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David,

Don't push the rank (major, colonel, etc.) comparison too hard. I spent 4 years as an Army doctor, paying back for college tuition. It is clearly (as far as the Medical Corps) not a merit based system. The only reason for rank is longevity. I earned Board Certification, ACLS, ATLS and volunteered for field stations, and never earned a single decoration or speedier promotion. In a sense, it is what you would expect if Uncle Sam ran the medical system, top to bottom. Since we weren't at war, I didn't do much work, however. I imagine that is different now.