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United States Army Medical Command
The U.S. Army Medical Command (MEDCOM) is a direct reporting unit of the U.S. Army that formerly provided command and control of the Army's fixed-facility medical, dental, and veterinary treatment facilities, providing preventive care, medical research and development and training institutions. On 1 October 2019, operational and administrative control of all military medical facilities transitioned to the Defense Health Agency.
MEDCOM is commanded by the Surgeon General of the United States Army. The Surgeon General is also head of the U.S. Army Medical Department (the AMEDD).
MEDCOM maintained day-to-day health care for soldiers, retired soldiers and the families of both. Despite the wide range of responsibilities involved in providing health care in traditional settings, as well as on the battlefield, it was claimed that quality of care compared very favorably with that of civilian health organizations, when measured by civilian standards, according to findings of the DoD's Civilian External Peer Review Program (CEPRP).
Historically, when Army field hospitals deployed, most clinical professional and support personnel came from MEDCOM's fixed facilities. In addition to support of combat operations, deployments were for humanitarian assistance, peacekeeping, and other stability and support operations. Under the Professional Officer Filler System (PROFIS), up to 26 percent of MEDCOM physicians and 43 percent of MEDCOM nurses were sent to field units during a full deployment.
Medical personnel are now MTOE Assigned Personnel, referred to as "MAPED" or "Reverse PROFIS." Under the new system, personnel are assigned to the MTOE (Modified Table of Organization and Equipment) unit with duty assigned elsewhere to support TDA facility operations. To substitute staff, Reserve units and Individual Mobilization Augmentees (non-unit reservists) are mobilized to work in medical treatment facilities. The department also provides trained medical specialists to the Army's combat medical units, which are assigned directly to combatant commanders.
Many Army Reserve and Army National Guard units deploy in support of the Army Medical Department. The Army depends heavily on its Reserve component for medical support—about 63 percent of the Army's medical forces are in the Reserve component. The concept of the Expeditionary Resuscitative Surgical Team (ERST) has been around for several years. However, an official force requisition for ERST Teams was relayed to LTG Nadja West, former Army Surgeon General, in January 2016. ERST falls under the command and control of Medical command (MEDCOM) for the US Army. ERST Training consists of 3 weeks that is split between Fort Sam Houston, TX and Camp Bullis, TX.
The first ERST Team was rapidly integrated and deployed in May 2016 as ERST 1. The training conducted to prepare the clinicians chosen for ERST is austere, arduous, and stressful. Often, clinicians must do complex procedures and care for patients in these training environments for prolonged periods of time, and with limited resources. ERST is also trained on operational decision making and planning to better posture them for the Special Operation Forces (SOF) environment. The members of the team are selected by their respective military occupational specialty's (MOS) consultant to the surgeon general. The consultant for the MOS then sends the candidate's name to The Surgeon General (TSG) for final approval. Selected members must be physically fit, subject matter experts in their fields, and ready to serve in a highly demanding position. An ERST Consists of elite 8 members. One Certified Nurse Anesthetist (CRNA), One General Surgeon, One Orthopaedic Physician's Assistant (PA), One Emergency Department Physician, One Critical Care Intensivist, One Surgical Technician, One Emergency Department Critical Care RN, and one Intensive Care/Critical Care RN. These members have also usually served on prior deployments within their medical capacity.
The team can be broken into three sub-units; Damage Control Resuscitation (DCR Team), Damage Control Surgery (DCS Team), and Critical Care Evacuation Team (CCET). The DCR Team is composed of the ED Physician and ER RN. The DCR Team consists of the General Surgeon, Ortho PA, CRNA, and the Surgical Technician. CCET Team includes the Intensivist and ICU Critical Care RN. ERST's mission is to deploy far forward with SOF units, decreasing the time between point of injury (POI) to surgical care in austere environments while also being as light and mobile as possible. At this time, ERST has only served in Africa Command's area of responsibility (AOR).
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United States Army Medical Command
The U.S. Army Medical Command (MEDCOM) is a direct reporting unit of the U.S. Army that formerly provided command and control of the Army's fixed-facility medical, dental, and veterinary treatment facilities, providing preventive care, medical research and development and training institutions. On 1 October 2019, operational and administrative control of all military medical facilities transitioned to the Defense Health Agency.
MEDCOM is commanded by the Surgeon General of the United States Army. The Surgeon General is also head of the U.S. Army Medical Department (the AMEDD).
MEDCOM maintained day-to-day health care for soldiers, retired soldiers and the families of both. Despite the wide range of responsibilities involved in providing health care in traditional settings, as well as on the battlefield, it was claimed that quality of care compared very favorably with that of civilian health organizations, when measured by civilian standards, according to findings of the DoD's Civilian External Peer Review Program (CEPRP).
Historically, when Army field hospitals deployed, most clinical professional and support personnel came from MEDCOM's fixed facilities. In addition to support of combat operations, deployments were for humanitarian assistance, peacekeeping, and other stability and support operations. Under the Professional Officer Filler System (PROFIS), up to 26 percent of MEDCOM physicians and 43 percent of MEDCOM nurses were sent to field units during a full deployment.
Medical personnel are now MTOE Assigned Personnel, referred to as "MAPED" or "Reverse PROFIS." Under the new system, personnel are assigned to the MTOE (Modified Table of Organization and Equipment) unit with duty assigned elsewhere to support TDA facility operations. To substitute staff, Reserve units and Individual Mobilization Augmentees (non-unit reservists) are mobilized to work in medical treatment facilities. The department also provides trained medical specialists to the Army's combat medical units, which are assigned directly to combatant commanders.
Many Army Reserve and Army National Guard units deploy in support of the Army Medical Department. The Army depends heavily on its Reserve component for medical support—about 63 percent of the Army's medical forces are in the Reserve component. The concept of the Expeditionary Resuscitative Surgical Team (ERST) has been around for several years. However, an official force requisition for ERST Teams was relayed to LTG Nadja West, former Army Surgeon General, in January 2016. ERST falls under the command and control of Medical command (MEDCOM) for the US Army. ERST Training consists of 3 weeks that is split between Fort Sam Houston, TX and Camp Bullis, TX.
The first ERST Team was rapidly integrated and deployed in May 2016 as ERST 1. The training conducted to prepare the clinicians chosen for ERST is austere, arduous, and stressful. Often, clinicians must do complex procedures and care for patients in these training environments for prolonged periods of time, and with limited resources. ERST is also trained on operational decision making and planning to better posture them for the Special Operation Forces (SOF) environment. The members of the team are selected by their respective military occupational specialty's (MOS) consultant to the surgeon general. The consultant for the MOS then sends the candidate's name to The Surgeon General (TSG) for final approval. Selected members must be physically fit, subject matter experts in their fields, and ready to serve in a highly demanding position. An ERST Consists of elite 8 members. One Certified Nurse Anesthetist (CRNA), One General Surgeon, One Orthopaedic Physician's Assistant (PA), One Emergency Department Physician, One Critical Care Intensivist, One Surgical Technician, One Emergency Department Critical Care RN, and one Intensive Care/Critical Care RN. These members have also usually served on prior deployments within their medical capacity.
The team can be broken into three sub-units; Damage Control Resuscitation (DCR Team), Damage Control Surgery (DCS Team), and Critical Care Evacuation Team (CCET). The DCR Team is composed of the ED Physician and ER RN. The DCR Team consists of the General Surgeon, Ortho PA, CRNA, and the Surgical Technician. CCET Team includes the Intensivist and ICU Critical Care RN. ERST's mission is to deploy far forward with SOF units, decreasing the time between point of injury (POI) to surgical care in austere environments while also being as light and mobile as possible. At this time, ERST has only served in Africa Command's area of responsibility (AOR).