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The views expressed in this article are our own and do not represent the official policy or position of the United States Air Force or the Department of Defense. As a medical student participating in the Health Professions Scholarship Program, I am sharing my personal observations for the benefit of other medical students considering a career in military medicine.
The United States Air Force Medical Corps has many anesthesiologists serving to care for military personnel and their families. I am personally involved in the Health Professions Scholarship Program (HPSP) through the United States Air Force (USAF), where I will later serve in the Medical Corps. One of the opportunities available to all medical students accepted into anesthesiology is to later join operational medical teams—an aspect of military anesthesia that few may be aware of. These teams require additional training in combat and critical care, making them appealing to individuals with prior experience in high-stakes environments. My co-author, Andrew Woods, spent 18 months training for Navy SEAL selection before medical school, bringing a unique perspective to this challenging field. In this article, we outline three operational teams that anesthesiologists can apply for: Ground Surgical Teams (GSTs), Critical Care Air Transport Teams (CCATTs), and Special Operations Surgical Teams (SOSTs). These teams operate in high-acuity situations, requiring exceptional skill and poise, embodying the well-known adage often used in anesthesia training: "slow is smooth, smooth is fast."
The USAF’s GSTs are mobile surgical units assigned to provide damage control surgery, resuscitation, and emergency care for critically injured patients in extreme environments, with the primary goal of preparing them for casualty evacuation1. Each GST typically consists of six team members: an emergency medicine physician, critical care nurse, general surgeon, surgical service craftsman, anesthesiologist or CRNA, and health services administrator2. These teams receive specialized training focused on field exercises, logistical readiness, and weapons training. Unlike traditional battlefield medical units, GSTs are capable of performing surgery near or in the combat zone, allowing them to stabilize and prepare patients for evacuation more quickly. They can conduct up to 10 surgical procedures and provide critical care for up to 12 hours1. Medical students who desire to operate near the front lines in high-stakes medical scenarios may find GSTs to be a suitable career path!
The USAF’s CCATTs were formed in 1994 with the singular goal of transporting injured warfighters to higher levels of medical care quickly and efficiently3. CCAT teams consist of three medical professionals: a respiratory therapist, a critical care nurse, and a physician (eligible medical specialties include: anesthesiology, trauma/critical-care, surgery, emergency medicine pulmonology/critical-care, and cardiology4. It is essentially an intensive care unit (ICU) in the back of an aircraft (or any vehicle of opportunity (fixed-winged, rotary-wing, wheeled vehicle, boats, etc.)! Prior to implementation of the CCATTs, it could take up to three weeks for an injured soldier to be transported to a capable hospital in the United States, but the men and women in CCATT have shortened that period to less than three days on average. These teams undergo intense training in trauma and readiness skills, as well as critical care adaptability exercises. As of 2018, the training courses are streamlined to enable CCATT candidates to focus on practicing in-flight skills. The training prepares candidates for the challenges of limited space, materials, and unpredictable environmental conditions. CCATT is ideal for those with a strong interest in critical care in extreme environments!
The USAF SOSTs are elite six-member units deployed directly to conflict zones to provide emergency medical care. Their motto, "QUIS ILLOS BELLATORES CUSTODIET," translates to “Those Who Care for the Warriors”5. The team members have diverse expertise, including emergency medicine, general surgery, anesthesia, critical care nursing, surgical technology, and respiratory therapy. SOSTs typically deploy in support of special operations when high casualties are expected or when medical care is limited6. As such, they undergo rigorous training in survival skills, combat, trauma resuscitation, and on-site surgical capabilities. Members must apply and complete 10 to 12 months of specialized training before being ready for deployment. This training is comprehensive, covering operational medical techniques, SERE school (Survival, Evasion, Resistance, and Escape), and several months of special forces specific training to ensure seamless integration with special operators. SOST may appeal to applicants who are highly motivated to deploy into direct conflict zones and work alongside special operations forces!
In summary, there are numerous career pathways for an anesthesiologist to pursue in the USAF (e.g. Active Duty, Reserve, or Air National Guard). Whether stabilizing critical patients during air transportation with CCATT, providing life-saving care on the ground with GSTs, or working alongside special forces with SOSTs, each offers a unique opportunity to aid wounded warfighters. CCATT and GST are typically considered to be additional duties to practicing anesthesiology, CCATT carries a call responsibility while GST does not. For an anesthesiologist in SOST, the team is their primary responsibility. For any student interested in applying their anesthesia training to serve their country while developing combat and critical care skills in challenging environments, these teams offer an impactful career path!
Date of last update: October 9, 2024
