At any given time, 140 practicing orthopaedic surgeons are serving in the U.S. military, with another 110 who are undergoing residency and fellowship training, and numerous veteran alumni. Military faculty and residents are active members of both general and specialty orthopaedic associations, and many are involved in leadership and scholarship at all levels.

The military resident is both an officer and an orthopaedic surgeon. This article offers the military resident’s perspective on service, professionalism, and leadership in this dual role.

Our colleagues in uniform come to service in numerous ways. Some entered the service as undergraduates at the nation’s military academies or through the Reserve Officers Training Corps. Others completed their undergraduate degrees as civilians and entered as participants in the Armed Forces Health Professions Scholarship Program or the Uniformed Services University of the Health Sciences. Still others served in enlisted or commissioned capacity prior to seeking advanced degrees. The reasons for joining are numerous. Many, particularly the younger residents, made the decision to serve while the nation has been at war.

This constant specter of war and the reality of pending deployments mark the most significant difference between military and civilian resident physicians. Deployment to a combat zone is an opportunity to treat and heal those who have volunteered to put themselves in harms way to defend our freedom. There is no greater professional responsibility.

Deployment also represents a chance to advance the orthopaedic field with the study of combat-related extremity trauma. Wartime surgeons from every generation have contributed in this way, and the current conflicts are no exception, particularly in the areas of amputee and prosthetic care, infection management, and composite tissue loss from blast injuries. This opportunity for advancing the profession serves as a call to leadership for the military orthopaedic surgeon.

Military medical training
The shared mission of the armed forces’ medical departments is to provide the highest level of medical care to ensure readiness of the nation’s fighting forces. As many readers can attest, there is no better patient than the motivated and dedicated soldier, sailor, airman, or marine. The efforts and sacrifices made by members of our armed forces on behalf of the nation are a constant source of motivation and inspiration for the orthopaedic surgery resident. And, there is no better model of this required dedication to patient care than the faculty of our military medical teaching hospitals.

The faculty is distinguished in their academic pursuits, many with specialty training from leaders in the field. Many also serve in leadership positions in their respective specialty societies and within the Academy. However, the nature of military service is to have a constant renewal of leadership. Thus, faculty members of military medical centers are often young and recently out of training. Despite their limited experience, their passion for patient care and teaching is exemplary.

Senior faculty members often retire from military service just as they are reaching the peak of their orthopaedic surgical prowess. Although this in some ways may limit the training residents receive, it also provides tremendous opportunity. Those who once served in uniform now serve across the country with distinction at all levels of leadership in the orthopaedic community.

Many remain connected to the uniformed services through active involvement in organizations such as the Society of Military Orthopaedic Surgeons (SOMOS) and in programs like the Landstuhl Distinguished Visiting Professorships. As Aaron G. Rosenberg, MD, acknowledged, “Speaking at the annual SOMOS meeting stands out as one of the highlights of my career.”

Through these and other programs, orthopaedists who may not have served in uniform continue to provide assistance in the care of our wounded military and contribute to our education and surgical training.

“The interchange surrounding the best ways to manage severely injured warriors was very satisfying,” said Marc F. Swiontkowski, MD, describing his experience with the Landstuhl Distinguished Visiting Professor Program. “The combination of experience from the civilian trauma center with that of the Operation Iraqi Freedom and Operation Enduring Freedom conflicts seemed to produce decision-making that was far superior to what either perspective could accomplish alone for these very deserving soldiers.”

Your opportunity to serve
We invite all those who wish to support military orthopaedics to become involved and to join us in building and strengthening the relationships between our military and civilian alumni and supporters.

For example, Lawrence B. Bone, MD, who has served both at Landstuhl as a visiting professor and aboard the USNS Comfort in Haiti, wondered, “Wouldn’t it be something if the Department of Defense (DoD) could establish an organization where civilian orthopaedic surgeons could volunteer as mentors, teachers, or even back fill (fill in where needed stateside when military orthopaedic surgeons are deployed). We certainly need to develop a collaboration to have medical personnel of all types credentialed by the DoD, so that they can be called on when the next ‘Haiti’ occurs.”

You will know who we are; we are easy to identify in our uniforms. To us, however, you are in camouflage; step forward and be recognized.

Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

For more information on SOMOS, see “Fifty years of SOMOS,” AAOS Now, November 2008; for more information on the Landstuhl Distinguished Visiting Professor Program, see “The ultimate volunteer experience: Serving at LRMC,” AAOS Now, December 2008.

CPT(P) Brendan D. Masini, MD, is a chief resident at Brooke Army Medical Center, Ft. Sam Houston, Texas. He can be reached at Brendan.Masini@amedd.army.mil

CPT Daniel J. Stinner, MD, is a fourth year resident at Brooke Army Medical Center, Ft. Sam Houston, Texas. He can be reached at Daniel.Stinner@amedd.army.mil