Towards the True Acute Care Surgeons

: Acute Care Surgery‘Not' the Same Meaning as Abdominal Emergency Surgery

Abstract

‘Acute care surgery（ACS）’ has been widely recognized in Japan, though it is not precisely defined. The concept of ACS arose in trauma surgery, and includes ‘trauma’, ‘emergency surgery’ and ‘surgical critical care’. In the United States of America, an ACS fellowship training curriculum of 24 months has been established involving abdominal, thoracic, vascular, orthopedic, brain surgery, and so on. The ACS is, in other words, a new division which comprehensively attends to seriously injured or multiple traumatized patients, and patients in similar conditions suffering from some disease. Thus, it is of importance to train acute care surgeons with the intention of giving them broad surgical techniques. However, in Japan, not so much concern has been given to the development of individual acute care surgeons. Japan also needs proper acute care surgeons and suitable education programs. Experience in many kinds of surgery should be flexibly assigned to the trainee in a case-by-case setting not by departmentally-regulated vertical division. Furthermore, a longer period training curriculum is required in Japan. Abdominal surgery is essential in the ACS, and should provide not only basic surgical techniques but skills to manage severely traumatized patients.