Preparedness Evaluation of French Military Orthopedic Surgeons Before Deployment

A deployed military orthopedic surgeon is a trauma surgeon working in austere conditions. The first aim of this study was to analyze the current activity of French military orthopedic surgeons in the field and to identify the differences of the combat zone with their daily practice. The second aim was to assess the adequacy of the preparedness they received before their deployment and to identify additional needs that could be addressed in future training. An evaluation survey was sent to all French military orthopedic surgeons deployed in theaters of operations between 2004 and 2014. An analogic visual scale of 10 was used to evaluate their surgical activity abroad and prior training. A total of 55 surgeons, with a median deployment number of 7, were included in this study after they answered the survey. Debridement and external fixation were the most common orthopedic procedures. The practice of general surgery was mostly concerned with vascular and abdominal injuries as part of damage control procedures. Median scores were ranked at seven for surgical preparedness, five for physical readiness, and three for mental preparedness. There was a significant inverse relationship between the number of missions performed and the evaluation of surgical preparedness. The higher they perceived their mental preparedness, the better they estimated their surgical preparedness. In the French Army, deployed orthopedic surgeons perform general surgical activity. Their initial training must be adapted to this constraint and enhanced by continuing medical education.