Emergency medicine in the Canadian military

I repeatedly read in CMAJ that the Canadian Forces Health Services are in “critical need” of doctors1 and that there are severe shortages of uniformed personnel.2 CMA Past-President Ruth Collins-Nakai has been quoted as saying that “we must do something to ease the burden of our medical colleagues [in Afghanistan].”3 Despite this so-called critical need, it would seem that the Canadian Forces Health Services simply have no use for specialists in emergency medicine, who have acute care experience and advanced skills in airway management, trauma resuscitation, procedural sedation, prehospital care and aeromedical evacuation. Notwithstanding the fact that the US and British militaries have been welcoming emergency medicine specialists with open arms for years,4^–6 the Canadian military still does not recognize the specialty of emergency medicine.

Emergency medicine specialists can only join the Canadian Forces as general duty medical officers, which means that they cannot maintain their skills by working full-time in civilian hospitals when they are not deployed, unlike their specialist colleagues in orthopedic surgery, general surgery, anesthesiology, radiology and internal medicine. Rather, emergency medicine specialists would be required to work between deployments as family physicians in military clinics, something that they are simply not trained to do.

I know of several other soon-to-be emergency medicine specialists who would be interested in a military career. However, until the Canadian Forces recognizes our specialty and puts in place the necessary memoranda of understanding with “busy civilian hospitals” and “high-acuity practices” in large cities so that we can maintain our clinical competence the way Canadian military surgeons can,7 young physicians like me cannot in good conscience join the Canadian Forces.