When Vermont Air National Guardsman Senior Airman Corbin Bailey graduated Air Force Technical School as a 4N031, the Air Force Specialty Code for an aerospace medical service technician, job prospects in the civilian medical field were limited to EMT or nursing assistant roles.

During 4N0 technical school, medically inclined Airmen like Bailey are trained to thrive in and outside of hospital settings, developing their EMT and nursing services skillset, and applying that intensive training throughout the course. Upon graduation, these medical service technicians reenter the civilian realm and face an immediate set-back by means of restriction on their scope of practice, required to pursue additional schooling to be able to practice at the tier of training they had just received, which equates to that of a licensed practical nurse (LPN) or licensed vocational nurse (LVN).

For these Airmen seeking opportunities in the medical field upon reentering the civilian workforce, the alternative path to becoming an EMT was to apply for their LNA (licensed nursing assistant), an option which requires six additional weeks of courses and results in an entry-level, low-paying position as a nursing assistant. In such a role, these Airmen remain legally unable to apply most of the skills gained from technical school.

In late November 2019, Bailey made history when he became the first Vermont Air National Guard 4N0 to be approved to challenge the LPN board, test for licensure in Vermont, and successfully pass the exam.

Achieving the LPN is a significant step that better aligns the civilian career path of Airmen with their AFSC classification, also providing opportunities for increased scope of practice, expanded responsibilities, better pay, and more job opportunities in the nursing field.

Previously, graduates that sought this opportunity were required to take their licensing exam in either Missouri or New York, both states approved as Guard initiative programs for the 4N0 AFSC to directly challenge the LPN board. After testing, candidates would need to practice in that respective state for 400 hours or 50 days, only then to apply again in their home state of Vermont, often also sitting in front of a board to prove their worthiness of earning that licensure in their desired practice state.

To avoid this parallel, redundant training and application for licensure, Bailey actively sought out a way to directly align his civilian qualifications and permissible scopes of practice in Vermont with his military training, improving his career opportunities beyond EMT and nursing assistant.

In September 2019, Bailey reached out to Phyllis Mitchell, the executive officer for the Board of Nursing within Vermont’s Office of Professional Regulation (OPR), to inquire about starting an initiative program in Vermont that laid the foundation for a pathway that did not go the traditional, long route of going through Missouri or New York. With Mitchell’s interest in supporting this initiative, Bailey began the process of submitting his own transcripts from the U.S. Air Force School of Aerospace Medicine and Community College of the Air Force, thoroughly explaining the 4N0 program, course details and proficiency levels, and outlining how those closely parallel the LPN skillset for civilian credentialing.

“The only thing that had ever been explained to her unfortunately was that we were, kind of, nursing assistants,” explained Bailey. “A lot of states gave [4N0s] the ability right away to our nursing assistant license, not even our practical nursing. So, we could sit there and turn patients and help with baths, but that was the extent to what we were permitted to do initially.”

Speaking with Mitchell, Bailey confirmed that there is a National Council of State Boards of Nursing process of case-by-case granting of LPN testing for Air Force personnel, an opportunity made possible in Vermont by a recent statutory amendment to 3 V.S.A. § 123(g), which authorized and directed OPR to establish procedures for “appropriate recognition of education, training, or service completed by a member of the U.S. Armed Forces toward the requirements of professional licensure.” With the statute supporting Mitchell’s desire to recognize Vermonter’s 4N0 education, she started her analysis of Bailey’s submitted paperwork with Gabriel (Gabe) Gilman, general counsel for the OPR.

“I worked with Gabe and looked at [Bailey’s] documents. I also engaged a member of our board, a lieutenant colonel in the Air Guard and a registered nurse. I wanted his thoughts on this particular 4N0 military training,” reflected Mitchell about this process.

At Mitchell’s inquiry, Lt. Col. Douglas Sutton, chief of medical operations, 158th Medical Group, also reviewed the curricula, transcripts, and checklists that Bailey submitted, as well as previous analysis by the NCSBN.

“We spent about thirty minutes on the phone going through [Sutton’s] interpretation of this particular education, which he finds to be quality and equivalent to a civilian LPN. These 4N0’s have been under his command for approximately 10 years and they function as essentially LPNs. So, I took that information and worked with Gabe to discuss this with our director. Based on our evaluation, we moved forward,” explained Mitchell.

In the days that followed, Bailey successfully earned approval from Vermont’s director of the OPR for this initiative, which would allow 4N0’s to provide their transcripts as proof of their prior relevant education required to sit for the LPN exam in Vermont. This approval circumvents the need to test and work in another state, and provides Airmen with the opportunity to symbiotically further their nursing careers in the civilian workforce.

“He deserves a lot of credit for his patience and persistence and organization, because he is really the first person to use this particular statute to create this particular path,” said Gilman. “He really did his homework, and in doing his homework in that way, as cooperatively and with the degree of organization that he did, I think he has made it much easier for the people that will follow him. He’s done a real service to the military medics who will come after him by working with us.”

In total, these discussions took approximately six weeks of phone calls, requesting transcripts, transcribing AFIs (Air Force Instruction), providing definitions of different curriculums and acronyms, and providing a better understand of what 4N0’s do to give the Board of Nursing confidence that these Airmen have the ability to go up against the LPN board, challenge it, and successfully show proficiency to be able to function as that practical, vocational nurse.

“I am just really impressed with his determination and initiative to work on this, and do it, and make it happen. I wish I had that a long time ago. I’m really proud of him for taking that initiative,” said Major Sara Burton, the chief nurse for the 158th MDG. Burton oversees the nurses and enlisted medical technicians in nursing services within the Vermont Air National Guard, which includes Bailey.

History has been made, and any 4N0 Airman in the Vermont Air National Guard, who is also a Vermont resident, is now eligible to prove their education at the three-level and above, and challenge the LPN board, without taking an additional, conventional LPN course or applying through a different state.

“I do think this is probably the beginning of a broader project. There is a lot of interest in in state legislatures throughout the country in taking similar measures to harmonize military training with civilian credentialing,” concluded Gilman.

Since Bailey challenged the LPN board in November 2019, three other Airmen from the 158th Fighter Wing have started this process, seeking to test for licensure in the coming weeks.