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Enhancing Surgical Proficiency in the USAF: Addressing Volume and Skills Deficiencies

This document outlines the surgical proficiency challenges faced by USAF surgeons, highlighting the lack of clinical cases as a primary concern. It emphasizes the need for greater surgical volume to maintain necessary skills and improve patient outcomes. The report cites data from WHMC and studies indicating that busy and proficient surgeons yield better results, increased job satisfaction, and enhanced patient safety. Strategies for recapturing surgical care into military treatment facilities (MTFs) are discussed to support organizational proficiency and surgeon retention.

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Enhancing Surgical Proficiency in the USAF: Addressing Volume and Skills Deficiencies

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  1. Surgery Proficiency Targets Col Mark Boston, USAF, MC AFMOA/SGHM Version 2

  2. Defining the Problem • Proficient – highly competent, skilled, adept • Ready – prepared to act or be used immediately • AFMS Surgeons are not busy enough • Avg Gen Surg performed • 79 to 192 (WHMC) cases baseline (2008) • 159 cases (2010 data) • #1 complaint of AF surgeons - lack of clinical cases • Surgical volume not sufficient to maintain skills

  3. AFMS OR Optimization

  4. AFMS Current State

  5. Civilian General Surgery AFMS 2010 King, et al. Annals of Surgery, 2009.

  6. Busy is Better Smith, et al. Surg Obes Relat Dis, 2010.

  7. Speed Reduces Complications Procter, et al. J Am Coll Surg, 2010

  8. Proficiency Requirements

  9. Benefits Improved patient safety and quality surgical outcomes Busy surgeons are ready surgeons Busy, proficient surgeons are resilient surgeons Increased surgeon job satisfaction - Retention Performance plan supported – if increase can be done “in-house” – Recapture Recapturing care into the MTF supports organizational proficiency

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