Page 69 - Journal of Special Operations Medicine - Winter 2014

Special Forces Medical Sergeants’ Perceptions and Beliefs
Regarding Their Current Medical Sustainment Program:

Implications for the Field

Ramey L. Wilson, MD, FACP; Kent J. DeZee, MD, MPH, FACP

ABSTRACT
Background: Special Forces Medical Sergeants (SFMS) operations and diplomatic missions throughout the
are trained to provide trauma and medical care in sup- world with indirect physician oversight. While trained
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port of military operations and diplomatic missions to a high level of competency in medical, surgical, vet-
throughout the world with indirect physician oversight. erinary, dental, and preventive medicine knowledge
This study assessed their perceptions of the current and skills, the system designed to sustain their level of
program designed to sustain their medical skills. Meth- competency has not changed significantly over the past
ods: An Internet-based survey was developed using the decade. With a shift in focus from supporting major
constructs of the Theory of Reasoned Action/Planned combat operations back to traditional special warfare
Behavior and validated through survey best practices. operations, the ability of SFMS to provide medical care
Results: Of the 334 respondents, 92.8% had deployed in remote or austere locations mitigates the inherent
at least once as an SFMS. Respondents reported spend- risks of using small units to accomplish national objec-
ing 4 hours per week sustaining their medical skills and tives. If a member of the Special Forces team is injured
were highly confident that they could perform their du- while operating in locations far from conventional med-
ties on a no-notice deployment. On a 5-point, Likert- ical support, the medics provide the team with an intrin-
type response scale, SFMS felt that only slight change sic medical capability.
is needed to the Special Operations Medical Skills Sus-
tainment Course (mean: 2.17; standard deviation [SD]: More recently, however, many of the Special Forces
1.05), while moderate change is needed to the Medical teams deployed in Iraq and Afghanistan conducted
Proficiency Training (mean: 2.82; SD: 1.21) and non- their operations under an umbrella of care provided by
trauma modules (mean: 3.02; SD: 1.22). Respondents conventional military health services, which may have
desire a medical sustainment program that is provided removed opportunities to sustain medical skills beyond
by subject matter experts, involves actual patient care, initial trauma management. As conventional forces con-
incorporates new technology, uses hands-on simulation, tinue to downsize over the next year in Afghanistan, for
and is always available. Conclusions: SFMS are chal- example, the areas with a quick response aerial mede-
lenged to sustain their medical skills in the current op- vac provided by general purpose forces will be reduced.
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erational environment, and barriers to medical training However, the demand for Special Forces units to operate
should be minimized to facilitate sustainment training. as trainers and advisors in places like Afghanistan and
Changes to the current medical sustainment program other areas of instability will continue. 3
should incorporate operator-level perspectives to en-
sure acceptability and utility but must be balanced with In addition to providing medical care to US soldiers,
organizational realities. Improving the medical sustain- SFMS also advise and train host-nation forces on medi-
ment program will prepare SFMS for the challenges of cal and prehospital care as part of international part-
future missions. nerships or Security Force Assistance/Foreign Internal
Defense operations. To be effective medical instructors
Keywords: Special Forces Medical Sergeants, medical sus- and advisors, medics must sustain and improve the
tainment program, medical training quality of their medical skills and knowledge through
continuing medical education, training, and practice. In
addition, as the only combatant medical practitioners
on the battlefield, SFMS must also maintain their com-
Introduction
bat, tactical, cultural, and language skills to be effective.
Special Forces Medical Sergeants (SFMS) are trained to Despite mandatory programs to direct and resource
provide trauma and medical care in support of military medical sustainment training, the demands on SFMS’

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