Integrating Military Service into an Academic Surgical Career

"I don't know of a single institution that would empower every individual faculty to really go for their goal, no matter how far off and bright it is, with the support that has been installed by this promise." Dawn Coleman, MD, Handleman Research Professor of Vascular Surgery, Associate Professor of Vascular Surgery and Pediatrics & Communicable Diseases

I confess, my pathway to academic surgery at the University of Michigan has been non-traditional. It started with my early enthusiastic steps toward a career in ‘Disaster Medicine’. Born of a family with a strong history of military service, and drawn to the University of Michigan by a very academic Emergency Medicine Residency, I commissioned with the US Army Reserve as a Captain in 2003. It was a decision that I made independently, and quietly, without the consultation of family, friends or mentors. It was a decision I thought might complicate my future relationships and academic potential. It was a decision that I made, however, without hesitation or regret as I felt a compelling need to serve our Country selflessly and to be a part of something much bigger than any one individual.

Over the course of my clinical education, I transitioned into surgical training that culminated with Vascular Surgery fellowship and an academic surgical career that looks very different from my earlier plans. I now manage a busy vascular surgery practice that includes the surgical care of children with renovascular hypertension, hold an educational leadership commitment as a program director to integrated vascular surgery residents and fellows, and prioritize exciting translational research efforts with a collaborative team. My military service, while not central to my current academic mission, will continue to define me and remains a meaningful and critical component of my personal mission.

What does Active Reserve service mean?

As a Lieutenant Colonel in the Active Reserve Component of the US Army Reserve, I am attached to a Forward Surgical Team. I spend one weekend a month training with my team. These weekend efforts involve common warrior tasks, physical fitness/training, administrative efforts, and medical training that encompasses primarily damage control resuscitation and existing Army clinical practice guidelines. Two weeks each year there is a period of active duty training (typically off-site and medically-oriented). Every 18-24 months I can be (and have been) mobilized with a medical/surgical team based on the needs of the US Army. My 120-day orders reflect 90 days in country (‘boots on the ground’) with the additional time accounted for at a US Army base for pre- and post-deployment efforts. Since entering the Active Reserve Component of the US Army Reserve in 2012, following the completion of my fellowship, I have had attended Officer Basic Course, had two children and deployed twice.

My first tour was with a forward surgical team to an austere base in central Iraq; our mission was to advise and assist the Host Nation. Our surgical team cared for a large number of Iraqi casualties providing primarily damage control resuscitation and damage control surgery. Essentially – we stabilized critically-wounded war fighters to facilitate their successful transport to a higher level of (local) care. My most recent mobilization orders came when my daughter was 8 days old. Eight months later, I deployed to support a Combat Support Hospital in Kuwait, caring for US soldiers with acute surgical and critical care needs while also helping with collaborative training and educational missions.

How do I balance the demands of Active Reserve Military service with my academic civilian job?

This is not an easy task, and balance is truly never the goal. Rather, I attempt "sustainment" and this takes a village. My service is only made possible by my partners, leadership, and friends from the University of Michigan’s Department of Surgery that support me – they cover my call, my patients, my local leadership responsibilities, alongside educational and programmatic efforts. There is no question that my academic progress stalls however with each deployment. I am certain that deployment has compromised previous funding applications and leadership opportunities; I have missed speaking opportunities at national meetings; I have had co-authors present data on my behalf and missed the fun of supporting students/residents presenting our data. Certainly, while I attempt to maintain forward momentum with scholarly efforts, there are simply limitations to the amount of work, and the kind of work, that can be done remotely (especially with limited WiFi). What deployment makes up for in this regard however is time. I am gifted the time for honest self-reflection, critical thinking and strategy. I plan, I read, I write and I make big plans while I rely on the collective power of great teams – my collaborative research team, Societal teams (committees) with shared leadership, and my Michigan team.

Why do I continue to serve?

The Army challenges me with clinical scenarios and conflict that I would not otherwise navigate. I have cared for mass casualties, catastrophic injuries, and deep human suffering with limited resources and support. I have witnessed extreme hatred, terrible violence, cruelty and fear. I have been stained with the blood of bravery, without available running water to wash. I have been afraid, tired, hungry, dirty, and uncomfortable. I have wept with tremendous grief. I have also witnessed profound strength, camaraderie, selfless sacrifice, and courage that transcends rank, language and societal custom. I have witnessed true resilience, raw human kindness, overwhelming compassion and love. I am forever indebted to the men and women I have had the true honor to serve alongside, care for, and learn from along this journey of service.

I continue to serve because I am certain this experience makes me a better surgeon, a better leader, a better friend, a better wife, a better mother and a better human. There is no question, however, that this service is a true ‘distraction’ to my own personal academic surgical mission. And while it likely compromises my "impact factor", this service is part of the legacy I wish to leave to those that I love most. My ‘little humans’, my children, will learn strength, and kindness, and confidence, and bravery. This is what we all need. A dear friend and mentor to me, Jon Eliason, recently gave a powerful presidential address to the Vascular and Endovascular Surgical Society, a society committed to the young, academic vascular surgeon. I will close with his fitting reminder from Mother Teresa: "If we have no peace, it’s because we have forgotten we belong to each other".

Article by Dawn Coleman, MD (Twitter: @ColemanDM_vasc)