It's the public health service -- no relation to the DOD. It's a pretty good gig to be a commissioned officer in the PHS. I know a couple people have done it. Same benefits as the military but a lot less BS and not as much moving around. Also not that hard to make O6. They are pretty small so I don't know how they rate a 4 star equivalent but I guess politics are at play. It looks like Rachel already awarded herself a couple ribbons. She'll look like a Russian General (in more ways than one) by the time it's all over.