Objectives Accounts of numerous military campaigns throughout history have shown that casualties from medical illness usually greatly outnumber combat injuries. We aimed to see whether this remained the case in a modern campaign where predominantly surgical facilities were deployed.

Methods We examined 1511 hospital records of inpatients in the Oman theatre during the last three months of Exercise Saif Sareea II and the initial period of Operation Veritas.

Results Of the 1399 records included, 1033 (74%) required care from a physician, whereas 366 (26%) were treated by surgeons. However, of patients returning to duty in theatre (total 985), 884 (90%) had been treated by physicians and 101 had been treated by surgeons. Notably, only 23 (2%) of these had undergone a surgical procedure.

Conclusions Experience in Oman suggests that the lessons of history in respect of casualties in times of conflict are both unlearned and being repeated. The role of the medical specialities in military secondary care should be recognised and deployed facilities should not be defined by surgical capability alone.