Page 104 - JSOM Spring 2026

The 3rd ISTC Medical Symposium
(Pfullendorf 2025)

From Lessons Observed to Capabilities Delivered

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Oronzo Chiala’, PhD, MSN *; Jennifer Pregler, MD ; Anargyros Parathyras, RN ;
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Stijn Spruytte, RN ; Julian Goehring, ISTC-NSOCM ; Jace Kennemer, US-SOCM ;
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Mike R. Hetzler, NRP ; Mike Turconi, ACP, BSc ; Juan R. Grado, DMS, MPAS, PA-C ;
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Stacy A. Shackelford, MD ; Michael A. Broussard, DMS, PA-C 11

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Introduction Training Architecture as Capability
Training Architecture as Capability MAJ Michael A. Broussard opened the symposium by framing
The 3rd International Special Training Center (ISTC) Medical ISTC’s Medical Branch as a capability engine rather than a
Symposium, held in Pfullendorf, Germany, from 4–6 Novem- course factory. His update underscored how the NATO Special
ber 2025, was designed as an engaging, interactive forum that Operations Combat Medic (NSOCM) program is evolving
moved well beyond the format of a conventional lecture-style into a multinational quality benchmark: 25 weeks, multiple
conference. It was intentionally engineered as an operation- training sites across a four-country footprint, and an increas-
ally informed forum: international, multidisciplinary, and ingly deliberate blend of core clinical medicine, TCCC, critical
explicitly focused on translating what we are learning (and re- care, Chemical Biological Radiation Nuclear (CBRN) medi-
learning) into practice for austere, high-consequence environ- cine, canine (K9) medicine, clinical rotations, and culminating
ments. The audience reflected that mission: Special Operations field training.
Combat Medics (SOCMs) alongside surgeons, anesthetists,
nurses, technical subject matter experts, and industry partners. The introduction of the newly developed Advanced Medical
Roughly 100 participants from 13 nations participated in this Skills Course (AMSC) signaled a strategic push to tighten the
event. Such an assembly rarely exists in the same room in a seam between prehospital care and surgical capability, espe-
setting protected enough to speak candidly about challenges cially in Role 1– and Special Operations surgical team (SOST)–
in real-world operational medicine. adjacent contexts, through a structured 2-week pathway com-
bining didactics, high-fidelity simulation, cadaver procedural
A defining feature was the deliberate safe space principle. In training, and live tissue surgical skills training. The implied
Special Operations medicine, this is not a feel-good slogan; it message was clear: integration does not happen by adjacency,
is a performance enabler. When medics with only weeks or and “working together” is not the same as being interopera-
months of experience can ask basic questions without social ble under stress. AMSC is best viewed as a purposeful bridge
penalty, and senior clinicians can openly revisit assumptions that needs validation, iteration, and, critically, alignment with
without reputational risk, the group becomes faster at identi- national legal frameworks and staffing realities if it is to scale
fying friction points and more honest about gaps. That archi- beyond a motivated minority. MAJ Broussard closed by outlin-
tecture, paired with the selection of particularly timely topics ing the Medical Branch’s work in international standardization
and continuing education credit availability, created a rhythm through the Committee for NSOCM Sites (CNS), focusing on
closer to that of an operational after action review (AAR) than quality assurance (e.g., curriculum evaluation, instructor qual-
a traditional scientific meeting, while still respecting profes- ification, and site compliance) to enable transparent endorse-
sional rigor. ment processes and reliable graduate trust across nations.

*Correspondence to chiala@istc-sof.org
1 CPT Oronzo Chiala´ is a member of Italian Army, affiliated with International Special Training Center, Pfullendorf, Germany. LCL Jennifer
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Pregler is a member of the German Army, affiliated with International Special Training Center, Pfullendorf, Germany. CPT Anargyros Parathyras is
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a member of the Hellenic Army, affiliated with International Special Training Center, Pfullendorf, Germany. OR-9 Stijn Spruytte is a member of the
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Belgian Special Forces Group, affiliated with the International Special Training Centre, Pfullendorf, Germany. OR-8 Julian Goehring is a German
SOF medic, affiliated with International Special Training Center, Pfullendorf, Germany. SSG Jace Kennemer is a U.S. SOF medic, affiliated with
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International Special Training Center, Pfullendorf, Germany. Mike R. Hetzler is the co-chair of the SOMA Medical Support to Irregular Warfare
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Committee and a contributing Lecturer at the University College Cork, Cork, Ireland. Mike Turconi is a former ITASOF NSOCM, current Crit-
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ical Care Flight Paramedic and adjunct Lecturer at University College Cork. MAJ Juan R. Grado is a member of the U.S. Army, and the director
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of Special Operations Medical Training at the International Special Training Center, Pfullendorf, Germany. COL (Ret) Stacy A. Shackelford is a
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professor of surgery affiliated with the Uniformed Services University of Health Sciences, Bethesda, MD. MAJ Michael A. Broussard is a member
of the U.S. Army, affiliated with International Special Training Center, Pfullendorf, Germany, and the University College of Cork, Cork, Ireland.
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