title: Modern teaching of military surgery: why and how to prepare the orthopaedic surgeons before deployment? The French experience.
abstract: OBJECTIVE
  Improved survival of combat casualties in modern conflicts is especially due to early access to damage control resuscitation and surgery in forward surgical facilities. In the French Army, these small mobile units are staffed with one general surgeon and one orthopaedic surgeon who must be able to perform any kind of trauma or non trauma emergency surgery.
  
  
  METHODS
  This concept of forward surgery requires a solid foundation in general surgery which is no longer provided by the current surgical programs due to an early specialization of the residents. Obviously a specific training is needed in war trauma due to the special pathology and practice, but also in humanitarian care which is often provided in military field facilities.
  
  
  RESULTS
  To meet that demand the French Military Health Service Academy created an Advanced Course for Deployment Surgery (ACDS), also called CACHIRMEX (Cours Avancé de CHIRurgie en Mission EXtérieure). Since 2007 this course is mandatory for young military surgeons before their first deployment. Orthopaedic trainees are particularly interested in learning war damage control orthopaedic tactics, general surgery life-saving procedures and humanitarian orthopaedic surgery principles in austere environments.
  
  
  CONCLUSIONS
  Additional pre-deployment training was recently developed to improve the preparation of mobile surgical teams, as well as a continuing medical education for any active-duty or reserve surgeon to be deployed.
authors: Clinic of Traumatology and Orthopaedics, Percy Military Teaching Hospital, Clamart, France.
authors: Laurent
authors: L
authors: Mathieu
authors: Clinic of Traumatology and Orthopaedics, Percy Military Teaching Hospital, Clamart, France.
authors: Benjamin
authors: B
authors: Joly
authors: Clinic of Abdominal, Thoracic and Vascular Surgery, Percy Military Teaching Hospital, Clamart, France.|French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors: Stéphane
authors: S
authors: Bonnet
authors: Clinic of Traumatology and Orthopaedics, Desgenettes Military Teaching Hospital, Lyon, France.
authors: Antoine
authors: A
authors: Bertani
authors: Clinic of Traumatology and Orthopaedics, Desgenettes Military Teaching Hospital, Lyon, France.|French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors: Frédéric
authors: F
authors: Rongiéras
authors: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors: François
authors: F
authors: Pons
authors: Clinic of Traumatology and Orthopaedics, Percy Military Teaching Hospital, Clamart, France. s.rig@libertysurf.fr.|French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France. s.rig@libertysurf.fr.|Service de Chirurgie Orthopédique, Traumatologie et Chirurgie Réparatrice des Membres, 101 avenue Henri Barbusse, 92140, Clamart, France. s.rig@libertysurf.fr.
authors: Sylvain
authors: S
authors: Rigal
mesh_terms: D000533:Altruism; D004502:Education, Medical, Continuing; D005602:France; D006801:Humans; D008887:Military Medicine / Q000193:education*; D008889:Military Personnel / Q000193:education*; D009985:Orthopedics / Q000193:education*; D066231:Surgeons; D000067398:War-Related Injuries / Q000601:surgery*
keywords: Combat casualty; Humanitarian care; Military; Orthopaedic surgery; Surgical training