title: A concluding after-action report of the Senior Visiting Surgeon program with the United States Military at Landstuhl Regional Medical Center, Germany.
abstract: BACKGROUND
  The Senior Visiting Surgeon (SVS) program at Landstuhl Regional Medical Center (LRMC), Germany, was developed during the wars in Afghanistan and Iraq as a measure to build military-civilian interaction in trauma care and research. The objective of this study was to provide a summary of the program including workload and experiences. An additional objective was to identify factors needed for sustainment of this program during an interwar period.
  
  
  METHODS
  An electronic, 34-question survey was distributed to 192 surgeons who participated in the SVS program at LRMC, either through the American Association for the Surgery of Trauma or the Society of Vascular Surgery between 2005 and 2012. The survey was composed of multiple-choice and open-ended questions.
  
  
  RESULTS
  The response rate was 61% (n = 118), with 24% (n = 28) indicating previous military service. These 117 respondents provided 24.5 months of volunteer coverage at LRMC, with 22% (n = 26) performing multiple, 2-week rotations. Visiting surgeons participated in two to five operative cases per week, with the majority of operations related to the management of soft tissue wounds and burns followed by abdominal and vascular procedures, conducted daily multidisciplinary intensive care unit rounds, and collaborated with military surgeons in research projects resulting in 22 publications. More than half (n = 59) of the respondents maintained contact with military colleagues during the 12 months following the rotation. The majority of surveyed surgeons support continuation of the SVS at military facilities in the United States and hosting military surgeons at their civilian trauma center.
  
  
  CONCLUSIONS
  This study is the first to quantify the SVS program during the wars in Afghanistan and Iraq. Visiting surgeons provided more than 2 years of combat casualty care during these, the longest wars in US history. Continuation of this program will require expanded military-civilian interaction in trauma care, training, and research during any interwar period.
authors.affiliation: From the University of California (M.M.K.), San Francisco, California; Institute of Surgical Research (T.W.E.), Fort Sam Houston, Texas; US Air Force C-Stars (R.F.), Baltimore; and US Combat Casualty Care Research Program (T.E.R.), Fort Detrick, Maryland; Landstuhl Regional Trauma Center (KM), Landstuhl, Germany; University of Cincinnati (W.D.), Cincinnati, Ohio; Heart and Vascular Center (D.L.G.), New Beford, Massachusetts; University of Virginia (K.L.C.), Charlottesville, Virginia.
authors.forename: M Margaret
authors.initials: MM
authors.lastname: Knudson
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Evans
authors.forename: Raymond
authors.initials: R
authors.lastname: Fang
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Martin
authors.forename: Warren
authors.initials: W
authors.lastname: Dorlac
authors.forename: David L
authors.initials: DL
authors.lastname: Gillespie
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cherry
authors.forename: Todd E
authors.initials: TE
authors.lastname: Rasmussen
mesh_terms: D055826:Afghan Campaign 2001-; D003625:Data Collection; D005858:Germany; D006772:Hospitals, Military / Q000458:organization & administration; D006801:Humans; D054542:Iraq War, 2003-2011; D008887:Military Medicine / Q000193:education / Q000458:organization & administration; D008889:Military Personnel / Q000193:education; D015397:Program Evaluation; D012955:Societies, Medical; D014194:Traumatology / Q000193:education* / Q000458:organization & administration; D014481:United States / Q000208:ethnology; D014947:Wounds and Injuries / Q000601:surgery