Page 14 - JSOM Winter 2025

FIGURE 1 Division Medical Operations Center (DMOC) diagram.

Adapted from Headquarters, Department of the Army. Division Medical Operations Center: Tactics, Techniques, and Procedures. Field Manual
(FM) 8-10.3. Department of the Army; November 12, 1996.
NOTE: This figure depicts the staffing for a heavy division as authorized by the base TOE, The Light Infantry, Airborne, and Air Assault Divisions
are subject to change. The latest base and modified TOEs should be checked for current staffing authorization.
*May be carried in the DISCOM Command Section or may be shown under the DMOC.
† Dual-Hatted as the MSMC Commander.
‡ Not Authorized when single-channel ground and airborne radio system (SINGARS) are fielded.
DISCOM = Division Support Command; DMMC = Division Materiel Management Center; DMOC = Division Medical Operations Center;
MED OPS BR = Medical Operations Branch; DISCOM SURG = DISCOM Surgeon; OPS OFF = Operations Officer; EVAC = Evacuation; OPS
SGT = Operations Sergeant; MED MAT MGT BR = Medical Maintenance Management Branch; HLTH SVC MAT OFF = Health Service Main-
tenance Officer; MED SUP SGT = Medical Supply Sergeant; PNT DISP = Patient Disposition; RPTS BR = Reports Branch; PNT ADMIN NCO =
Patient Administration Non- Commissioned Officer; PNT ADMIN SP = Patient Administration Specialist; MEDICAL COMM BR = Medical Com-
munications Branch; SR RADIO OP/MAINT = Senior Radio Operator/Maintainer; RADIO OP/MAINT = Radio Operator/Maintainer; HQ =
Headquarters; SEC = Section.

significantly different from those authorized in the current di- control CASEVAC operations, ensuring that resources are al-
vision surgeon cell. The Army’s growth constraints will impact located appropriately. Summarily, the Army needs to identify
ability to create a force structure to achieve the same capability the correct proponent to advocate for initiatives that support
and capacity of a DISCOM medical evacuation battalion and CASEVAC doctrine and training, procurement of equipment
DMOC. But force design updates that formalize and authorize and vehicles, and changes to force structure to ensure effective
patient evacuation coordination cells (PECC) in divisions and execution at all echelons. Beyond the authors’ analysis above,
corps may provide the evacuation coordination capability and the Army and Joint Forces should look ahead to three unique
capacity. The PECC provides clinical and operational expertise concepts and three recommendations to set conditions for
capable of clinical validation and regulating patient movement CASEVAC in the future.
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across ground and air. Despite the use of PECCs over the
last 10 years within Army exercises (and its historical use in OPPORTUNITIES: Three Concepts and
combat), the PECC remains undefined in Army doctrine. Until Three Recommendations
structural changes improve the division’s and corps’ ability to
coordinate patient evacuation, the Army must rely on existing “If I had asked people what they wanted, they would have
doctrinal support relationships to achieve similar results. said faster horses.” — Henry Ford

Maximizing combat power and saving lives relies on effec- Three unique concepts that will set conditions for the future
tively managing CASEVAC and MEDEVAC resources during of CASEVAC are creating asymmetric outcomes, thinking
large-scale combat operations. Recent WFXs highlight the differently, and having a bias for action. These concepts are
need for CASEVAC to become the primary evacuation method gamechangers in themselves but are synergistic when applied
because of rising casualty rates and mortality. Supported by holistically. As is often said in the Army, the thing that got you
historical data from World War II, high volumes of casualties here after a significant promotion will not make you successful
demand a shift towards CASEVAC as the primary means of in positions of greater responsibility. Similarly, the paradigms
evacuation, especially in environments like Ukraine, where en- that allowed the United States to achieve stunningly high
emy actions and targeting of medical personnel and facilities recovery rates during the last two decades of conflict in the
complicate evacuation. A unified approach from the brigade Middle East may not enable the Army to employ a synergistic
to theater army levels is needed to properly plan, execute, and “whole of force” approach to clear casualties in the division

12 | JSOM Volume 25, Edition 4 / Winter 2025