Specialized Transversal Surgical Training in War and Disaster Situations: Maintain Versatility in the Face of a Traumatic Emergency Despite the Disappearance of General Surgery?

The current amendment of the postgraduate medical education in France is leading to important changes in the training of medical doctors, including an early separation in the specialization of futurs surgeons. Since 2017, the residents now choose their specialty in their first year of internship. The former "general surgery" degree has thus disappeared, officially giving an end point to theoretical surgical versatility.
At the same time, the occurrence of terrorist attacks on our national territory highlighted the need for our health system to be able to respond efficiently to these exceptional health situations, and the importance for a surgical training for severe trauma care. There is no trauma and acute care surgery specialty in France, as in the US for instance. In this context, the French Health authorities decided on the creation of a Transversal Specialized Course (TSC) for Emergency War or Disaster Surgery.
The surgeons possibly attending this TSC will be from the specialties dealing with surgical emergencies and trauma (orthopedics, digestive, maxillofacial, pediatrics, thoracic and cardiovascular surgery, urology) and also interested in the technical and organizational aspects of disaster surgery, either in the civilian or military settings. Thirty to 50 students are expected to enroll each year in the TSC. The course will focus on trauma surgery and consist of four three-day modules spread over one year, combining didactic courses, hands-on workshops and simulation, and two 6-month fellowhisps.