+---------------+------+-----------+-----------+------+---------------+
| DEPARTMENT OF |      |           |           |      |               |
| HEALTH AND    |      |           |           |      |               |
| HUMAN         |      |           |           |      |               |
| SERVICES\     |      |           |           |      |               |
| PUBLIC HEALTH |      |           |           |      |               |
| SERVICE       |      |           |           |      |               |
| COMMISSIONED  |      |           |           |      |               |
| CORPS         |      |           |           |      |               |
|               |      |           |           |      |               |
| **JUNIOR      |      |           |           |      |               |
| COMMISSIONED  |      |           |           |      |               |
| OFFICER       |      |           |           |      |               |
| STUDENT       |      |           |           |      |               |
| TRAINING AND  |      |           |           |      |               |
| EXTERN        |      |           |           |      |               |
| PROGRAM       |      |           |           |      |               |
| (JRCOSTEP)**  |      |           |           |      |               |
|               |      |           |           |      |               |
| **STATEMENT   |      |           |           |      |               |
| OF DUTIES**   |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 1\.           |      |           | BUREAU /  |      |               |
| DEPARTMENT OF |      |           | INSTITUTE |      |               |
| HEALTH AND    |      |           | / CENTER  |      |               |
| HUMAN         |      |           | /         |      |               |
| SERVICES      |      |           | DIVISION  |      |               |
| (HHS)         |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| > OPERATING   |      |           |           |      |               |
| > DIVISION    |      |           |           |      |               |
| > (OPDIV),    |      |           |           |      |               |
| > STAFF       |      |           |           |      |               |
| > DIVISION    |      |           |           |      |               |
| > (STAFFDIV), |      |           |           |      |               |
| > OR NON-HHS  |      |           |           |      |               |
| >             |      |           |           |      |               |
|  ORGANIZATION |      |           |           |      |               |
| > TO WHICH    |      |           |           |      |               |
| > ASSIGNED    |      |           |           |      |               |
| >             |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 2\. BRANCH    |      |           | SECTION   |      |               |
+---------------+------+-----------+-----------+------+---------------+
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 3\. DUTY      |      |           |           |      |               |
| STATION       |      |           |           |      |               |
| ADDRESS AND   |      |           |           |      |               |
| PHONE NUMBER  |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 4\. DATES OF  |      | Start     |           | End  |               |
| ASSIGNMENT    |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| >             |      |           |           |      |               |
|               |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 5\.           |      |           |           |      |               |
| ASSIGNMENT    |      |           |           |      |               |
| SETTING       |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 6\. JRCOSTEP  |      |           |           |      |               |
| RES           |      |           |           |      |               |
| PONSIBILITIES |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 7\. TRAINING  |      |           |           |      |               |
| TO BE         |      |           |           |      |               |
| RECEIVED ON   |      |           |           |      |               |
| THE JOB       |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 8\. JRCOSTEP  |      |           |           |      |               |
| PRECEPTOR     |      |           |           |      |               |
| *(Name,       |      |           |           |      |               |
| Title,        |      |           |           |      |               |
| Address,      |      |           |           |      |               |
| E-mail        |      |           |           |      |               |
| Address, and  |      |           |           |      |               |
| Phone         |      |           |           |      |               |
| Number)*      |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 9\. MINIMUM   |      |           |           |      |               |
| Q             |      |           |           |      |               |
| UALIFICATIONS |      |           |           |      |               |
| FOR JRCOSTEP  |      |           |           |      |               |
|               |      |           |           |      |               |
| >             |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 10\.          |      |           |           |      |               |
| CATEGORIES    |      |           |           |      |               |
| *(Mark all    |      |           |           |      |               |
| applicable    |      |           |           |      |               |
| categories)*  |      |           |           |      |               |
|               |      |           |           |      |               |
| > Medical     |      |           |           |      |               |
| > Dental      |      |           |           |      |               |
| > Nurse       |      |           |           |      |               |
| > Engineer    |      |           |           |      |               |
| > Scientist   |      |           |           |      |               |
| >             |      |           |           |      |               |
| Environmental |      |           |           |      |               |
| > Health      |      |           |           |      |               |
| >             |      |           |           |      |               |
| > Veterinary  |      |           |           |      |               |
| > Pharmacy    |      |           |           |      |               |
| > Dietetics   |      |           |           |      |               |
| > Therapy     |      |           |           |      |               |
| > Health      |      |           |           |      |               |
| > Services    |      |           |           |      |               |
| > *(Specify)* |      |           |           |      |               |
| > [           |      |           |           |      |               |
| ]{.underline} |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 11\. OPDIV /  | S    |           |           |      | Date          |
| STAFFDIV /    | igna |           |           |      |               |
|               | ture |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| > NON-HHS     |      |           |           |      |               |
| >             |      |           |           |      |               |
|  ORGANIZATION |      |           |           |      |               |
| > R           |      |           |           |      |               |
| EPRESENTATIVE |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
|               | Name |           |           |      |               |
|               | and  |           |           |      |               |
|               | T    |           |           |      |               |
|               | itle |           |           |      |               |
|               | *(Pl |           |           |      |               |
|               | ease |           |           |      |               |
|               | type |           |           |      |               |
|               | or   |           |           |      |               |
|               | pri  |           |           |      |               |
|               | nt)* |           |           |      |               |
|               |      |           |           |      |               |
|               |      |           |           |      |               |
|               |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
| 12\. OCCO     | S    |           |           |      | Date          |
| JRCOSTEP      | igna |           |           |      |               |
| R             | ture |           |           |      |               |
| EPRESENTATIVE |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+
|               |      |           |           |      |               |
+---------------+------+-----------+-----------+------+---------------+

+-----------------------------------------------------------------------+
| DEPARTMENT OF HEALTH AND HUMAN SERVICES                               |
|                                                                       |
| PUBLIC HEALTH SERVICE COMMISSIONED CORPS                              |
|                                                                       |
| **INSTRUCTIONS FOR COMPLETING**                                       |
|                                                                       |
| **JRCOSTEP STATEMENT OF DUTIES, FORM PHS-6279**                       |
+-----------------------------------------------------------------------+
| > For information on JRCOSTEP, see INSTRUCTION 4, Subchapter CC25.2,  |
| > Commissioned Corps Personnel Manual (CCPM). The CCPM is available   |
| > on the Commissioned Corps Management Information System Web site    |
| > \--\                                                                |
| > *http://dcp.psc.gov* \--click on Publications.                      |
+-----------------------------------------------------------------------+
| > ***GENERAL***                                                       |
|                                                                       |
| -   Prepare a typed copy of form PHS-6279 for each assignment.        |
|                                                                       |
| -   Send form(s) to your OPDIV/STAFFDIV/non-HHS organization JRCOSTEP |
|     representative for review.                                        |
|                                                                       |
| -   The OPDIV/STAFFDIV/non-HHS organization JRCOSTEP representative   |
|     will forward the form(s) to:                                      |
|                                                                       |
| > Office of Commissioned Corps Operations                             |
| >                                                                     |
| > ATTN: JRCOSTEP Coordinator                                          |
| >                                                                     |
| > 1101 Wootton Parkway, Plaza Level, Suite 100                        |
| >                                                                     |
| > Rockville, MD 20852                                                 |
|                                                                       |
| -   An approved form PHS-6279 will be:                                |
|                                                                       |
| > a\. Signed by the Office of Commissioned Corps Operations (OCCO)    |
| > JRCOSTEP Coordinator; and                                           |
| >                                                                     |
| > b\. Distributed to:                                                 |
|                                                                       |
| (1) OPDIV/STAFFDIV/non-HHS organization JRCOSTEP representative \-- 2 |
|     copies (one for immediate supervisor)                             |
|                                                                       |
| > \(2\) JRCOSTEP participant in orders packet                         |
+-----------------------------------------------------------------------+
| > ***SPECIFIC***                                                      |
| >                                                                     |
| > Items 1 - 4 Self-explanatory.                                       |
| >                                                                     |
| > Item 5 Describe the setting in which the student will work.         |
| > Example: XYZ Medical Center serving 15,000\                         |
| > residents. Comprehensive health services are provided by a health   |
| > team of physicians, nurses, dentists,\                              |
| > etc. The student will work with selected cases from the hospital's  |
| > outpatient load of 54,000 visits annually.                          |
| >                                                                     |
| > Item 6 JRCOSTEP Responsibilities examples: (70% participant's time) |
|                                                                       |
| a.  Assist with physical examination of selected patients. Calculate  |
|     major health hazards for each patient\                            |
|     and assist with the development of a preventive medical program   |
|     to reduce health hazards.                                         |
|                                                                       |
| b.  Collect water samples for laboratory examination and assist with  |
|     analysis of same.                                                 |
|                                                                       |
| c.  Assist with the nursing care of medical and surgical patients and |
|     administer authorized medications\                                |
|     and treatments.                                                   |
|                                                                       |
| > Item 7 Training Activities examples: (30% participant's time)       |
|                                                                       |
| a.  Will be introduced to epidemiology of major clinical entities of  |
|     cancer.                                                           |
|                                                                       |
| b.  Will participate in staff meetings and in-service education       |
|     programs.                                                         |
|                                                                       |
| c.  Will receive orientation on the Commissioned Corps of the United  |
|     States Public Health Service (Corps).                             |
|                                                                       |
| > Item 8 Preceptor:                                                   |
| >                                                                     |
| > Identify a senior level staff member, preferably a Corps officer,   |
| > who will be responsible for the conduct of\                         |
| > the training experience and the orientation program.                |
| >                                                                     |
| > Item 9 State whether a 2nd, 3rd, or 4th year baccalaureate student  |
| > is desired, or whether a student in a graduate program or a 1st,    |
| > 2nd, 3rd, or 4th year medical, dental, or veterinary student is     |
| > desired.                                                            |
| >                                                                     |
| > Item 10 State discipline desired. Examples are: Physician,          |
| > Engineer, Veterinarian, Therapist, Dentist, Pharmacist, Dietitian,  |
| > Nurse, Environmental Health professional, Scientist, Health Record  |
| > Administrator, Social\                                              |
| > Worker, Optometrist, Podiatrist, Medical Technologist, Health       |
| > Educator, Physician Assistant, Hospital Administrator,              |
| > Psychologist, or Physicist.                                         |
| >                                                                     |
| > Item 11 Self-explanatory.                                           |
+-----------------------------------------------------------------------+