Acute care surgery in the USA: the orthopaedic conflict

Excerpt

Acute care surgery is a relatively new surgical specialty that has been devised in the USA. Its creation was the consequence of two important realisations. Firstly, competence in trauma surgery was notably declining. Increasing levels of sub-specialisation (resulting in trauma being neglected in the curriculum) and improvements in road and occupational safety (causing reductions in operative volume) were thought to be responsible [1]. Secondly, diminishing interest in this specialty from junior doctors was observed. Amongst others, the realities of reduced number of surgeries (compared with other specialties), unappealing working hours, high stress and poor opportunities for elective practice were blamed [2‐8]. A poll commissioned by the Coalition for American Trauma Care (CATC) showed that 88 % of trauma surgeons were in favour of a change to the current training and practice model [3]. …