B. A. Capacio1, P. M. McCarthy7, E. West1, T. Oseni6, E. Jones5, D. Coleman3, D. Nelson4, J. Bingham2, D. Vicente1, P. M. Choi1 1Naval Medical Center, San Diego, CA, San Diego, CA, USA 2Madigan Army Medical Center, Tacoma, WA, USA 3University Of Michigan, Ann Arbor, MI, USA 4William Beaumont Army Medical Center, El Paso, TX, USA 5University Of Colorado Denver, Aurora, CO, USA 6Massachusetts General Hospital, Boston, MA, USA 7Brooke Army Medical Center, Ft Sam Houston, TX, USA
Introduction: Pursuing a career in academic surgery within the military presents unique challenges. In addition to combat deployments and operational demands, military surgeons frequently encounter organizational obstacles to conducting high-impact clinical research. Furthermore, academic productivity is not valued when considering military promotions and subsequent salary raises. The purpose of this study is to explore current perceptions within the military surgery community in order to stratify key obstacles to pursuing a career in academic surgery in the military and identify opportunities for mitigation.
Methods: After receiving IRB approval, an anonymous electronic survey was distributed to military surgeons (residents/fellows/attendings) across all branches. Survey response data was collected and analyzed using chi-square.
Results: The response rate was approximately 22% (n = 161, Table 1). Of those who responded to the survey, 94% are interested in an academic career; however, 64% believe this to be much more difficult as a military surgeon than as a civilian surgeon. The top 3 perceived obstacles include administrative obstacles (76.4%), operational commitments (65.8%), and lack of funding for academic pursuits (62.7%). Most respondents indicated that they have never received formal education regarding how to apply for research funding (84.5%) and most do not have a research mentor (60.9%). Additionally, 42.9% state that obstacles to academic career in surgery impact their decision to leave the military.
Approximately a third of responders indicated intent to leave the military once commitment is completed, while a third plan on a long-term military career. There were no differences in branch of service, gender, family/marital status, civilian vs military training, subspecialty training, and prior military service between those who wished to have a long-term military career and those who wished to leave the military once their service commitment is completed. However, those who wished to leave after their service commitment tended to be younger (67.9% vs 46.4% aged 20-39 years, p=0.02), were more likely to have had dedicated time off during residency for research (73.6% vs 49.0%, p=0.01), and were less likely to believe it was possible to have a successful academic career as a military surgeon (18.9% vs 5.4%, p=0.03).
Conclusion:This is the first study to quantify the perceived challenges to academic surgery within the military. These challenges pose irreconcilable conflict between academic surgery and active military service risking attrition in greater than a third of respondents, particularly in the younger generation of military surgeons. Importantly, this study also identifies actionable opportunities for interventions.
