Combat Readiness for the Modern Military Surgeon: Data from a Decade of Combat Operations

OBJECTIVE Hundreds of general surgeons from the army, navy, and air force have been deployed during the past 10 years to support combat forces, but little data exist on their preparedness to handle the challenging injuries that they are currently encountering. Our objective was to assess operative and operational experience in theater with the goal of improving combat readiness among surgeons. METHODS A detailed survey was sent to 246 active duty surgeons from the army, navy, and air force who have been deployed at least once in the past 10 years, requesting information on cases performed, perceptions of efficacy of pre-deployment training, knowledge deficits, and post-deployment emotional challenges. Survey data were kept confidential and analyzed using standard statistical methods. RESULTS Of 246 individuals, 137 56 responded and 93 68 have been deployed two or more times. More than 18,500 operative procedures were reported, with abdominal and soft tissue cases predominating. Many surgeons identified knowledge or practice gaps in pre-deployment vascular 46, neurosurgical 29.9, and orthopedic 28.5 training. The personal burden of deployment manifested itself with both family approximately 10 deployment-related divorce rate and personal 37 surgeons 27 with two or more symptoms of posttraumatic stress syndrome stressors. CONCLUSION These data support modifications of pre-deployment combat surgical training to include increased exposure to open vascular procedures and curriculum traditionally outside general surgery neurosurgery and orthopedics. The acute care surgical model may be ideal for the military surgeon preparing for deployment. Further research should be directed toward identifying factors contributing to psychological stress among military medics.