War has influenced the evolution of global neurosurgery throughout the past century. Armed conflict and mass casualty disasters (MCDs), including Humanitarian Assistance Disaster Relief missions, require military surgeons to innovate to meet extreme demands. However, the military medical apparatus is seldom integrated into the civilian healthcare sector. Neurosurgeons serving in the military have provided a pragmatic template for global neurosurgeons to emulate in humanitarian disaster responses.
Asfaw et al. performed a narrative review of the literature examining the influence of wars and MCD on contemporary global neurosurgery practices.
Wartime innovations that influenced global neurosurgery include the development of triage systems and modernization with airlifts, the implementation of ambulance corps, early operation on cranial injuries in hospital camps near the battlefield, the use of combat body armor, and the rise of damage control neurosurgery. In addition to promoting task-shifting and task-sharing, workforce shortages during wars and disasters contributed to establishing the physician assistant/physician associate profession in the USA. Low- and middle-income countries (LMICs) face similar challenges in developing trauma systems and obtaining advanced technology, including neurosurgical equipment like battery-powered computed tomography scanners. These challenges-ubiquitous in low-resource settings have underpinned innovations in triage and wound care, rapid evacuation to tertiary care centers, and minimizing infection risk.
War and MCDs have catalyzed significant advancements in neurosurgical care both in the pre-hospital and inpatient settings. Most of these innovations originated in the military and spread to the civilian sector as military neurosurgeons and reservist civilian neurosurgeons returned from the battlefront or other low-resource locations. Military neurosurgeons have utilized their experience in low-resource settings to make volunteer global neurosurgery efforts in LMICs successful. LMICs have, by necessity, responded to challenges arising from resource shortages by developing innovative, context-specific care paradigms and technologies 1) JOB DUTIES
Examine, diagnose, and perform surgery as required in cases of patients suffering from disease, injury, or disorder of the nervous system.
REQUIREMENTS
Active Duty
Current license to practice medicine in the United States, District of Columbia or Puerto Rico Eligibility for board certification Completion of at least one year of an approved graduate medical education internship Completion of a training program in neurosurgery Between 21 and 42 years of age (may request a waiver, Locate A Recruiter for more information) Must be a U.S. citizen Army Reserve In addition to the above qualifications, permanent U.S. residency is required for Reserve duty officers. TRAINING
In the U.S. Army, physicians gain experience that far exceeds the medical care environment of the private sector. As an Army Medical Corps Officer, you’ll have access to the most sophisticated technology, and you will have the opportunity to consult with experts in both the military and private sector. In addition, you will have exceptional professional growth opportunities, including continuing education courses, seminars and conferences. Physicians may even serve as faculty at one of our prestigious Graduate Medical Education programs. For physicians just starting out, the Army Medical Corps offers first-year graduate medical education, residency and fellowship programs. Qualifying medical school students can also benefit through unique training opportunities exclusive to Army Medical Corps Officers. Medical Corps Officers will also attend certain military short courses designed to develop and enhance the tactical, technical and operational skills unique to the military environment.
HELPFUL SKILLS
The normal environment of an Army Medical Corps officer’s work requires time-sensitive problem analysis with an accurate, sound and immediate decision. Ability to operate under stress, apply critical thinking skills, make decisions and translate these skills to battlefield conditions is critical to medical and mission success.
Effective patient care requires the proper balance between technical skills and the ability to apply appropriate treatment. Army Medical Corps Officers have expert knowledge in their area of concentration, patient management, and general support and coordination principles. Physicians gain this knowledge through mentoring, training, continuous self-development and progressive levels of assignments within their specialty.
COMPENSATION
ACTIVE BENEFITS: In addition to the many privileges that come with being an officer on the U.S. Army health care team, you’ll be rewarded with: 30 days of paid vacation earned annually Noncontributory retirement benefits with 20 years of qualifying service No-cost or low-cost medical and dental care for you and your family RESERVE BENEFITS: Health Professional Special Pay Health Professions Loan Repayment Noncontributory retirement benefits at age 60 with 20 years of qualifying Service Low-cost life and dental insurance Travel opportunities, including humanitarian missions Both active and Reserve duty Officers enjoy commissary and post exchange shopping privileges and a flexible, portable retirement savings and investment plan similar to a 401(k). Officers may also receive pay for continuing education.
EDUCATION BENEFITS
ACTIVE: Not only are physicians paid as commissioned officers but they also are eligible to receive special pay incentives and take advantage of unique education benefits. Through the Health Professions Scholarship Program, the Army Medical Corps will pay 100 percent of a student’s tuition, as well as expenses for required books, equipment and most academic fees. Medical students may also be eligible to receive a sign-on bonus. Active duty physicians with the U.S. Army health care team can earn up to $120,000 in student loan repayment through our Active Duty Health Professions Loan Repayment Program.
RESERVE: One of the many advantages of becoming a member of the U.S. Army Reserve health care team is that you’ll be able to focus on patient care instead of medical school loans. By continuing to practice in your own community and serving when needed, you may qualify for HPLR to repay your medical school loans.
FUTURE CIVILIAN CAREERS
As you advance through your medical career, you will be looking for experiences that blend teaching, research and clinical excellence to best prepare you for unique and challenging opportunities in medicine. Our physicians excel in the clinical, research, operational, academic and health administration arenas. Many have worked in more than one career track throughout their time in the U.S. Army and have held leadership positions ahead of their private sector counterparts.
U.S. Army physicians are highly desired candidates for competitive private sector jobs upon leaving the Army. In fact, many former U.S. Army physicians serve as faculty in elite medical schools and residency programs, and our fellows are accepted by many renowned training institutions.
PARTNERSHIP FOR YOUTH SUCCESS (PAYS) PROGRAM
Those interested in this job may be eligible for civilian employment, after the Army, by enrolling in the Army PaYS program. The PaYS program is a recruitment option that guarantees a job interview with military friendly employers that are looking for experienced and trained Veterans to join their organization. Find out more about the Army PaYS Program at http://www.armypays.com.
see Military trauma.