Not a topic most of us like to talk about, but I think this is a bitter pill we’re going to need to swallow if we want to get better at what we do. Because let’s face it… we’re not really as good as we think are. Unless you’re a medic that’s frequently operating in deployed settings, you probably fall short in these 3 key areas:
1. Actual trauma care experience
The initial training for medics is second to none. In fact, I’m not sure you can find better point-of-injury trauma training anywhere else in the civilian sector. But that training isn’t immediately justified by the operation tempo that you’re likely to encounter, especially if you’re a NG/Reserve medic. Many of the medics that I’ve met have gone their whole career without ever having to deal with a single real-life trauma patient. There’s just not enough real trauma patients in the military setting nowadays for every medic to have one.
2. Clinical medicine
Trauma knowledge? Check. Clinical knowledge….not so much. Most medics fresh out of school wouldn’t even know where to begin with treating things like cellulitis, strep throat, or acute abdominal pain. Clinical medicine just isn’t emphasized in AIT, which is a shame because these are the patients that medics are more likely to encounter in the average military setting. Some solid PAs are often willing to personally train their medics in garrison care to offset this knowledge gap. However, I’ve found that much of this training tends to be hip-pocket, sporadic, and frequently irrelevant or outside of the scope of a field medic.
I hate to say it, but we SUCK at drugs. Most of the medics I’ve worked with seem to know just enough about pharmacology to name a handful of TCCC drugs (Fentanyl, Meloxicam, Moxifloxacin), but that’s about it. I often get blank stares when I start talking about the finer details of TXA or Ketamine. I think what kills me the most though is that many medics don’t seem to understand when or how to use basic over-the-counter medications like loperamide, clotrimazole, ranitidine, or omeprazole. Of course, I don’t really blame them though. For whatever reason, learning basic pharmacology doesn’t seem to be a priority in our pipeline training.
Where do you think we fall short?