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How do deployed general surgeons acquire relevant skill sets and competencies and mitigate skill fade?
  1. Matthew Robert Cant1,
  2. D N Naumann2,
  3. T C König3,4 and
  4. D M Bowley3
  1. 1 Headquarters Army Medical Services, Robertson House, Camberley, Surrey, UK
  2. 2 Academic Department of Military Surgery and Trauma, Birmingham, UK
  3. 3 Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, UK
  4. 4 16 Medical Regiment, Royal Army Medical Corps, Merville Barracks, Colchester, Essex, UK
  1. Correspondence to D M Bowley, Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK; douglas.m.bowley.gbr{at}


There are recognised difficulties internationally with acquisition and retention of skills among deployed military general surgeons. These are compounded by reduced trauma workload in non-deployed roles or during low tempo or limited activity deployments, and the winding-down of combat operations in Iraq and Afghanistan. We summarise the relevant military-run courses, military-civilian collaborations and potential future strategies that have been used to address skill sets and competencies of deployed surgeons. We use examples from the American, British, Danish, French, German and Swedish Armed Forces. There is variation between nations in training, with a combination of didactic lectures, simulation training and trauma placements in civilian settings at home and overseas. Data regarding effectiveness of these techniques are sparse. It is likely that combat surgical skill-set acquisition and maintenance requires a combination of employment at a high-volume trauma centre during a surgeon’s non-deployed role, together with military-specific courses and high-fidelity simulation to fill skill gaps. There are multiple newer modalities of training that require further evaluation if they are to prove effective in the future. We aimed to summarise the current methods used internationally to ensure acquisition and retention of vital skill sets for these surgeons.

  • trauma management
  • surgery
  • medical education & training
  • accident & emergency medicine

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  • Contributors MRC and DNN initiated the project. MRC drafted the manuscript. DNN reviewed and revised substantial aspects of the manuscript. DMB and TCK advised on policy aspects and contributed to manuscript revisions. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.