Military deployment's impact on the surgeon's practice.

Area of Science:

• Military medicine
• Surgical readiness
• Combat casualty care

Background:

• General surgeons are vital for combat casualty care during overseas operations.
• Low surgical case volume and acuity can negatively impact surgeon readiness for frequent deployments.
• The deployment cycle affects surgical practices, including training, clinical practice drawdown, and reintegration.

Purpose of the Study:

• To assess the effects of deployment on the surgical practices of general surgeons.
• To quantify the impact of deployment on surgical volume and skill retention.
• To inform measures for mitigating deployment-related effects on surgical readiness and patient care.

Main Methods:

• Analysis of surgeon case logs from military treatment facilities for surgeons deploying between 2017 and 2020.
• Inclusion of surgeons with consistent practice at a single facility 26 weeks pre- and post-deployment.
• Data collection on deployment duration, location, and case numbers.

Main Results:

• Surgical case counts decreased by 4.8% weekly leading up to deployment (p < 0.0001).
• Post-deployment, case counts increased by 6% weekly (p < 0.0001), with volumes normalizing around 7 weeks after return.
• Significant pre- and post-deployment volume fluctuations were observed across all military branches.

Conclusions:

• Deployment significantly impacts general surgeons' case volumes, with notable decreases before and increases after service.
• Understanding and mitigating the perideployment surgical volume decline is crucial for maintaining surgical readiness.
• Further development and implementation of predeployment training, skill retention programs, and safe reintegration measures are recommended.