Direct commission is a long standing practice, especially for technical fields like medical and now electronic warfare. Surgeons may direct commission to varying field-grade ranks as well, with bonus structure to be competitive with private practice. Military outsources these technical degrees to bring in blood in these voids.
What? Per https://www.army.mil/ranks/, they outrank all enlisted and warrant officers, plus Second Lieutenants, First Lieutenants, Captains, and Majors.
Only full Colonels and the 1-5 star Generals outrank them.