all my perspective. Next month I will have been in the Navy 24 years. 14 of that enlisted and 10 as an officer and a PA. I have done well and am on track as far as promotion (LCDR O-4), but I have also taken some difficult assignments in the past 10 years. The truth of the matter is regardless of what medical specialty you are, MD, DO, PA, NP, Nurse,Dietician, PT, etc. the longer you stay in the military the more you will move further away from direct patient care. It is just the nature of the beast. A prime example is my director, she is a Navy Captain (O-6) and an NP. She hasn't done direct patient care in a number of years, she was just selected to become the XO of a major naval medical facility and she will most likely become an admiral in the future. A friend of mine is also an NP and turned down a department head job to stay in patient care. She was passed over for O-5 but she is ok with that and she will retire as an O-4. I also have a friend of mine who is not prior enlisted and is a PA, he just pinned on O-6. Somehow he was able to stay predominantly in patient care his entire career until now when he was made a director at BUMED. I think for everyone's military experience is different, however I think everyone can agree that there is no higher calling than serving your country and regardless if you serve 3 years or 30 the experience changes you for the better and makes you a more versatile health care professional.