Civilian and military doctors join forces for surgical skills bootcamp
On a recent morning, military doctors from Edmonton, Petawawa, Saint-Gabriel-de-Valcartier and Ottawa gathered in a surgical simulation facility in a Toronto hospital for an unusual bootcamp. The military professionals – all Medical Specialists in the Canadian Armed Forces (CAF) – joined forces with Toronto-area surgeons to practice surgical techniques they might encounter on the battlefield.
A joint exercise between Unity Health Toronto and the CAF, the General Surgery Bootcamp offered practical, hands-on training among surgeons who operate at some of the largest specialty care hospitals in the country. It was a unique example of collaboration and information sharing between civilian and military health care leaders as global emergencies are putting the need for their expertise increasingly under the spotlight.
Over several days, the medical specialists practiced a variety of trauma, vascular and neurosurgical techniques that might be useful in emergency situations. In combat, military doctors can encounter traumatic brain injuries, complex limb wounds, and major bleeding, among other things. The goal of the bootcamp was to train participants across a range of specialties to be able to react quickly to whatever is in front of them.
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Their educators included vascular surgeons, trauma surgeons and neurosurgeons from some of Toronto’s largest and busiest downtown hospitals including St. Michael’s.
Dr. Mark Wheatcroft, vascular surgeon at St. Michael’s Hospital, led part of the program, educating participants on ultrasound-guided techniques and emergency procedures to stop major bleeding and treat severe limb injuries.
As a surgeon, teaching and skill transfer are integral parts of Wheatcroft’s job.
“The interesting thing about this initiative is that we were teaching surgeons who are already highly skilled rather than junior trainees,” says Wheatcroft. “It was very humbling for me to learn about the austere environments these surgeons work in and the challenges they face every day that we would never face in the civilian arena.”
Dr. Francois Mathieu, a Neurosurgeon at St. Michael’s Hospital, led another section of the course guiding participants through procedures that relieve pressure and drain fluid from the brain.
“The goal isn’t to turn military general surgeons into neurosurgeons, but to teach them the core principles of emergency cranial surgery,” said Mathieu. “It was impressive to see how quickly their comfort level and technical confidence evolved, and humbling to learn about the conditions under which these surgeons may be expected to perform these procedures with limited technical resources, no brain imaging, and minimal support staff.”
Mathieu says the course was also a learning experience for the faculty, challenging them to “think creatively about how to make cranial procedures safer and more efficient in resource-constrained environments, how to teach techniques that are broadly applicable across multiple neurosurgical emergencies, and how to approach injuries that are relatively uncommon in civilian practice.”
The training program was coordinated by Dr. Andrew Beckett, medical director, Trauma Program, St. Michael’s Hospital and Lieutenant-Colonel in the Canadian Armed Forces.
“Sustained collaboration between civilian and military health care professionals is fundamental to a resilient and adaptable medical capability. Training alongside our partners at Unity Health Toronto strengthens clinical skills, advances shared expertise, and reinforces the relationships that enable the Canadian Armed Forces to respond effectively across a range of complex scenarios,” says Brigadier-General William Rideout, Director General Clinical Services.
The course is one example of collaboration between Canada’s military and public health care systems meant to strengthen Canada’s response to a range of potential events. In a recent editorial in the Canadian Medical Association Journal, Dr. Beckett and co-authors said it’s not just military conflict that necessitates the need for cooperation and partnership between the civilian system and military, but any number of emergency events, such as cyber attacks, mass casualty events and environmental disasters.
Three things should be taken into account when building a framework for partnership between Canada’s civilian and military health systems, the co-authors wrote. They include readiness built through training and embedded personnel, scalable capacity that benefits both civilians and forces, and data systems that can operate for both purposes.
“By training military physicians alongside civilian specialists, we’re strengthening skills that matter in both systems,” Beckett said. “We need physicians who are adaptable.”
By Olivia Lavery
Photos by Kevin van Paassen