Preparing for the Future Fight: Training Medical Units for Large-Scale Combat Operations

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Video by Lt. Col. Kristin Porter

807th Theater Medical Command

June 5, 2025 | 1:23

As the U.S. military transitions from two decades of counterinsurgency operations to a renewed focus on large-scale combat operations (LSCO), the way we train, organize, and prepare our medical forces must evolve. At the heart of this transformation lies a comprehensive, multi-domain training exercise designed to rigorously test the limits of military medical capabilities under the most challenging and realistic conditions imaginable: Global Medic.

At the core of the exercise planning effort is the collaboration between the 807th Theater Medical Command (TMC) and the Medical Readiness and Training Command (MRTC). Together, they developed a complex training scenario that injects real-world stressors and operational friction points to test and evaluate medical units' ability to perform their mission essential tasks within a dynamic exercise. From scenario design to execution, the objective is clear: push units to their limits, let them struggle, and then coach, mentor, and guide them toward excellence.

This year’s integrated training environment, Mojave Falcon, includes multiple concurrent events such as the Combat Support Training Exercise (CSTX) and Global Medic. Together, they form a comprehensive platform for testing not just medical readiness, but also the operational integration between medical and sustainment forces, a critical capability in LSCO.

Mojave Falcon spans over 300 miles, encompassing units at the forward edge of battle at the National Training Center and those in the corps support area at Fort Hunter Liggett. This vast operational footprint challenges the Army Health System across its entire continuum, from point of injury to definitive care.

For the first time, medical and sustainment forces are being integrated at this scale in a real-world, doctrine-driven setting. Communicating across that distance while coordinating logistics and support is a deliberate stressor.

“Our connection to the signal network, our fuel and water support, our food services—it’s all being provided by the sustainment community,” noted Brig. Gen. Todd Traver, 807th TMC Deputy Commanding General, who also serves as the senior Global Medic trainer. “We’re exercising dependencies we’ve only seen on paper until now.”

Facing a New Reality in Combat Medicine

The shift toward LSCO requires a complete reimagining of how Army medical units prepare for and execute their missions. In LSCO environments, assumptions from the past two decades, such as immediate medical evacuation under air superiority, can no longer be taken for granted.

“We don’t expect to have air superiority, at least early in the fight, which delays medical evacuation,” said Traver. “That changes everything.”

Without guaranteed air evacuation, forward-deployed medics must deliver prolonged field care under austere and resource-constrained conditions. The entire Army Health System will bottleneck, forcing medical units to adapt, prioritize, and triage under duress.

As traditional MEDEVAC (medical evacuation) options are limited or unavailable, the exercise emphasizes the role of CASEVAC (casualty evacuation) requiring non-medical units to transport their own wounded to the next level of care. This concept reintroduces responsibilities at the unit level, particularly for first sergeants and junior leaders, to plan and execute casualty movement.

Smaller CASEVAC injects are embedded throughout the exercise, building up to a 300-casualty mass casualty event designed to overwhelm medical and sustainment units alike and force rapid adaptation and coordination.

One of the defining challenges of this new operational paradigm is contested logistics. Medical units will face shortages in critical supplies such as blood, bandages, and life-saving equipment. Communication and supply lines will be disrupted, and leaders will face ethical challenges.

“We medicate and take care of patients exceptionally well. We're the best medical capability in any army anywhere in the world. I don't have any concerns at all about our capabilities from a medical standpoint,” said Traver. “But when you're limited in capability, be it blood supplies, it’s going to force them to make very difficult decisions—about blood use, patient prioritization, and even who gets evacuated.”

Dynamic, on-the-spot decisions will be necessary. Revamping “walking blood banks,” where unit members donate blood in real-time, and improvisational treatment planning will become essential tools in the field medic’s arsenal.

While the exercise is designed to be grueling, it’s also structured around a culture of learning. Evaluators and mentors serve as senior trainers and guides, observing unit performance, identifying shortfalls, and delivering tailored feedback to help soldiers and commanders improve.

“We make it harder here than we hope it’ll be on the battlefield,” Traver emphasized. “If every soldier leaves better trained than when they arrived, that’s a win.”

As the U.S. Army Reserve prepares for the demands of future conflicts, exercises like these are instrumental in forging the adaptability, resilience, and competence required to save lives and sustain operations in the harshest conditions imaginable. Through tough training, close mentorship, and inter-organizational cooperation, Army medicine is proving ready for whatever the future battlefield may bring.