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Jean E. Rinaldo, MD MPH and Gregory J Argyros, MD, LTC USA. Department of Medicine, Walter Reed Army Medical Center (WRAMC), 6900 Georgia Ave. N.W., Washington, DC 20307, 202-782-1773, Jean.Rinaldo@na.amedd.army.mil
INTRODUCTION:: After war, healthcare infrastructure is shattered and security is tenuous. Military forces must take on humanitarian activities (HA)including rapid public health assessment, urgent care, and primary care. These overlap in conflict zones, refugee/IDP sites, and contiguous resource constrained environments. Army physicians participate but no direct training for HA exists during internal medicine (IM) residency because no data has been available to support this need. METHODS: In a retrospective cohort study we queried all WRAMC US Army IM residency graduates (RG) (1998-2002),and WRAMC residents in training (RIT)in February 2003. We labeled RG not proceeding to subspecialties “deployable” (D.)"D" was surveyed to determine if they had: 1) been deployed; 2) participated in HA, and 3) worked with NGO-IGO’s. RIT were surveyed about attitudes toward HA training in residency. HA was defined as any care of local civilians. RESULTS: A total of 104 IM residents were studied: 69 RG and 35 RIT. Of the 69 RG, 27 were deemed "D"; 20/27 responded to the survey. Of respondents, 11/20 had been deployed and 10/20 had participated in HA: 3 in war/peacekeeping, 3 in Civil Affairs outreach clinics, 4 with NGO/IGO, and 5 in other primary care settings. In the separate questionnaire addressed to RIT, 71% of RIT expressed interest in HA training and 8/35 voluntarily stipulated a strong interest. DISCUSSION: This study is small but suggests that 50% of deployable Army internists engage in HA within 5 years. Army IM house-staff are positively motivated to learn HA skills. Military IM residency training should include international public health and should teach communication and coordination with the civil medical relief community.
Learning Objectives:
Keywords: War, Refugees
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.