How is this even a question?

I am so angry that this is still an issue after nearly three DECADES of military medical officers and MEDEVAC enlisted requesting, pleading for, then demanding that the flight medics skills be upgraded to paramedic+ to be better able to treat the wounded. The Army finally agreed to upgrade its flight medics a few years ago, the Marines are STILL debating the issue?!?

Please save the whole CASEVAC vs MEDEVAC argument for another time. The wounded troops don’t give a rat’s ass about that, they expect EVERYTHING possible will be done to save their lives and minimize the after effects of being wounded.

Over those 3 decades how many TRILLIONS of dollars have been spent (with billions wasted) on hardware (or new uniform designs)? None of that couldn’t have been better spent on uptraining the medics? At one point late last decade there was an official DoD report that said fully 51% of deaths were preventable from a medical treatment point of view. The reasons spanned from needing better tourniquets, developing better ways to stop bleeding from torso wounds and improving the training of combat and flight medics. Some of those needed advancements have happened, but at least the Navy and Marine Crops are still falling short on training combat and flight medics (corpsmen).

This is not a tirade against the medics themselves – they do everything they can to save lives and hate it when their training or regulations limit their ability to do more. This is a condemnation of the leadership of the Army, the Navy and the Marine Corps. Shame on them all for their dereliction of duty to the wounded and those who try to save their lives.

“Special operations medics with ­SOCOM go through a 36-week ­intensive medical training package called ­SOCOM-Advanced Tactical Paramedic, or SO-ATP that includes, ­EMT-paramedic-level skills in emergency cardiac care and emergency trauma care, advanced TCCC, TCCC instructor, tactical medical emergency management protocols, military medicine and ­preventive medicine,” Sumner said.

The Navy and ­Marine Corps’ flight medics are the only ones not getting paramedic certifications; this despite the fact that the SMT mission is to perform advanced life support independent of a medical officer during search and rescue, casualty evacuation or medevac missions.

The Navy claims advanced training is in the works for its SMTs in the future but wouldn’t provide further details of what that training would entail.

In the meantime, the Navy says its current SMTs can achieve their paramedic certifications through an online portal called Navy Cool, which guides sailors through certifications related to their fields, Gulick told Marine Corps Times.”

Yup. Get YOUR training online. SMH.

[Update: we have been informed that the online portal Navy Cool is only a way to get the Navy to pay for the National Registry EMT (NREMT) exam required to obtain your paramedic certification. The Sailor must first complete an outside accredited paramedic course on their own PAID FOR OUT OF HIS/HER OWN POCKET to be eligible to apply for the COOL voucher that will pay for the NREMT exam. They are NOT reimbursed for the cost of the paramedic training course itself.

I wonder if a Navy pilot must pay for their own instruction to get a pilot’s license, or if a Marine needs to pay for firearms training outside the Corps to be able to qualify for his/her job?]…/putting-marines-at-risk…/

see also:

How the Army is slow to meet MEDEVAC Challenges in the 21st Century

Revamped Flight Medic Training


Join the conversation on our Facebook page at where people are asking more questions and offering more information that is critical to getting these issues addressed. If you’d like to offer information or guidance to the effort, we honor the need for confidentiality of those who work with us. Go to the Facebook page and send us a message to kick things off.


9 Responses to “How is this even a question?”
  1. JCscuba says:

    Great post, taking to my site for further exposure, received it from Michael Yon, Thanks.

  2. Barry Sheridan says:

    It is a surprise that the well funded US forces do not do this. If lives can be saved by additional training then it should be done, not debated.

  3. Carolyn Granlund says:

    Who can we send this to, to wake up real help?

    • Administrator says:

      We are working with several active duty and retired Hospital Corpsmen and others with knowledge of various aspects of the situation in order to pull together material that can be presented to various influencers in the Navy, the Pentagon and public sphere. Please check back here for more details about how you can help in the effort and/or join the conversation at Thanks for your interest in helping.

  4. Gismofly says:

    Whoa, Mike, it is time and distance that’s the factor with a casualty. Can a brain surgeon stem the blood any better/quicker than a medic immediately after the man is down using the same kit? There is such a thing as being over qualified in any given situation.

  5. Joseph J. Ogershok, Jr. says:

    ATP is Advanced Tactical Provider not paramedic. !8D’s are eligible to test for the NREMT-P.

  6. Joseph J. Ogershok, Jr. says:

    No Marines is a corpsman; only Navy Hospital Mates are medical providers with the Marines. Medevac is NOT a primary mission for the Navy. Most are dedicated to Search and Rescue (SAR)like the Air Force “Pedros” which have been trying to pick up the slack with Medevac coverage. “Pedros” do not have Red Crosses on them because the platform is for SAR and carry plenty of weapons. The PJ’s, on the SAR bird, are trained at the Paramedic level by the Air Force.

    • Administrator says:

      Joseph, thanks for your comment and thank you for your service as a 68W and TCCC trainer. As we are speaking to many civilians who know combat medical care is provided by a “medic” regardless of military branch we have on occasion taking to using the terms loosely for purposes of comprehension. People with experience in the military know the distinctions in terms and I thank you for your clarifications for those readers who did not know.

      You are also right that under the current arrangements technically only the US Army provides MEDEVAC services, the Marines provide CASEVAC, the Navy provides SAR as does the USAF as CSAR. As discussed in a few posts, the reasons behind the distinctions in Afghanistan and Iraq were eventually addressed by Secretary Gates when he ordered the Pedros to be more integrated into the battlefield evacuation efforts. This policy directive certainly resulted in more lives saved through making available assets that otherwise would have sat idle waiting for an AF plane to crash and the pilot and crew needed rescue.

      The issue of Red Crosses was less directed at the Pedros that do not wear the crosses, but at the Army refusing to acknowledge that it was in fact entitled to fly its MEDEVAC helicopters without the Red Crosses and to arm them. This can be verified by reading the Geneva Convention and related accords’ provisions allowing the practice – especially when engaging with non-state actors and non-signatories to the conventions. The Army JAG specialist on the laws of war issued an opinion related to this specific question raised in the context of the combat in Afghanistan and informed the Combat Arms leadership that it was permitted to remove the Red Crosses and arm the MEDEVAC without violating treaties or laws.

      The crews of the Pedros are trained as paramedics, as are many if not most of those flight medics flying with the National Guard. The DoD published a report that showed the probability of surviving being wounded was statistically much higher if you were evacuated from the battlefield by a NG MEDEVAC than an Army MEDEVAC (in the days before the Army provided paramedic training). The primary distinction was the paramedic certification held by the flight medics in the NG – that extra level of training was paying off in lives saved. That is the point at hand with the Navy still resisting adding paramedic level training to its corpsman curriculum.

      It is likely that future conflicts involving the Navy and Marines will not be the entrenched land based combat that we have seen for the past 17 years in the Middle East or where the Army has a presence to provide MEDEVAC for the Marines and SEALS. It is incumbent on the Navy to take that into account and factor in the lead time to train paramedics to fill all the corpsman slots before those conflicts happen. It is the right thing to do.

      Thanks again for your thoughts.

      • Joseph OGERSHOK says:

        I am a former Special Forces Medic before they became 18D’s. Joseph J. Ogershok, Jr.

        ACLS & BLS Training Site Manager, Faculty, and Instructor PALS, PHTLS, TCCC & Stop the Bleed Instructor ATLS Coordinator Fort Detrick, MD 21702

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