Under pressure and under fire, training prepares medics to save lives in combat

At Joint Base San Antonio-Camp Bullis, the Air Force’s 937th Training Support Squadron is ramping up realistic, high-pressure instruction designed to bridge the gap between hospital care and battlefield medicine for active duty, Air National Guard and Air Force Reserve personnel.

The unit runs five courses — the Expeditionary Medical Readiness Course (EMRC), Expeditionary Medical Support, Ground Surgical Team, Patient Decontamination, and the Aeromedical Evacuation and Patient Staging Course — to prepare medics to triage, treat and evacuate casualties under austere conditions. “There is only one training support squadron across the Air Force Medical Service,” said Lt. Col. Mark Hassett, commander, 937th Training Support Squadron. “The 113 members of the 937th TRSS are vehemently committed to producing warrior medics and ensuring they are prepared when they go downrange.”

The two-day EMRC is the entry point for many Airmen rotating into operational roles. It delivers hands-on Tactical Combat Casualty Care (TCCC) across 16 medical Air Force specialties, emphasizing life-saving interventions outside the controlled environment of a hospital. “We teach the fundamentals of Tactical Combat Casualty Care with a hands-on approach to lifesaving combat medic interventions,” said Staff Sgt. Michelle Garcia, an EMRC instructor. “This is their foundational exposure to the real-life experiences they might face down the line.”

For clinicians more accustomed to stabilized patients and calm wards, the curriculum forces a mindset shift to first-contact, high-threat scenarios. “In a hospital setting, staff typically receive patients who have already been treated and stabilized,” Garcia said. “They may never otherwise experience a high-stress, tactical scenario where they actually have to apply tourniquets to stop massive bleeding or perform emergency airway interventions themselves.”

Courses are structured to foster small-team dynamics under pressure, blending students from multiple specialties into squads that must make rapid, coordinated decisions. “They have to be able to work in austere, highly unpredictable deployment scenarios, utilize their clinical skills appropriately and make rapid, critical medical decisions on the fly as a unit,” said Staff Sgt. Aaliyah Fernandez-Vineski, a surgical services specialist and GST ground supervisor.

Fernandez-Vineski, who deployed to Bagram Airfield, Afghanistan, during the U.S. troop withdrawal, said first-hand experience informs the instruction. “Having been in that environment, I wanted to teach so I could help build the next generation of teams heading out into this rapidly evolving battlespace,” she said. “This training means the world to me, but I know it means even more to our heroes downrange, who deserve the absolute best quality of care on the worst day of their lives.”

Once patients are stabilized, the aeromedical mission begins. The Aeromedical Evacuation and Patient Staging Course trains medics to stage, triage and prepare casualties for flight, including lifting and moving patients, building pallets, operating staging facilities and configuring loads on aircraft such as the C-130 Hercules and KC-135 Stratotanker. “Our primary focus is making sure our members are trained to safely stage, triage and stabilize patients so they are secure for flight,” said Tech. Sgt. Imelda Herrera, a 937th TRSS instructor. “This training gives them the vital foundation they need to perform when the pressure is on.”

Instructors layer in physical, environmental and psychological stressors to mirror operational realities. San Antonio’s summer heat becomes a training variable, and simulated battlefield sounds — gunfire and explosions — force students to maintain situational awareness while treating multiple casualties. “The heat actually becomes part of the training,” Herrera said. “You’re tired, you’re working hard, and depending on where you deploy, those are exactly the kinds of conditions you will face.”

The program’s realism is shaped by a 28-member cadre whose backgrounds span aeromedical evacuation, patient staging and tactical medical teams. “Our cadre do extremely well tailoring their exercise scenarios to meet changes in the operational environment,” Hassett said. “Over the last year, we’ve introduced longer patient hold times, resource constraints, increased drone attack scenarios and a greater focus on behavioral health response to ensure our medics are ready for today’s fight.”

That operational currency, Herrera added, helps translate hard-earned lessons directly to students. “Collectively, our experiences allow us to paint a much clearer picture for our students,” Herrera said. “It’s an incredible opportunity to teach from real-world lessons and help prepare them for what lies ahead.”

The 937th Training Support Squadron underpins a broader enterprise at the 937th Training Group that cycles approximately 13,000 medics annually through technical and advanced coursework. “Our personnel are the support engine and pillars of the 937th Training Group’s ability to deliver warrior medics to the operational Air Force,” Hassett said. “This group supports the 13,000 medics who attend technical or advanced training annually. Without them, the mission stops.”

For the squadron, the objective is unambiguous — build medics who can perform when it matters most. “They will do whatever it takes to execute that mission, because at the end of each training day is a patient, a family member, a coworker, or a friend who our students will be taking care of,” Hassett said. “It’s that simple.”