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Abstract
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At a stroke, opening infantry roles to women has introduced a biological dimorphism among soldiers, with profound implications at every level, from metabolism and endocrinology, to fitness and strength, to psychology and ethnography.1 2 As women begin to pioneer these roles, medical officers and policymakers the world over might pause to question our traditional rites of passage into the military: why are soldiers trained to breaking point?
The personal view of Lt Col Fieldhouse and Dr O'Leary3 helpfully contrasts Israel Defense Forces (IDF) policy with the UK's recent full integration of women into ground close combat (WGCC) roles. This comparison is salutary for the many nations now introducing WGCC, which may have upheld the IDF as a 'gold standard' in this domain. Musculoskeletal injury rates were higher among women than men (even though women were employed in less elite roles); however, retention rates were high among IDF women, perhaps relating to motivation for combat roles.3 A rigorous scientific process has recently been used to develop physical employment standards (PES), but not to develop compressed physical training. Injuries caused by compressed training do not appear with the same high incidence in subsequent military careers.4 Training paradigms, typified by idioms like 'breaking down to build up', are common to many nations but have evolved without (as far as we are aware) any evidence of improved length of service or prevention of adverse outcomes for men, at whom they are directed. Such paradigms may be even less suited to women.
When the IDF created the Caracal Battalion with new combat roles for women in 2004, they immediately put women through standard male training and incurred a 30% stress fracture prevalence; with a little more military medical consultation, this was halved in the following year (personal communication). Several years later, rates remained tenfold higher for women than for men in the same training (21.0%, 95% CI 16.2% to 26.5% vs 2.3%, 95% CI 0.3% to 8.2%).5 In reality, IDF WGCC policy is more nuanced than the UK and many other nations (likely a reflection of Israel's unique geopolitical circumstances); however, the basic tenets of training are generalisable. Fieldhouse and O'Leary3 identified incongruity between physical and cognitive outcomes of IDF WGCC training, which highlights the disconnect between how training of the body and mind has historically been considered.
The highest priority in preparing today's recruits to become soldiers is not just to achieve physical robustness but to concurrently instil core values, ethics and self-management skills, bringing young men and women with a wide variety of educational and experiential backgrounds to a common level of expected behaviours and personal responsibility.6 The future warfighter is likely to rely more on cognitive than corporeal dominance...
Language: en |