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“You fight like you train” is a military dictum. If this Return also applies to the Naval Reserve’s medical de- Psrtment, then I expect that we are not training for a tough fight.
My ten years of Naval Reserve experience tell me ,aat instead of preparing for a fight, reserve doctors have een training to perform physical examinations on healthy people and “mobilizing” mountains of paperwork to justify their existence. Annual physical examina- ll°ns are designed to monitor the fitness levels of mili- lary personnel, but medical departments’ limited jNuipment, space, and supplies render most exams super- ,lc>al at best. Having performed thousands of these phys- 1Cal exams, I can testify that rarely is anything discovered that requires further medical attention or disqualifies s°meone from the naval service.
The large number of required physical examinations and the fact that these exams take precedence over al- Jj'ost everything else allow very little scheduled training ()r the reserve medical departments. An entire weekend ?ay be needed for a reservist to complete all the tests 0r a physical exam. The medical departments suffer, r*lling reservists may lose up to one-twelfth of their anaual training time, and units lose the reservists’ servos because of these physicals. t After mobilization, the reserve doctors will be asked Provide medical support for forces operating in a hose environment. They will be called upon to treat large j Ufnbers of serious casualties, on short notice, with lim- eP support personnel and supplies. Medical personnel 1 * have to prevent disease from spreading, monitor food and water supplies, and supervise field sanitation and vector control. They will need to rapidly establish lines of communication and chains of evacuation and resupply.
Consequently, the demands that routine physical examinations make on reserve medical doctors must be reduced. Physical exams could be performed only at enlistment and reenlistment. They also should be more comprehensive than they are now. Physicals could be repeated for special personnel categories—those unable to perform tasks or complete the physical fitness test, those who do not meet the body fat norms, or those being considered for promotion.
Reducing the numbers of routine and unnecessary exams would allow more time for training reserve medical personnel. Reserve medical departments need training to support operational activities in the field and on board ship, to be familiar with their gaining commands, and to care for combat casualties (e.g., advanced trauma life support).
If these changes are made, reserve medical personnel, who will be relied upon heavily in a conflict, will not have to relearn the lessons of triage and wound management at the expense of their first casualties.
If we will fight like we train, we had best train for a fight.
Commander Michael S. Baker, Medical Corps, U. S. Naval Reserve, is the Chief of Surgery at Contra Costa County Hospital, Martinez, California. He recently was appointed to the Navy Committee for Trauma of the American College of Surgeons.