Anyone have any experience with military surgery training? I'm especially curious about WORKING in the military as a trauma surgeon. Not that I wanna do it; rather, I'm just curious. They must be REALLY good.. .can you imagine the stuff they see and do now a days?
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I'm currently in a 'military' surgery program. I rotate at the base maybe once a year; some of my co-military prelim interns won't rotate there at all. This is less true with the Army and Navy, but they still need to farm their people out for trauma, transplant, pediatrics, etc.
Mitchconnie is exactly right- trauma ain't happenin' at most military hospitals. The one base I was at where they did do trauma, they seemed to do it badly. It was disorganized as ER and surgery alternated each day as to who was running the trauma. As a result, everyone was trying to be in charge. When a high level trauma patient came in (e.g. GSW), it was a cluster as everyone wanted to get it on the action. There also wasn't a designated trauma surgery team. Instead, it was split between two general surgery services. So you would have to deal with Level I Trauma as well as clinic/floor work/ scheduled OR cases.
It's quite telling, I think, that Bethesda, Wilford Hall, and Walter Reed aren't mentioned in the same breath as Parkland, Harborview, Baltimore Shock/Trauma, etc. Military residents doing trauma fellowships tend to go to civilian programs (don't even think the military has a trauma fellowship).
If you're really interested in operative trauma, go into ortho. Even in Iraq, >70% of operative trauma is ortho (sorry, don't remember the source).
Though old, this is more formal data on stateside military training:
Mil Med. 1996 Aug;161(8):453-7.Links
Trauma experience of Navy surgeons: assessment and commentary.
Smith RS, Morabito DJ, Bohman HR, Ludwig FE.
Department of Surgery, University of Kansas-Wichita
Numerous reports have suggested that surgical readiness during Operation Desert Storm was poor. We surveyed active duty Navy surgeons to assess current trauma experience and capability. A survey concerning trauma and critical care experience, as well as self-rating of skills, was mailed to all active duty surgeons (n = 185) in 1993. The response rate was 79% (146/185). A high turnover rate of surgeons was indicated by: (1) 51% (75/146) of surgeons had less than 3 years of experience following residency; and (2) only 42% (61/146) had served in the Gulf War. Only 12% of active duty surgeons (18/146) were involved in trauma care. Only 10% (14/146) had performed more than 20 operations for trauma in the preceding 1 years, and 85% (124/146) had performed fewer than 10 operations. In the preceding 5 years, 84% (122/146) had performed fewer than 100 operations for trauma, and 42% (61/146) had performed none. Critical care experience ranged from 0 to 20 patients per month (mean = 3). Despite limited recent experience, 84% (123/146) of respondents rated their trauma skills as adequate (n = 43), good (n = 49), or excellent (n = 31). We conclude that most Navy surgeons have minimal recent experience in trauma care. A high rate of turnover mandates training strategies that provide an ongoing exposure to injured patients. This could be accomplished by designating military hospitals as trauma centers or by placing military surgeons in civilian trauma centers.
