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1. The participants were exceptionally motivated to learn, 6. Boutonnet M, Raynaud L, Pasquier P, et al. Critical care skill
having already experienced the disparity in level of train- triad for tactical evacuations. Air Med J. 2018;37(6):362–366.
ing versus scope of responsibility. This mismatch was high- 7. Hurd WW, Montminy RJ, De Lorenzo RA, et al. Physician roles
lighted the first day by numerous operational questions and in aeromedical evacuation: current practices in USAF operations.
Aviat Space Environ Med. 2006;77(6):631–638.
challenging examples presented to the MOs. 8. Andicochea CT, Wilson J, Raetz E, Walrath B. An assessment
2. The course was taught by a broad range of civilian and of flight surgeon confidence to perform en route care. Mil Med.
military experts who provided the most up-to-date infor- 2019;184(Suppl 1):306–309.
mation and prevented the didactic portions of the course 9. Campbell BH, Alderman SM. Planning for success: desired char-
from becoming stale or routine. 25–28 acteristics of special operations surgeons, a pilot study. J Spec
3. The course was designed in a “crawl-walk-run” fashion, be- Oper Med. 2012;12(3):8–13.
ginning with lectures and introductory material to develop 10. Lyons TJ, Connor SB. Increased flight surgeon role in military
aeromedical evacuation. Aviat Space Environ Med 1995;66(10):
a firm foundation, followed by individual low stress skills, 927–929.
and progressing to steadily increasing complexity and stress. 11. Kosequat J, Rush SC, Simonsen I, et al. Efficacy of the mnemonic
Less experienced clinicians were able to build mastery from device “MARCH PAWS” as a checklist for pararescuemen during
the ground up, and seasoned MOs could fill in the gaps in tactical field care and tactical evacuation. J Spec Oper Med.
their knowledge and replace outdated information. 2017;17(4):80–84.
4. Among the students, there was a mix of clinical and mili- 12. Hart D, Rush R, Rule G, et al. Training and assessing critical air-
way, breathing, and hemorrhage control procedures for trauma
tary experience (from new GMOs to board-certified phy- care: live tissue versus synthetic models. Acad Emerg Med. 2018;
sicians with experience from several deployments). This 25(2):148–167.
allowed mentoring and sharing of knowledge and tips be- 13. Kim M, Torrie I, Poisson R, et al. The value of live tissue training
tween students, which supplemented lessons from faculty. for combat casualty care: a survey of Canadian combat medics
5. The course culminated in an opportunity to demonstrate with battlefield experience in Afghanistan. Mil Med. 2017;182(9):
the new skills and acquired knowledge in a team-based, e1834–e1840.
simulated tactical environment. This encouraged students 14. Joint Trauma System. Clinical Practice Guidelines (CPGs). https:/
/jts.amedd.army.mil/index.cfm/PI_CPGs/cpgs. Accessed on 2 De-
to study, learn, and practice along the way, and created ac- cember 2020.
countability to fellow students. 15. Bloom BS. Automaticity: the hands and feet of genius. Educa-
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16. Coyle D. The Talent Code. New York City, NY: Bantam; 2009.
Conclusion 17. Ericcson KA. The influence of experience and deliberate practice
on the development of superior expert performance. In: Ericcson
This is the first formal operationally focused MO course that KA, Hoffman RR, Kozbelt A, Williams AM, eds. Cambridge
covers such a comprehensive range of relevant issues including Handbook of Expertise and Expert Performance. Cambridge,
operational medicine, Operator behavioral health, nonbattle England: Cambridge University Press; 2006:685–706.
injuries, and unique expeditionary issues, in addition to educa- 18. Knowles M. The Adult Learner: A Neglected Species. Houston,
tion and prehospital medical direction skills. While this course TX: Gulf Publishing; 1973.
has been useful to flight surgeons and PAs attached to PJ units, 19. Knowles, M. Andragogy in Action. San Francisco, CA: Jossey-
Bass; 1984.
there is a rationale for all SOFMOs, indeed any MO deploy- 20. US Army. Tactical Combat Medical Care (TCMC). https://www
ing to an operational theater, to receive similarly specialized .first.army.mil/DivEast/documents/pdf/Coursedescription09.pdf.
training. Development of this course has exposed significant Accessed 3 December 2020.
gaps in the unified training of our SOFMOs and will hopefully 21. Faudree K. 160th SOAR (A) flight medic specialized training:
drive discussions on core cross-service education in the future. the Special Operations Aviation Medical Indoctrination Course.
To offer anything less would be a missed opportunity to elim- J Spec Oper Med. 2010;10(2):4–6.
inate preventable death on the battlefield and to best serve 22. Joint Special Operations Medical Training Center. Special Op-
those in harm’s way. erations Civil Affairs Medical Sergeant. https://learn.jsomtc.org
/course/index.php?categoryid=2. Accessed on 3 December 2020.
23. Navy Medicine Operational Training Center – Pensacola. Course
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