title: The French Advanced Course for Deployment Surgery (ACDS) called Cours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX): history of its development and future prospects.
abstract: BACKGROUND
  The composition of a French Forward Surgical Team (FST) has remained constant since its creation in the early 1950s: 12 personnel, including a general and an orthopaedic surgeon. The training of military surgeons, however, has had to evolve to adapt to the growing complexities of modern warfare injuries in the context of increasing subspecialisation within surgery. The Advanced Course for Deployment Surgery (ACDS)-called Cours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX)-has been designed to extend, reinforce and adapt the surgical skill set of the FST that will be deployed.
  
  
  METHODS
  Created in 2007 by the French Military Health Service Academy (Ecole du Val-de-Grâce), this annual course is composed of five modules. The surgical knowledge and skills necessary to manage complex military trauma and give medical support to populations during deployment are provided through a combination of didactic lectures, deployment experience reports and hands-on workshops.
  
  
  RESULTS
  The course is now a compulsory component of initial surgical training for junior military surgeons and part of the Continuous Medical Education programme for senior military surgeons. From 2012, the standardised content of the ACDS paved the way for the development of two more team-training courses: the FST and the Special Operation Surgical Team training. The content of this French military original war surgery course is described, emphasising its practical implications and future prospects.
  
  
  CONCLUSIONS
  The military surgical training needs to be regularly assessed to deliver the best quality of care in an context of evolving modern warfare casualties.
authors.affiliation: Department of Visceral and General Surgery, Percy Military Teaching Hospital, Clamart Cedex, France French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonnet
authors.affiliation: Department of Visceral and General Surgery, Percy Military Teaching Hospital, Clamart Cedex, France French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Gonzalez
authors.affiliation: Department of Traumatology and Orthopedics, Percy Military Teaching Hospital, Clamart, France.
authors.forename: L
authors.initials: L
authors.lastname: Mathieu
authors.affiliation: Department of Thoracic and Vascular Surgery, Percy Military Teaching Hospital, Clamart, France.
authors.forename: G
authors.initials: G
authors.lastname: Boddaert
authors.affiliation: Department of Visceral and General Surgery, Percy Military Teaching Hospital, Clamart Cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Hornez
authors.affiliation: Department of Traumatology and Orthopedics, Desgenettes Military Teaching Hospital, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bertani
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France Department of Thoracic and Vascular Surgery, Sainte-Anne Teaching Hospital, Toulon, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Avaro
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France Department of Urology, Val-de-Grâce Military Teaching Hospital, Paris, France.
authors.forename: X
authors.initials: X
authors.lastname: Durand
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France Department of Traumatology and Orthopedics, Desgenettes Military Teaching Hospital, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Rongieras
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France Department of Digestive Surgery, Sainte-Anne Military Teaching Hospital, Toulon, France.
authors.forename: P
authors.initials: P
authors.lastname: Balandraud
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France Department of Traumatology and Orthopedics, Percy Military Teaching Hospital, Clamart, France.
authors.forename: S
authors.initials: S
authors.lastname: Rigal
authors.affiliation: French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Pons
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods*; D005602:France; D013502:General Surgery / Q000193:education*; D006801:Humans; D008887:Military Medicine / Q000193:education*; D009985:Orthopedics / Q000193:education*; D014194:Traumatology / Q000193:education*