title: Perceived effects of deployments on surgeon and physician skills in the US Army Medical Department.
abstract: BACKGROUND
  The military health care system is unique in that almost every physician deploys for ≥6 months to a combat or far-forward setting. The aim of this study was to determine the perceived changes in clinical skills in this deployed population.
  
  
  METHODS
  A survey was sent out to all specialty consultants to the Army Surgeon General to query active duty staff physicians in their specialty areas who have deployment experience in August 2007. Questions concerning specialty, length of deployment, perceived changes in skills, skill use while deployed, and time to get back to baseline clinically after deployment were asked.
  
  
  RESULTS
  Surveys were sent to approximately 1,500 physicians, of which 673 were usable, for a 45% response rate. More than 70% of respondents were deployed for >6 months. Fifty-nine percent reported that they were used in their specialties <40% of the time deployed. Surgeons rated surgical skills before and after deployment as 6.0 ± 1.0 and 4.0 ± 1.5, respectively (on a 7-point, Likert-type scale ranging from 1 = worst to 7 = best; P = .001). Most felt that the time needed to get back to predeployment skill levels was 1 to 6 months.
  
  
  CONCLUSIONS
  There was significant perceived degradation in both the surgical and clinical skills of those deploying for >6 months, and the degradation was correlated with the length of time deployed. Most surgical specialists felt that it took them 3 to 6 months to return to their clinical and surgical performance baseline upon returning from a deployment and that 6 months was the most amount of time they could be deployed without a significant decrement in skills.
authors.affiliation: Department of Obstetrics and Gynecology, Andersen Simulation Center, Madigan Army Medical Center, Uniformed Services University of the Health Sciences, University of Washington School of Medicine, Tacoma, WA, USA.
authors.forename: Shad H
authors.initials: SH
authors.lastname: Deering
authors.forename: Robert M
authors.initials: RM
authors.lastname: Rush
authors.forename: Richard N
authors.initials: RN
authors.lastname: Lesperance
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Roth
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D013502:General Surgery / Q000592:standards*; D006772:Hospitals, Military / Q000592:standards*; D006801:Humans; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel; D010820:Physicians / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States; D014857:Warfare