To the Editor:—
The main message and demonstration of the excellent article by Martin et al. 1is that World War II created the need for, and the rapid production of, anesthesiologists. From my perspective, as someone who became an anesthesiologist because of the Vietnam War, the same is true of the Vietnam War both in concept and in the process details that were so well described by Martin et al. At the height of the Vietnam War in 1968–1969, there were great numbers of soldiers with multiple fragment wounds due to rocket-propelled grenades, and there was a need for medical doctors to staff the anesthesia and orthopedic departments of forward-placed MASH units. The US Army offered graduating interns, who for one reason or another were not going straight into a residency (called a Berry deferment), a 2-yr on-the-job training (OJT) assignment in anesthesiology or orthopedics rather than just routinely becoming a general medical officer. The anesthesiology OJT tour of duty started out with being assigned to a stateside Army hospital and being taught/trained by a board-eligible or -certified anesthesiologist for approximately 3 months (a short, intense 90-day course in anesthesiology). At this juncture, many/most OJTs were assigned to positions in forward-placed MASH units in Vietnam for 1 yr, and these OJTs practiced almost exclusively emergency/trauma anesthesia. The remainder of the 2-yr obligation (6 months) was fulfilled by practicing anesthesia once again in a stateside Army hospital. It is my impression that many/most of the medical doctors who went through the OJT experience in anesthesiology in 1968–1969 then went on to take formal residencies in anesthesiology, and presumably many became board-certified anesthesiologists. Therefore, with respect to the anesthesiology “Short Course,” the teachers of the course, and the eventful professional outcome (board eligibility/certification) for the doctors who went through the program, I think the Vietnam War OJT anesthesia program was quite similar to the World War II anesthesia program.
UCSD Medical Center, San Diego, California. firstname.lastname@example.org