Emergency medicine in the Canadian military

[The Director of Health Services Personnel, Canadian Forces, responds:]

The Canadian Forces believes that, given the good general health of most members of the Forces on operational deployment, the requirements for emergency medicine in operations can be fully met by the spectrum of medical experts on deployment. To address the Canadian Forces' acute care needs, we will continue to rely upon a team-based approach to trauma care that includes family physicians with the CCFP and CCFP(EM) designations who have received additional training in and exposure to trauma care. It is true that the United States military deploys emergency medicine specialists, but they work no further forward than their combat support hospitals. The situation in the United States also differs from that in Canada in that family members of serving members of the US Forces and military retirees all receive their health care through military facilities, and these patients make up much of the patient load of emergency medicine specialists in the US military when they are working at home. As the Canadian Forces does not operate any emergency departments in Canada, full-time emergency physicians have no role in the Canadian Forces at home. Given the relatively small size of the Canadian Forces Health Services, we must have as many generalists as possible, who receive additional specialized training as required. However, the Canadian Forces is considering opening up reserve positions for emergency physicians certified through the Royal College of Physicians and Surgeons of Canada.

As Matthew Erskine correctly pointed out, the Canadian Forces is short of physicians and continues to recruit aggressively, but only in certain core disciplines: family medicine (including family physicians with the CCFP[EM] designation), internal medicine, general surgery, orthopedic surgery, psychiatry, anesthesia and radiology. All military physicians are expected to maintain a generalist skill set while focusing on acute trauma management and other areas relevant to military operations.