Combined Arms Center commanding general visits MEDCoE
March 19, 2021
Virtual Brain Awareness Day
By Tish Williamson | U.S. Army Medical Center of Excellence Public Affairs | Jan. 21, 2021
JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
The U.S. Army Medical Center of Excellence hosted Lt. Gen. James Rainey, commanding general, U.S. Army Combined Arms Center and Fort Leavenworth, Kansas, at Joint Base San Antonio-Fort Sam Houston Jan. 19-20.
In a visit planners described as “battlefield circulation,” Rainey met with key MEDCoE leaders, received an update brief on Army Medicine in large-scale combat operations and conducted leader professional development, or LPD, sessions with unit command teams and Medical Captains Career Course students.
Previously aligned under the U.S. Army Medical Command, MEDCoE realigned from MEDCOM to the U.S. Army Training and Doctrine Command, or TRADOC, with operational control under the CAC that began Oct. 19, 2018, and was completed Oct. 2, 2019.
MEDCoE is one of the 10 centers of excellence under CAC and TRADOC to include aviation, fires, cyber and intelligence.
Before the first LPD session, Rainey – in command since December 2019 – recognized several Soldiers and civilians who were nominated by the command for excellence. He then thanked attendees for their service and noted that less than one percent of Americans have volunteered to serve something greater than themselves as they all have through their military service.
Rainey explained that, if those who serve are the best America has to offer, then those he is being asked to recognize for excellence must be truly outstanding.
“That is why I never miss a chance to recognize excellence,” Rainey said. “You are really in the presence of greatness when you talk about the best of this group of people who are willing to serve their country.”
The Combined Arms Center is the U.S. Army's lead organization for several modernization initiatives to include managing the Army Leader Development and Army Profession Programs.
“Leaders should focus on doing well personally and developing others,” Rainey said to the MEDCoE company, battalion and brigade command teams.
MEDCoE’s Borden Institute releases teledermatology E-book
By Ernest J. Barner | Borden Institute Public Affairs | Jan. 25, 2021
JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
The Borden Institute, an agency of the U.S. Army Medical Center of Excellence at Joint Base San Antonio-Fort Sam Houston, recently released “Teledermatology in Military Medicine” as a part of its specialty publication titles.
The 12-chapter book, released Dec. 17, 2020, covers all major skin diseases from bacterial, fungal and viral infections to bullous disorders, arthropod-borne diseases, and tumors of the skin. Other selected topics include shipboard consults, cold and hot weather factors, and combat-related burns.
The unique factors affecting dermatologic care in each major geographical command are discussed. Representative cases and more than 620 color images are included in this book to demonstrate instructional sample cases from each region.
The foreword was written by Lt. Gen. Raymond S. Dingle, U.S. Army Surgeon General and commanding general of the U.S. Army Medical Command.
“This publication captures a piece of history and is basically a testament to the military dermatologists who provided services before the world had smartphones, social media and reliable internet bandwidth,” said retired Army Col. (Dr.) Jon H. Meyerle, senior consultant and editor for the publication. “Teledermatology and this publication directly contribute to the care of thousands of service members from every region of the globe.”
The electronic publication exemplifies the continuing readiness commitment to U.S. Soldiers, Sailors, Airmen, Guardians and Marines and is the ideal resource for military dermatologists and providers who operate at home bases and various remote areas of responsibility.
The debut edition of “Teledermatology in Military Medicine” is currently available in PDF and E-book formats on the Borden Institute website at http://www.medcoe.army.mil/borden.
A New Way of Training the
Army’s Flight Paramedics
Cavallaro | U.S. Army Medical Center of Excellence Public Affairs |
The Army is changing the way it trains its flight paramedics to prepare for a future battlefield where swift medical
evacuation won’t be assured. The Combat Paramedic Course, a 30-week pilot, marks the first step in ramping up
medical expertise that could include ground paramedics and more advanced skills for the Army’s almost 34,000
combat medics. Jay Harmon III, deputy to the commander of the U.S. Army Medical Center of Excellence in San
Antonio, Maj. Chris Gonzalez, pilot program director, and Master Sgt. Joey Hernandez, pilot NCO in charge, explain.
Their answers have been condensed and edited for space.
1. How were paramedics
trained until now?
The Army was producing
the paramedic certification
through a contract
here in San Antonio.
programs are focused on
medical services, but the
dynamics change in an
operational context like
combat. [Civilian paramedics]
have protocols and standing
guidance provided by their medical
director; we teach our students how
to think critically through a problem
set in the event they have no doctor
they can go back to.
2. Do you have an example of that
Take something as simple as tourniquet
application. We teach combat
medics which wounds can be controlled
with a tourniquet and then
reinforce the accurate, adequate and
timely delivery of that. With combat
paramedics, we don’t just need them
to be experts at that kind of basic
skill, we need them to understand,
“OK, I can’t evacuate this person for
two hours. Can I convert this tourniquet
to another kind of dressing
that’s not going to cut off circulation
to the entire limb?” “Now I’ve got
them for 12 hours, and I have a new
problem. How do I prepare for that?”
That sort of thing.
3. When will the pilot end?
The first course began in January;
there were two more starts in March
and June, so the pilot will end early
in 2021. Our objective is to make it
a program of record, build it into
the [budget] and make it a recurring
and permanent part of our curriculum.
Graduates who go on to serve
as flight paramedics will attend and eight-week critical care course in
San Antonio] and a four-week air
crew member training course at Fort
4. Any additional certifications?
Graduates will receive 51 of 60 semester
credit hours toward an associate
degree in Health Sciences–Emergency
Medical Services (Army Paramedic)
from the Uniformed Services University,
a National Registered Paramedic
certificate and [several certifications
from national emergency medical and
trauma care organizations].
5. Why just flight paramedics?
At this time, the only paramedic
requirement is for flight paramedics.
If you look at this thing as a pyramid,
the critical-care flight paramedics are
the very top level. They’re the cap, the
most highly trained medic that we are
going to put in the force.
Army leadership may
determine that there are
for this capability at the
ground [level. If so,] we
will already have a validated
program in place
that will simply require
resourcing to scale.
6. What’s the next level
down on the pyramid?
An advanced medical NCO trained to
a combat paramedic standard that we would try to employ on all evacuation
platforms in certain scenarios, units
and situations. We want to make our
medics better at the base of the pyramid
by giving them more knowledge
and more skills that, quite frankly,
before have only been seen in our
nursing care specialists who receive
training in how to take care of patients
for longer periods of time. We
want to take portions of that [training]
to include in Advanced Individual
Training for combat medics.
7. How significant is this?
It’s the contract that we have with our
soldiers that when they go into harm’s
way, that we’re going to do everything
medically, humanly possible to
prevent loss of life. With this, we are
just increasing the trust and confidence
of the soldiers in us.
Army Medical Department Board test auto-injectors, gets feedback from Soldiers
By Jose E. Rodriguez | U.S. Army Medical Center of Excellence Public Affairs | Sep 2019
While training during a simulated Chemical, Biological, Radiological, and Nuclear, or CBRN, attack at Joint Base San Antonio-Camp Bullis, a Soldier checks a causality's Mission Oriented Protective Posture, or MOPP, mask.
While training during a simulated Chemical, Biological, Radiological, and Nuclear, or CBRN, attack at Joint Base San Antonio-Camp Bullis, a Soldier checks a causality's Mission Oriented Protective Posture, or MOPP, mask. (Photo by Jose E. Rodriguez)
Army Medical Department Board test auto-injectors, gets feedback from Soldiers (Related Story)
JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
The Chemical and Biological Defense Auto-Injector Device, or CBD auto-injector, is something no Soldier ever wants to use on the battlefield. The effects of chemical and biological weapons are horrific.
Nerve agents are the most toxic of the known chemical agents. They are hazards in both liquid and vapor states and can cause death within minutes after exposure. Nerve agents are the primary chemical warfare agent threat because of their high toxicity and effectiveness through multiple routes of entry. They are absorbed through the eyes, respiratory tract, and skin.
Ensuring CBD auto-injectors are functional and usable are critical in savings lives. The CBD Auto-Injector Device is designed to be used in a Chemical, Biological, Radiological, and Nuclear, or CBRN, environment.
Recently the U.S. Army Medical Department Board, or USAMEDDBD, assigned to the U.S. Army Medical Center of Excellence at Joint Base San Antonio-Fort Sam Houston, conducted a test of these devices at JBSA-Camp Bullis.
The Joint Program Executive Office for Chemical and Biological Defense, Medical Countermeasure Systems, or JPEO-CBD MCS, at Fort Detrick, Maryland, requested the AMEDD Board conduct a customer test of the CBD auto-injector device within the operational environment. The data and test findings collected by the AMEDD Board will be will be provided to JPEO--CBD MCS.
The CBD Auto-Injector Device is a replacement for the currently fielded auto-injector for treatment against nerve agent and insecticide poisoning, adjunctive treatment, and management of agent-induced seizures. The United States military adopted the auto-injector as the drug delivery device because of ease of use, packaging durability, and drug product stability under varying storage conditions.
Soldiers donned Mission Oriented Protective Posture, more commonly known as MOPP protective gear, and tested the CBD auto-injectors in a simulated battlefield exercise complete with smoke grenades. MOPA masks can limit visibility, so the injectors have clear, easy to understand pictorial instructions.
"A lot of these auto-injectors used to have wording, just written instructions," said Gary Cabigon, an operational tester with the AMEDD Board.
"What we learned over the years is that pictures are easier to comprehend, especially in a stressful environment." Cabigon said that when under a CBRN attack vital seconds saved in dispensing the injector matter.
Sgt. First Class Elijah Williamson, an AMEDD Board test officer, talked about conducting the test in the field.
"I think it's great having the training asset here at Fort Sam," Williamson said.
We have the austere environment where we can create the simulation of the battlefield. We do so much on slides and videos that you want to get hands-on and create that realism out at JBSA-Camp Bullis. You can't get that in the classroom."
The CBD auto-injectors are designed to deliver an intramuscular injection with a 22-gauge needle with a pressure-activated coil spring mechanism that triggers the needle after removal of the safety cap. When activated, the needle protrudes through the needle end.
The CBD auto-injector device is a replacement for the currently fielded auto-injector for treatment against nerve agent and insecticide poisoning, adjunctive treatment, and management of agent-induced seizures. The United States military adopted the auto-injector as the drug delivery device because of ease of use, packaging durability, and drug product stability under varying storage conditions.
To learn more about the Army Medical Department Board's mission, visit https://www.cs.amedd.army.mil/ameddbd.
The U.S. Army Medical Center of Excellence, or MEDCoE, is located at Fort Sam Houston, Texas. The Army Medicine proponent responsible to envision and design responsive Army Medicine capabilities and structure that support the fielded force and the future force. We develop adaptive medical doctrine that supports Army and Joint Force operational requirements. As one of the U.S. Army Training and Doctrine Command’s 10 Centers of Excellence, MEDCoE is who the Army relies upon to train, educate and inspire all of its medical personnel. Army Medicine Starts Here! We ensure that Army Medicine is ready today “To Conserve Fighting Strength,” so that Soldiers are able to win our nation’s wars and then come home safely. MEDCoE creates the highest standards of achievement in medical expertise by generating synergy through effective and efficient combination and integration of functions while reinforcing the unique requirements and capabilities of the Army Medical Department.
Learn More ⟩
CSM Clark Charpentier
Command Sergeant Major
Learn More ⟩
We envision, design, train, educate and inspire the world`s premier military medical force to enable readiness and strengthen America`s Army.
Envision means looking at what the Army`s medical force should look like and what it should be able to accomplish given the missions it can be expected to receive.
Design means building the tactical medical units, approving their equipment sets and developing the medical doctrine needed to provide quality healthcare in the field: whether the battlefield or the humanitarian assistance field.
Train means providing the education and training to develop military and civilian students into proficient and ready members of the military healthcare team.
Educate means through state-of-the-art, hands-on, scenario driven training based on lessons learned from today`s battlefields and clinical settings, we create an environment in which students can develop the educational and training capabilities they will need in order to provide the best casualty and patient care possible.
Inspire means the MEDCoE professional staff development and career life-cycle management assures us that students will continue to receive the benefits of the best education and training opportunities available from some of the world`s most capable and innovative instructors, training developers and professional staff members.
To be the foundation on which Army Medicine is built, sustained and transformed.
- Army medical and non-medical personnel
- Navy, Air Force and Coast Guard medical personnel
- Military leaders, political representatives and other decision-makers
- DOD Personnel (military and civilian)
- General public
There are seven major organizations that comprise the U.S. Army Medical Center of Excellence:
The Directorate of Training and Academic Affairs (DoTAA). The MEDCoE is accredited by the Council of Occupational Education, and all programs of instruction are reviewed by the American Council on Education. Students attending courses at the MEDCoE can get undergraduate and graduate college credits. The Graduate School also conducts nine doctoral and five masters degree programs.
The 32d Medical Brigade is comprised of the 232nd Medical Battalion and the 264th Medical Battalion.
The Medical Professional Training Brigade is comprised of the 187th Medical Battalion and the 188th Medical Battalion.
The Directorate of Simulations (DOS) is the central focal point for Army Medical Modeling and Simulation initiatives with the responsibility for the development and execution of medical simulation training and the emerging medical simulated training environment, or STE.
The Fielded Force Integration Directorate (FFID) enables the delivery of solutions for the fielded force across the domains of doctrine, organization, training, materiel, leadership, personnel, facilities and policy (DOTmLPF-P) for the Army Health System.
The Medical Capability Development and Integration Directorate (CDID) develops future concepts and requirements and conducts experimentation, data collection and analysis to validate those concepts and capabilities. Identifies capability gaps, and develops appropriate requirements to mitigate and close capability gaps for the future. As of 1 OCT 2019, CDID is a subordinate organization of the Futures and Concepts Center (FCC), Army Futures Command, though located at Fort Sam Houston with MEDCoE to ensure synchronization of effort. (LINK: https://armyfuturescommand.com/)
The Noncommissioned Officers Academy (NCOA) is our center for NCO professional military leadership education. The Academy teaches courses at both the entry and advanced levels.
The Personnel Proponent Directorate (APPD) does force modeling. The Army Medical Department has over 130,000 military and civilian members who work in 200 different officer, warrant officer, enlisted, and civilian specialties. This directorate ensures that the Army`s medical force is properly structured to accomplish the Army Medicine`s many missions.
The Army Medical Department Board provides independent operational test and evaluation of medical and medical related materiel and information technology products in support of the Army and Department of Defense acquisition process; provides assessments of emerging concepts, doctrine, and advanced technology applications applied to the delivery of healthcare, both on the battlefield and in fixed facilities.
The U.S. Army Medical Center of Excellence (MEDCoE) traces its origin to the Medical Field Service School (MFSS) established, nearly 100 years ago in 1920 at Carlisle Barracks, Pennsylvania. The mission of the MFSS was to train doctors, dentists and nurses in their duties as Army officers.
In 1924, the MFSS conducted the first professional courses for noncommissioned officers and privates first class.
The MFSS moved to Fort Sam Houston in 1946 and was located in the 9th Infantry Regiment quadrangle; where U.S Army North (5th Army) is now located.
In 1972 a reorganization of the MFSS resulted in the re-designation of the MFSS as the Academy of Health Sciences, making it one of the largest medical training institutions in the world.
In 1991, it was re-designated as the Army Medical Department Center and School (AMEDDC&S), with the Academy of Health Sciences becoming the school arm of the institution.
In 1993, AMEDD Center and School was realigned under the U.S. Army Medical Command (Provisional) and remained under the U.S. Army Medical Command (MEDCOM) as it became fully functional in 1994.
On 19 February 2015, to better align with the other education and training institutions across the Army, though still under MEDCOM, the Department of the Army added Health Readiness Center of Excellence to the school’s designation, becoming the U.S. Army Medical Department Center and School, Health Readiness Center of Excellence (AMEDDC&S HRCoE).
On 19 October 2018, AMEDDC&S HRCoE began realignment from the U.S. Army Medical Command (USAMEDCOM) to U.S. Army Training and Doctrine Command (TRADOC) with operational control by the U.S. Army Combined Arms Center, to be completed effective 2 October 2019.
Effective 15 September 2019, the CoE was finally redesignated as the U.S. Army Medical Center of Excellence (MEDCoE) to further solidify their abiding dedication to Army Medicine, reverence to their profound history, and their commitment towards Army modernization with the singular focus of training Soldiers who will win our nations wars and then come home safely.
The MEDCoE supports the Army to lead the design, integration, education, and training of new and innovative approaches to health and the Army Health System.
MEDCoE is postured to enable effective and efficient integration and synchronization of Army Medical Department Doctrine, Organization, Training, Material, Leadership, Personnel and Facility, and Policy (DOTMLPF-P) development to ensure the latest solutions to any perceived or predicted Army Medicine gaps are documented and incorporated into our doctrine and instruction.
MEDCoE is organized with two brigades to enhance mission command, improve functional alignment, and set the conditions for becoming a degree-granting institution. Each brigade has the responsibility for the execution of training and education, as well as quality of life and immersion into the Army Profession.
The CoE structure increases collaboration across TRADOC, other organizations, programs, and the generating force to improve support to the operating force. It embraces best practices and initiatives that improve efficiency and effectiveness of the Army and other Service partners overall. The common structure across all CoEs improves the ability of external agencies to communicate with CoE subordinate elements. Where integrated staffs are realized and common instruction shared, manpower requirements are decreased and greater synergy is gained between staffs and schools.
The MEDCoE is focused on the Army and improving the readiness of the force and training the Army’s Medical Professionals. We ensure that Army Medicine is ready today “To Conserve Fighting Strength” by training, educating and inspiring Soldiers and Leaders who are capable of meeting the Army’s requirements for a ready medical force and a medically ready force.
Army Medicine Starts Here!