ThP7.8 - What is the gap in operative trauma surgical skills needed for humanitarian and military deployment? A systematic narrative review of surgeons in high-income countries

Abstract Aims The incidence of armed conflict, terrorist attacks and environmental disaster is increasing and death from traumatic injury remains a leading cause of mortality globally, posing complex challenges in surgical care. Despite advancements in trauma systems development, practice in high-income countries (HICs) is characterised by low trauma volumes, evolving non-operative strategies and increasing sub-specialisation, raising concerns about surgical preparedness for managing diverse injuries. This systematic review aims to assess the operative trauma skills of surgeons in HICs mapped against core military and humanitarian procedures. Examination of the breadth of skills acquired and identification of areas where further experience is required will inform the development of more comprehensive and adaptable surgical training programs. Methods A systematic literature review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using MEDLINE and EMBASE. Inclusion criteria targeted general and trauma surgery consultants or trainees in HICs, analysing quantitative and qualitative data on operative workload and skills acquisition. Results Twelve studies from the USA, UK, Netherlands, Ireland, Australia, and New Zealand were included. Trainees demonstrated experience in general surgical trauma but lack exposure to critical skills in orthopaedic, vascular and obstetric and gynaecological surgery. Conclusion This review highlights a gap in the operative trauma surgical skills of surgeons in HICs and the need for re-evaluation of surgical training curricula to address the dynamic challenges posed by contemporary trauma care. Emphasising a versatile skillset and exploring avenues for enhanced exposure through didactic courses and global surgery partnerships might prove crucial for better preparing surgeons for the diverse and demanding scenarios in the field of trauma care