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Traditionally, the United States has downsized its armed forces after periods of military success. These periods are generally accompanied by times of reduced defense budgets and military spending. Along with the Army, the Medical Department has experienced a significant reduction in its force structure over the last ten years. The assumption that future battlefields will be more survivable due to the Army's technological superiority has driven a reduction of the division casualty rates that are used to establish the force structure of the future. This assumption is not consistent with historical data. Using the employment of the 4th Armored Division during the reduction of Nancy, France, in September 1944 as a historical example, it is clear that casualties are not incurred at a standard rate over time and space. Based on this example and the similarities between the World War II era 4th Armored Division and the Force XXI division, has the reduction in medical force structure negatively affected the ability to provide far forward surgical care?
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