From 2024 to 2027, the Ministry of Health and Welfare (MOHW) is implementing the National Resilient Healthcare Preparedness Program. As part of this initiative, the Taiwan Surgical Association, Taipei Medical University’s Resilience Project Management Center, and the Formosa Association for the Surgery of Trauma are collaborating on the "Surgeon Resilience Training Program." Chien-Sung Tsai, President of the Taiwan Surgical Association and Director General of the Medical Affairs Bureau, Ministry of National Defense, stated that the program aims to establish Backup Operating Room Teams (BORP) across Taiwan, which will be deployed by MOHW in the event of a national-level disaster.
Tsai explained that the program includes both in-person courses and technology-driven training through videos and virtual reality (VR). It aims to train 14,000 surgeons across Taiwan, equipping them with fundamental knowledge of emergency trauma care. In the future, BORP teams will be stationed at medical centers nationwide and can be mobilized by MOHW or Regional Emergency Medical Operation Centers (REMOC) in response to large-scale disasters or special incidents. For regional emergencies, local governments will have the authority to dispatch these teams.
Heng-Fu Lin, Chair of the Trauma Committee at the Taiwan Surgical Association, highlighted that surgeons are accustomed to performing procedures in highly sterile environments with advanced equipment. To prepare for emergency scenarios, the training requires surgeons to assemble an "Emergency Surgical Medical Kit." Considering the weight limitations medical personnel can carry, all essential equipment—including laparotomy kits and thoracotomy instruments—will be packed into a 29-inch suitcase and a cooler box.
Yueh-Ping Liu, Director General of the Department of Medical Affairs at MOHW, stated that the ministry has entrusted the Taiwan Surgical Association with training surgeons in emergency trauma care. Moving forward, MOHW will collaborate with other government agencies to define deployment protocols for BORP teams, including insurance coverage, transportation logistics, and safety measures. Additionally, they will explore incentives to encourage more surgeons to participate in emergency trauma response efforts.
Kuan-Ming Chiu, President of Far Eastern Memorial Hospital, noted that modern surgery has shifted toward greater precision and minimally invasive techniques, resulting in smaller incisions. As a consequence, younger surgeons have become less familiar with managing large traumatic wounds, making it difficult for them to respond effectively in major emergencies. This training program not only equips young surgeons with the necessary skills for worst-case scenarios but also rekindles their passion for surgical expertise that previous generations possessed but has since been lost.
Currently, Advanced Surgical Skills for Exposure in Trauma (ASSET) courses in Taiwan primarily use frozen cadavers for training. However, Tsai pointed out that cadaver resources are limited, and establishing dedicated training centers with the necessary freezing equipment would require an investment of at least several hundred million NT dollars. To enhance training capacity and frequency, the Medical Affairs Bureau has introduced the internationally recognized Definitive Surgical Trauma Care (DSTC) program, which utilizes animal models for training. However, such animal-based training must be conducted in internationally accredited laboratories that adhere to animal welfare regulations. Tsai hopes that Taiwan’s medical schools will support these efforts.
The Taiwan Surgical Association has also released training videos demonstrating battlefield trauma care, featuring surgeons wearing bulletproof vests and carrying rifles. The videos highlight explosion injuries as the primary type of battlefield trauma, emphasizing the critical importance of hemorrhage control. Another scenario depicts a major tunnel car accident, where surgeons collaborate with paramedics to administer intraosseous infusion to patients. According to Lin, each 15- to 20-minute simulated course is designed to help surgeons quickly grasp emergency response protocols for disaster situations.
Resource: 因應戰爭、大型災難 全台醫學中心將設備援手術室團隊
