Adapting Military Resilience to Modern Surgery by SOSC: An of Surgery | July 2026
Introduction:
Surgery is an inherently high-stress profession, where complications, patient deaths, and difficult decisions can lead to burnout, moral injury, and mental health disorders. Inspired by the US Marine Corps' Combat and Operational Stress Control (COSC) program, this Perspective introduces Surgical Operational Stress Control (SOSC)—a structured framework designed to enhance surgeon resilience and sustain long-term performance.
Key Takeaways:
- Surgeons experience moral injury, burnout, and psychological stress similar to military personnel operating in high-pressure environments.
- SOSC adapts the military's proven five-step resilience model: Strengthen, Mitigate, Identify, Treat, and Reintegrate.
- The framework emphasizes early recognition of stress, encouraging intervention before temporary distress progresses to chronic burnout or mental illness.
- Peer support, mentorship, shared decision-making, and open conversations about stress are central to building a resilient surgical culture.
- SOSC promotes structured reintegration after major complications or emotional distress, reducing stigma and facilitating a safe return to clinical practice.
- The model encourages hospitals and surgical training programs to move beyond wellness initiatives toward proactive, system-based resilience programs.
- Incorporating SOSC into surgical education may improve surgeon well-being, reduce medical errors, strengthen teamwork, and enhance patient care.
Clinical Impact:
Surgeon well-being directly influences clinical performance and patient safety. By adapting battle-tested military principles, SOSC provides a practical framework to recognize stress early, support recovery, and foster a healthier surgical workforce. It shifts the focus from treating burnout to preventing it through structured organizational support.
Bottom Line:
Resilient surgeons deliver safer care. The proposed Surgical Operational Stress Control (SOSC) model offers a practical roadmap to identify, manage, and recover from occupational stress, ensuring surgeons remain healthy, effective, and "in the fight" throughout their careers.
