Military doctors and nurses are not getting enough hands-on patient care, leaving them ill-prepared to care for troops in combat and causing them to separate from service altogether, according to a federal watchdog.
据联邦监管机构称,军事医生和护士没有得到足够的动手患者护理,使他们准备不足以照顾战斗中的部队并使他们完全与服务分开。
“Because Army and Navy medical personnel are not consistently assigned where they can sustain their wartime readiness skills, they may not provide high quality, point-of-injury care to service members during deployments,” a Department of Defense Inspector General report released this month found.
国防部本月发布的一份国防部监察长报告发现:“由于陆军和海军医务人员并未始终如一地分配他们可以维持战时准备技能的地方,因此他们可能无法在部署期间为服务成员提供高质量的伤害关怀。”
The problem was most acute for Army and Navy personnel, compared to the Air Force. According to the report, emergency and trauma-focused medical officers were assigned to locations “that do not provide opportunities for direct patient care.” Instead, based on IG observations and conversations with medical personnel, they were assigned to one of the seven Navy fleets, a Marine Corps unit or Army Forces Command, where they saw a low volume of relevant cases and situations that lacked medical complexity.
与空军相比,军队和海军人员最为严重。根据该报告,将紧急情况和以创伤为重点的医务人员被分配到“没有为直接患者护理提供机会的地点。”取而代之的是,根据IG的观察和与医务人员的对话,他们被分配到七个海军舰队之一,一个海军陆战队单位或陆军司令部,在那里他们看到了缺乏医疗复杂性的相关案件和情况少。
The report focused specifically on critical care physicians and nurses, anesthesiologists, nurse anesthetists, emergency medicine doctors and trauma nurses, which are generally held by officers. Those roles are different from Navy corpsmen and Army and Air Force combat medics, who are enlisted military personnel organic to military units across the force, and in combat arms fields are tasked with providing frontline medical care.
该报告专门针对重症监护医师和护士,麻醉学家,护士麻醉师,急诊医学医生和创伤护士,这些护士通常由官员持有。这些角色与海军军官和军队以及空军战斗医生不同,后者是整个部队的军事部队的有机军事人员,在战斗武器领域的任务是提供一线医疗服务。
The wartime skills that medical officers are expected to maintain differ between services and by occupation, but overall, they are expected to perform combat casualty care in hospitals, which includes life-saving trauma surgeries or procedures to preserve limbs.
预计医务人员在服务和占领之间保持差异的战时技能,但总的来说,他们有望在医院进行战斗伤亡护理,其中包括挽救生命的创伤手术或程序以保护四肢。
The Army and Navy “did not consistently assign” medical personnel to military treatment facilities or civilian hospital partnership programs, which provide the most opportunities,” to meet readiness requirements, the IG said. Only 25% of Army, 52% of Navy and 81% of Air Force emergency doctors were placed at locations where they directly provided care to patients.
IG说,陆军和海军“没有始终将医务人员”为军事待遇设施或民用医院伙伴关系计划,以满足准备就绪要求。
Army officials told the IG that they did not account for personnel assigned to operational units but have duties at military hospitals, where they are required to spend 88% of their time according to policy. The IG did not confirm if personnel met this policy requirement.
陆军官员告诉IG,他们没有考虑分配给运营部门的人员,而是在军事医院担任职责,在那里他们根据政策需要花88%的时间。IG没有确认人员是否符合此政策要求。
Army medical personnel inspect a patient used to simulate a combat casualty before performing a mock surgery on June 1, 2025, at Fort Irwin, California. Army photo by Staff Sgt. Ian Valley.
陆军医务人员检查了一名用于模拟战斗人员伤亡的患者,然后于2025年6月1日在加利福尼亚州的欧文堡进行模拟手术。陆军照片由工作人员中士。伊恩谷。
The assignment issues led to poor outcomes for physician and nurse combat readiness. April 2025 data showed that officers’ medical skills often fell below readiness standards, even with each department having different requirements.
任务问题导致医生和护士战斗准备的不良结果。2025年4月的数据显示,即使每个部门都有不同的要求,官员的医疗技能也常常低于准备标准。
For instance, one annual training requirement involves medical officers placing flexible catheter tubes into arteries to monitor patients’ blood pressure. The Army requires critical care doctors to do two arterial lines each year, the Air Force requires 10, and the Navy scores arterial line procedures instead of requiring a certain number of them. The IG found that 9% of Army doctors, 25% of Navy doctors and 41% of Air Force doctors met their annual threshold. Overall, the IG found that the Air Force had more medical personnel in compliance with their readiness requirements.
例如,一项年度培训要求涉及将柔性导管管放入动脉中以监测患者血压的医务人员。陆军要求重症监护医生每年进行两条动脉线,空军需要10个动脉线,而海军得分进行了动脉线程序,而不是需要一定数量。IG发现,有9%的陆军医生,25%的海军医生和41%的空军医生达到了他们的年度门槛。总体而言,IG发现空军有更多的医务人员符合他们的准备要求。
The readiness concerns highlighted by the IG report echoed similar findings from the Government Accountability Office, but for enlisted personnel. The GAO found in a 2021 report that “the military departments lack reasonable assurance that all enlisted medical personnel are ready to perform during deployed operations.”
IG报告强调了准备就绪,这与政府问责办公室的类似发现相呼应,但对于入伍人员而言。GAO在2021年的一份报告中发现:“军事部门缺乏合理的保证,即所有入伍的医务人员都准备在部署的行动中执行。”
Leaving the service
离开服务
The long-term effect, the IG found, is that medical personnel in “wartime specialties” — like emergency care and trauma surgery — may end up separating because of the lack of opportunities for hands-on experience.
IG发现,长期的效果是,“战时专业”中的医务人员(例如急诊和创伤手术)可能会因为缺乏实践经验的机会而最终会分开。
A January 2024 Medical Corps Retention and Burnout Study cited in the report, which included a survey of emergency medicine doctors, found concerns over skill degradation listed as the most common reason for junior officers to leave the service.
该报告中引用的一项2024年1月的医疗团保留和倦怠研究,其中包括对急诊医学医生的调查,发现对列出的技能退化的担忧是初级官员离开服务的最常见原因。
“My biggest reason for wanting to get out is simply because I desire to do emergency medicine,” one medical service member said on the survey.
一位医疗服务成员在调查中说:“我想离开的最大原因是仅仅是因为我想吃急诊医学。”
The IG said that these issues exacerbate existing medical personnel shortages.
IG说,这些问题加剧了现有的医务人员短缺。
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An April 2024 Defense Department report to Congress looked at Walter Reed National Military Medical Center in Bethesda, Maryland, one of the military’s largest hospitals, and found that it was operating with only 68% of its authorized spots for nurses.
2024年4月的国防部报告向国会报告了马里兰州贝塞斯达的沃尔特·里德国家军事医疗中心,这是军事最大的医院之一,发现它仅在其授权的护士授权地点工作。
A September 2024 RAND Corporation report found that the Army’s recruitment of doctors has not been able to keep up with the rate of separations, which in turn led to unfilled positions at hospitals and other units and “compromising” the medical corps’ mission in deployed settings.
2024年9月的一份兰德公司报告发现,陆军招募医生无法跟上分离率,这反过来又导致了医院和其他部门的毫无疑问,并“妥协”了医疗团在部署的设置中的任务。
Personnel tell IG they want more hands-on experience
人员告诉他们是否想要更多的动手体验
Wartime readiness is not a new issue for military medical personnel.
对于军事医务人员来说,战时准备并不是新问题。
The IG cited prior studies referring to a “peacetime effect,” noting that for those who are stateside, it’s harder to maintain the kinds of skills they’d most likely rely on in a combat zone. A 2023 Institute for Defense Analyses report stated that Iraq and Afghanistan revealed significant medical readiness challenges because of their primary training at military hospitals.
IG引用了先前的研究,指的是“和平时期效应”,并指出对于那些国家的人来说,很难保持他们最有可能在战斗区依赖的技能。2023年的一份国防分析研究所的报告指出,伊拉克和阿富汗在军事医院进行了主要培训,揭示了严重的医疗准备挑战。
“This results in an unready medical force at the onset of another war,” the IG said.
IG说:“这在另一场战争开始时导致了一支尚未准备就绪的医疗部队。”
The IG interviewed 35 medical personnel across three services. In interviews with those assigned to military hospitals, the officers told the IG in interviews that they couldn’t complete enough trauma and emergency medical procedures “to maintain the skills necessary to provide care in an operational setting.”
IG在三个服务中采访了35名医务人员。在接受分配给军事医院的人的采访中,官员在采访中告诉IG,他们无法完成足够的创伤和紧急医疗程序,“以维持在运营环境中提供护理所需的技能。”
One critical care doctor assigned to the largest treatment facility — the report didn’t specify which hospital — told the IG that they had only performed 10 procedures independently since 2018. In comparison, they did 950 procedures as an off-duty volunteer at a civilian hospital and during a nine-month deployment, according to the report. Although the doctor did supervise medical residents and fellows at the military hospital, they told the IG that they needed to personally complete medical procedures rather than observe them “to feel ready to care for service members in a deployed environment.”
一位分配给最大治疗机构的重症监护医生(该报告未指定哪个医院)告诉IG,自2018年以来,他们仅独立执行了10次手术。相比之下,他们在一家民用医院和9个月部署期间作为下班志愿者进行了950次程序。尽管医生确实监督了军事医院的医疗居民和研究员,但他们告诉IG,他们需要亲自完成医疗程序,而不是观察他们“准备好在部署的环境中照顾服务成员”。
Naval hospital personnel conduct a code trauma drill on a simulated patient during a mass casualty drill. Navy photo by Daniel Taylor.
在大规模伤亡训练中,海军医院的人员对模拟患者进行代码创伤训练。丹尼尔·泰勒(Daniel Taylor)的海军照片。
Army officials said simulation and training devices supplement their training and “increase proficiency in specific skills.” In 2024, the Army began incorporating female-specific simulators and manikins to improve medic training and response to women’s injuries in battle.
陆军官员说,模拟和培训设备补充了他们的培训,并“提高了特定技能的熟练程度”。2024年,军队开始合并女性特异性的模拟器和Manikins,以改善医疗培训和对战斗中妇女受伤的反应。
Medical personnel interviewed by the IG recommended that the services offer more training with civilian hospitals. The Institute for Defense Analyses recommended that the military branches expand those civilian opportunities, but the IG found that “only a small percentage” of personnel were permanently assigned to civilian hospitals.
IG接受采访的医务人员建议这些服务为民用医院提供更多培训。国防分析研究所建议军事分支机构扩大这些平民机会,但IG发现,“只有一小部分”人员被永久分配到平民医院。
In 2016, Vice Adm. Forrest Faison, the Navy surgeon general at the time, established partnerships with hospitals in Chicago and Los Angeles. The service also allows Navy medical personnel to train at civilian hospitals for certain specialties like surgery.
2016年,当时的海军外科医生副总理福雷斯特·菲森(Forrest Faison)与芝加哥和洛杉矶的医院建立了伙伴关系。该服务还允许海军医务人员在民用医院培训某些专业,例如手术。
In 2019, the Army announced a program for 10 doctors and nurses to do a two-to-three year stints at civilian hospitals in New Jersey and Oregon. The program was new for the service at the time and directed by Congress in the fiscal year 2017 defense bill. It has since expanded to medical centers in Washington, Illinois, and Tennessee.
2019年,陆军宣布了一项计划,旨在为10名医生和护士在新泽西州和俄勒冈州的民用医院工作两到三年。该计划当时是新的服务,并由国会在2017财政年度的国防法案中指导。此后,它已扩展到华盛顿,伊利诺伊州和田纳西州的医疗中心。
The Army has also partnered with civilian trauma centers for training enlisted soldiers like combat medics, operating room technicians and practical nurse specialists.
陆军还与平民创伤中心合作,培训诸如战斗医务人员,手术室技术人员和实践护士专家等入伍士兵。
Earlier this month, the Navy announced a new partnership with the Morongo Basin Ambulance Association in Joshua Tree, California, for its corpsmen to take part in emergency call ride-alongs with civilian paramedics for “hands-on ambulance training.”
本月初,海军宣布与加利福尼亚约书亚树的莫林戈盆地救护车协会建立新的合作伙伴关系,以便其军官与平民护理人员一起参加紧急电话,以“动手救护车培训”。
The IG also found that Army and Navy policies did not emphasize the importance of civilian partnerships, while the Air Force is requiring 80% of positions at its military-civilian programs be filled as part of a 2023 staffing plan.
IG还发现,陆军和海军政策并未强调平民伙伴关系的重要性,而空军则需要在其军事 - 西维利亚计划中占据80%的职位,这是2023年人员配备计划的一部分。
However, the IG also found that when the departments did pursue civilian partnerships, the Defense Health Agency didn’t track performance, which could influence where and when the branches assign their personnel.
但是,IG还发现,当部门确实建立了平民伙伴关系时,国防卫生机构没有跟踪绩效,这可能会影响分支机构分配其人员的何时何地。
The GAO had similar findings in 2021 and recommended that DHA develop an inventory of civilian partnerships. Defense officials told the GAO that it was coming up with a process to identify civilian training opportunities by the end of 2025.
GAO在2021年也有类似的发现,并建议DHA建立平民伙伴关系的清单。国防官员告诉GAO,它正在提出一个程序,以在2025年底之前确定平民培训机会。
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