Barriers to Academic Surgery in the US Armed Forces: A Study of the AAS Military Committee

Introduction: The purpose of this study is to explore current perceptions within the military surgery community to stratify key obstacles to pursuing a career in academic surgery and identify opportunities for mitigation.Methods: After receiving institutional review board approval, an anonymous electronic survey was distributed to military surgeons across all branches. Survey response data were collected and analyzed using chi-square test.Results: The response rate was approximately 22%. Of those who responded to the survey, most are interested in an academic career (61.5%); however, 64% believe this to be much more difficult as a military surgeon than as a civilian surgeon. The top three perceived obstacles include administrative obstacles (76.4%), operational commitments (65.8%), and lack of funding for academic pursuits (62.7%). Most respondents indicated that they have never received formal education regarding how to apply for research funding (84.5%) and most do not have a research mentor (60.9%). Additionally, 42.9% state that obstacles to an academic career in surgery impact their decision to leave the military. Younger surgeons were more likely to leave the military upon completion of their service commitment (67.9% versus 46.4% aged 20-39 y, P = 0.02).Conclusions: We characterized the perceived challenges to academic surgery within the military. These barriers between academic surgery and military service risk medical force attrition, particularly in future generations of surgeons. Dedicated faculty billets (positions) with limited operational demands as well as associated mentorship and research funding may enhance the retention and productivity of military surgeons.