Authorized for optional wear by Article 3603.6 of the United States Navy Uniform Regulations, this buckle features a caduceus, symbol of Navy Medicine, and is worn by enlisted Sailors in the Hospital Corpsman rating and Officers serving as Physician’s Assistants. This insignia was also designated for wear by Technical Nurse Warrant Officers in 1991, but was no longer issued after the Navy eliminated Warrant Officer positions for Nurses (the online version of Navy uniform regulations still lists this designation, however). Similarly, Physician’s Assistant was originally a Warrant Officer specialty, but in the late 1980s the Navy decided to make it a commissioned Officer position.
The gold version of the buckle is worn by Officers and Chief Petty Officers (E-7 to E-9), while the silver is authorized for junior enlisted Sailors (E-1 to E-6). On average, it takes an enlisted Sailor 15 years to reach the rate of Chief Petty Officer in the Hospital Corpsman rating and earn the right to wear the gold buckle.