Specialists have a bit of a unique career progression. All ranks are working ranks with the senior specialist in each specialty having the additional duties of being the adviser to the Surgeon General on their specialty. These officers do not assume command roles within the Canadian Forces Health Service, and truth be told all report to the Commanding Officer of 1 Canadian Field Hospital while in Canada, who is a HSO LCol. Specialists, despite being under command of 1 Canadian Field Hospital, for the most part work in civilian hospitals in order to keep their skills finely honed. They then come out of the civilian hospital for short periods to teach, train and deploy as required by the needs of the service. A good example is our senior CF trauma (general) surgeon who works full time at Sunnybrook Hospital in Toronto where he is the Medical Director of the Trauma Centre, an Assistant Professor at U of T, and a Associate Scientist. Another example is our senior internal medicine physician who works in London as a Scientist, Attending Physician (trauma critical care) and as an Assistant Professor at University of Western Ontario School of Medicine. Again when we need them to teach, train, or deploy we call them out of these settings and they do so.
The entry rank rank as a specialist medical officer is Major with progression to LCol as appropriate. The LCol does the same thing as the Maj with a little more governance within the clinical specialty as required. There is then one Col for medicine (anesthesia or internal), one for surgery (orthopedics or general), and one for psychiatry. This system is somewhat flexible to meet the needs of the service and the specialists, so these numbers are not always absolute. They cap at the rank of Col and cannot as it stands currently (ironically) be appointed as the Surgeon General. They will not be base/wing/brigade surgeons as specialist medical officers. Most specialist medical officers were GDMOs prior to selection to become a specialist medical officer. This is different then the civilian model where you go from medical school into say surgery. The specialist medical officer is often duel qualified in family medicine and spent a few years as a junior GDMO before going onto to do a specialty and get promoted to Major via that route. We have on occasion had Major GDMOs seek selection and be selected for specialty training. We also have had in recent times a few direct entry specialist medical officers, who indeed enter the CF at the rank of Major.
All other qualified medical officers are GDMOs. They are able to progress from Captain to BGen and assume various clinical, staff, and teaching positions as well as some clinical leadership and command roles as they progress (or do not progress) throughout the ranks. These officers are GDMOs, who are certified in family medicine, but may have short additional specialty training (1-2 years) in emergency medicine, aerospace / public health medicine, or dive / public health medicine.
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