Combat Medic Specialist

You are the line medic-in-training. The platoon already calls you Doc and you have not earned it yet — your job for the next 18 months is to earn it for real.

You shadow the senior line medic, you stock the aid bag, you run sick call screenings, you maintain the medical sets and CLS bags in the company, and you train the line on TCCC. In garrison you spend time at troop medical clinic, drawing labs, doing vitals, immunizations, and minor procedures. In the field you carry the aid bag plus your fighting load and you are the only person who can save the soldier the platoon just left in the woodline.

• 01TCCC — Tactical Combat Casualty Care — MARCH-PAWS in the dark, under stress, in body armor.
• 02Apply a CAT tourniquet high-and-tight in under 25 seconds; transition to a deliberate tourniquet without losing the limb.
• 03NPA placement, NCD for tension pneumothorax, hypothermia management — the trauma trio every line medic owns.
• 04Start a saline lock and a 14-gauge IV in a stressed patient — and the difference between when to push fluids and when not to.
• 05Run a 9-line MEDEVAC request and a TCCC casualty card on a real patient with the platoon RTO standing over your shoulder.
• 06Stock and inventory the M5 aid bag and the CLS bag to the unit SOP — expiration dates, broken seals, missing items, all caught before the next field.

• —TC 8-800 — Medical Education and Demonstration of Individual Competence (the 68W validation manual).
• —JTS Tactical Combat Casualty Care Guidelines — current edition from CoTCCC (jts.health.mil).
• —ATP 4-02.4 — Medical Platoon; FM 4-02 — Army Health System.
• —Prehospital Trauma Life Support (PHTLS) Military Edition — the line-medic standard reference.
• —NREMT EMT-Basic exam objectives — you tested into it, you maintain it.
• —STP 8-68W13-SM-TG — Soldier's Manual and Trainer's Guide for the 68W (skill levels 1-3).

• —NREMT-B currency maintained — recertification windows do not slip.
• —68W Sustainment Skills Verification (SVT) every year — passed on the first attempt.
• —CLS instructor certification within your first 18 months — you teach the line you have to save.
• —ACFT 500+ to keep the platoon respecting Doc on the ruck.
• —Combat Lifesaver-level proficiency on every soldier in your platoon — measured, not assumed.

• —Storing expired medication in the aid bag. The CO's inspection or the IG visit finds it; your career is now a counseling statement.
• —Confusing your scope as a 68W with a civilian EMT-B scope. You do procedures (NCDs, IO, TXA, ketamine in some protocols) the civilian EMT-B does not — train them, document them, and own when they are appropriate.
• —Skipping sick call documentation. Every soldier you see, you write. If you do not, the VA fights them later and the unit cannot defend the encounter.
• —Burning the trust of the line by pushing a soldier to "tough it out" who is actually broken. You are paid to be the medical advocate, not the platoon sergeant's yes-doc.
• —Treating mental-health intakes as embarrassing. ASIST and the unit behavioral-health pathway exist; using them is the standard, not the failure.

The good cherry Doc is the medic the platoon sergeant trusts with the soldier who got smoked in PT and is "fine, doc." She runs sick call screenings cleanly, the CLS-class slides are in the OPORD annex, and the senior line medic is letting her run lanes by month nine. By the first re-enlistment window she has the F1 (flight medic) or W1 (SF/SOCM) packet in mind.

You are the line medic. The platoon medic billet is yours or you are a heartbeat from it. The line trusts you to keep them alive and to call sick call honestly.

You run platoon sick call. You build the unit's annual TCCC and CLS training plan. You inventory and order through the medical materiel system. You ride along with the line during gunnery, ranges, mounted ops, and you are the senior medical voice in the platoon LRP. You start to think hard about the F1 (flight medic), W1 (SOCM / SF medic), or the LPN / PA path the Army can pay for if you push.

• 01Run a deliberate trauma assessment under fire — MARCH-PAWS, with an IV/IO line and TXA on a real patient inside the 10-minute window.
• 02Execute a TCCC casualty handoff to a follow-on medevac element — by the standard the receiving Doc actually expects.
• 03Build and run a CLS class for 12-15 soldiers — slides, lanes, validation, ICTL-aligned, signed off as instructor.
• 04Operate as the senior medical voice in a platoon LRP / OPORD back-brief — casualty plan, evac plan, blood plan, MASCAL plan.
• 05Diagnose and triage at sick call to the level a PA / physician will trust your screening — and know exactly when to refer up.
• 06Lead a battlefield blood transfusion / cold-stored whole blood program at the company level if your unit is fielded with the Ruck-PLAS or RDCR kit.

• —JTS / CoTCCC TCCC Guidelines (current edition, jts.health.mil).
• —ATP 4-02.4 — Medical Platoon; ATP 4-25 — Medical Evacuation; ATP 4-02.85 — Multi-Service Tactics for Health Service Support.
• —PHTLS Military Edition; TCCC for Medical Personnel (TCCC-MP) curriculum.
• —NREMT EMT-B / Advanced curriculum (Army CA pays the NREMT-Advanced upgrade voucher).
• —AR 40-68 — Clinical Quality Management; AR 40-501 — Standards of Medical Fitness.
• —STP 8-68W13-SM-TG and the new IPC (Individual Performance Card) for 68W skill levels.

• —NREMT-Advanced or NREMT-P (Paramedic) packet in motion through Army CA before E-5 board.
• —TCCC-MP currency, CLS-instructor currency, ACLS/BLS / PALS as the unit demands.
• —BLC graduate; promotion points stacked with NREMT, ACLS, college, and at least one schoolhouse identifier (F2 EMT-P, W1 SOCM, F3 flight paramedic) in the application pipe.
• —Zero documentation gaps on sick call encounters — every encounter on AHLTA-T / MHS GENESIS or the unit paper SOP, signed.
• —Platoon TCCC certification rate at or above 95%; CLS at or above 50%.

• —Practicing outside your scope under stress and not documenting it after. If it is in your training, you can do it — and you write what you did, when, on whom, why.
• —Skipping the aid-bag inventory because you "know what is in it." The brigade surgeon's spot check finds the expired epi at the worst possible time.
• —Letting an injured soldier "walk it off" because the PSG asked. You are the one signing for the medical risk. Document the refusal of care.
• —Treating the Behavioral Health referral as the failure mode. The platoon's mental-health load is on your shoulders; the consult is the standard.
• —Going to the PA / surgeon around the senior medic. The medical chain runs through the SGT-medic for a reason.

The good Specialist Doc is the medic the platoon sergeant asks for by name when the platoon goes to the field. Sick call is run cleanly, the platoon's TCCC rate is above battalion average, and the platoon medical OPORD annex is the one the company medical NCO copies. She has the NREMT-P or W1 packet in motion before the E-5 board sees her.

You are the senior medical voice in a platoon or the senior treatment NCO at a battalion aid station. The line knows you; the PA / surgeon trusts you.

You run the medical platoon or BAS treatment cell — 3-5 medics, supplies, MEDEVAC posture, and the unit's entire health-readiness reporting. You write the medical annex of every OPORD that leaves the company. You sit in the BUB next to the LT and brief sick call, profiles, and Tier-1 health risks. You build your 3-5 junior medics into the next ALC-ready NCOs and you have a serious conversation with at least one of them about the W1 / F2 / 68WM6 (LPN) / PA path.

• 01Run a battalion aid station treatment cell — triage, sick call, sustained operations, MASCAL drill, restock cycle.
• 02Write a medical annex of an OPORD that the BN surgeon does not have to rewrite — casualty estimate, evac chain, blood plan, MASCAL plan, classes of supply.
• 03Operate as the senior medical NCO during a MASCAL — triage tags, START methodology, evac sequencing, communications.
• 04Lead a battalion-level TCCC validation event under the BN surgeon — every line medic re-validated to standard.
• 05Mentor a junior medic's NREMT-P / W1 / F2 / 68WM6 / IPAP packet from idea to selection board.
• 06Sit at brigade surgeon's synch as the senior NCO voice — readiness reporting, MEDPROS, profile management, health-readiness percentage.

• —ATP 4-02.4 — Medical Platoon; ATP 4-02 — Army Health System Support to the Operational Environment.
• —JTS / CoTCCC TCCC Guidelines (current); JTS Damage Control Resuscitation Clinical Practice Guidelines.
• —AR 40-66 — Medical Record Administration and Health Care Documentation; AR 40-68 — Clinical Quality Management.
• —AR 40-501 / DA PAM 40-502 — Medical Fitness Standards and Medical Readiness Procedures.
• —AR 600-8-19 — Promotions; AR 623-3 — NCOER (you write them now).
• —NREMT-Paramedic curriculum if you are upgrading; IPAP application criteria if you are PA-track.

• —ALC graduate; SLC packet built; NREMT-P or W1 / F2 / 68WM6 / IPAP packet in the pipeline if appropriate.
• —BAS / platoon-level MEDPROS at or above 95% throughout your tenure.
• —Platoon TCCC and CLS certification rates the BN surgeon presents in the BUB without a caveat.
• —NCOER bullets the senior rater can defend — measurable, action-result-impact, not generic medical filler.
• —ACFT 540+ as a floor at this rank; the line medics watch.

• —Allowing a documentation gap on a profile. The soldier is going to ETS / re-enlist / deploy on bad paper and the SGT-medic is the name on the chart.
• —Bypassing the BN surgeon to push a clinical decision the surgeon would have countermanded. Medical chain has discipline for a reason.
• —Treating the W1 / F2 / IPAP / 68WM6 conversation with your junior medics as transactional. Each path has a real selection rate and a real lifestyle impact — counsel honestly.
• —Skipping the MASCAL rehearsal because "we did one last quarter." Every new arrival to the platoon resets the curve.
• —Confusing readiness reporting (MEDPROS, e-Profile, MODS) accuracy with paperwork hygiene. The BN CO is briefed off this; if you lie to make it green, the ASR audit catches it.

The good Sergeant Doc is the medical NCO the BN surgeon and the LT both trust to walk the line during a gunnery and come back with the soldiers alive, the profiles current, and the MEDEVAC posture honest. His three junior medics have packets in motion; his MEDPROS is green; his MASCAL drill is the one the BCT surgeon asks other battalions to come watch.

You are the senior medical NCO in a battalion treatment platoon or the squad leader of a BAS medical squad. You are the one the BN CSM calls when the company medical posture goes sideways.

You run a BAS medical squad or a treatment platoon. You build the battalion's annual medical training plan. You write the medical platoon QTB input. You manage 10-15 medics through the certification cycle and the SVT. You sit on the brigade surgeon's synch as the senior NCO. You mentor your two SGT-medics into the next SSG slate and you push at least one toward W1 / F2 / IPAP / 68WM6 every year.

• 01Plan and execute a battalion-level MASCAL or medical sustainment validation lane — concept to AAR, including blood and damage-control-resuscitation drills if the unit is fielded.
• 02Defend a brigade-level medical readiness percentage (HRP) brief — MEDPROS, profile aging, mental-health waitlist, dental, immunizations — to the BCT CSM and BN CO without flinching.
• 03Manage the unit-level controlled-medication accountability and inventory — the documentation that gets units shut down when it fails.
• 04Build a six-month training plan that produces 1-2 W1 / F2 / IPAP / 68WM6 selectees per year.
• 05Translate clinical risk to a non-medical CO/CSM in language the line will repeat without rewording.
• 06Mentor the SGT-medics on NCOER writing, board prep, and packet timing — and be honest about the cost of each path.

• —AR 40-501 / DA PAM 40-502 — Medical Fitness and Readiness Procedures.
• —AR 40-66 — Medical Records; AR 40-3 — Medical, Dental, and Veterinary Care.
• —AR 40-68 — Clinical Quality Management; JC standards relevant to Army MTF / role-2/3 care.
• —ATP 4-02 series — Army Health System Support, Medical Platoon, Medical Evacuation, Health Service Support.
• —JTS Clinical Practice Guidelines — current, and indexed in your shop.
• —AR 623-3 + DA PAM 623-3 — Evaluation Reporting (you write four NCOERs per period now).

• —SLC graduate; MLC packet built.
• —Treatment platoon / squad MEDPROS at or above 97%; HRP defensible at BCT-level brief.
• —Controlled-substance inventory clean every cycle; zero unresolved inventory discrepancies.
• —NCOER profile defensible — your senior rater knows the unit medical climate and your bullets match it.
• —W1 / F2 / IPAP / 68WM6 packet pipeline producing 1+ selectee per year.

• —Treating MEDPROS / e-Profile accuracy as paperwork. The BCT CSM is briefed off it; if it is wrong, that is the conversation no SSG-medic wins.
• —Letting one junior NCO carry the documentation load because he is detail-oriented. When he ETS, the shop unravels and you cannot rebuild fast enough.
• —Skipping the controlled-substance inventory because "we did it last week." The Joint Commission / IG drop-in is unannounced and one missed locked-cabinet sweep ends careers.
• —Confusing seniority with clinical authority. The PA / physician / dentist owns the clinical decision; you own the medical-readiness execution.
• —Bypassing the brigade surgeon synch to take a problem direct to the BCT CSM. Career-limiting at this rank.

The good Staff Sergeant 68W runs the medical platoon the BN CO names in the slide as "medical is solid." HRP is green, MASCAL drills are run cold, controlled meds are clean, and at least one of his junior medics has a packet on the table every quarter. He is on the senior-medic short list for the brigade medical company before he sits MLC.

You are the senior medical NCO in a battalion or the platoon sergeant of a medical platoon. The BCT surgeon names you in the staff slide.

You run a medical platoon — 25-40 medics, the BAS, the medical equipment set, the brigade-level health-readiness reporting. You write four-to-five NCOERs per period that pick the next SSG and SFC medical slate. You operate at brigade staff as the senior medical NCO voice. You build the next 1SG of a forward support medical company. You mentor a steady pipeline of W1 / F2 / IPAP / 68WM6 selectees and you walk the line during every brigade-level medical validation.

• 01Defend a brigade-level health-readiness percentage and medical-readiness posture brief to the BCT CG and CSM — with the BN surgeon, not behind him.
• 02Run a brigade-level MASCAL or role-2/role-3 medical sustainment validation — concept, resourcing, execution, AAR.
• 03Operate as the senior medical NCO during a Combat Training Center rotation (NTC/JRTC/JMRC) — the OC/T medical observer's notes are written about you.
• 04Mentor a warrant officer (670A — Health Services Maintenance Tech if applicable) or commissioning packet (IPAP / Green-to-Gold) through to selection.
• 05Translate the brigade's medical-readiness risk to the BCT operations community — what the brigade can support, what it cannot.
• 06Build a training program that produces certified line medics, CLS instructors, and W1 / F2 / IPAP / 68WM6 selectees at brigade-required rates.

• —AR 40-501 / DA PAM 40-502; AR 40-66; AR 40-68; AR 40-3.
• —ATP 4-02 series — Army Health System Support, Medical Platoon (4-02.4), Medical Evacuation (4-25), Multi-Service Health Service Support (4-02.85).
• —JTS Clinical Practice Guidelines — full library.
• —AR 600-20 — Army Command Policy; AR 27-10 — Military Justice (you are in the room).
• —AR 350-1 — Army Training; AR 623-3 + DA PAM 623-3 — Evaluation Reporting.
• —TC 7-22.7 — NCO Guide; ADP 6-22 — Army Leadership.

• —MLC graduate; USASMA / SGM-A fellowship if SGM-track.
• —Brigade-level HRP defensible at division level; medical-readiness reporting accurate every cycle.
• —Medical-platoon CTC rotation rating in the upper third of the BCT.
• —Warrant officer / IPAP / commissioning pipeline producing 1+ selectee per year from your unit.
• —NCOER profile — Top Block / Most Qualified rate matching real-world delta in soldiers selected.

• —Hiding a HRP / MEDPROS gap from the BN CO to "fix it before the brigade brief." It surfaces. Senior NCOs lose battalions over this.
• —Letting the BN surgeon brief medical readiness in numbers you have not personally validated. You sign for the medical posture; you brief it.
• —Skipping the climate / SHARP / EO piece because "medical platoons are usually good." The brigade IG climate survey is the one that surprises units.
• —Treating the IPAP / W1 / commissioning conversation as transactional. The career-altering decisions you support at this rank build the brigade's 5-year medical bench.
• —Confusing seniority with clinical authority. The brigade surgeon's call is the brigade surgeon's; you own enlisted execution.

The good Sergeant First Class 68W is the senior medical NCO the BCT CG and surgeon both trust to walk into a brigade-level CTC rotation and come out with the soldiers alive, the OC/T notes complimentary, and the medical posture defensible at division. He runs the warrant / IPAP / commissioning pipeline for the brigade; his NCOERs pick the next SSG-board slate; he is on the short list for 1SG of a forward support medical company before he sits MLC.

You are the senior enlisted medical voice in a brigade, a medical battalion, or an MTF. The CG names you in the slide.

As 1SG of a forward support medical company or HHC of a medical battalion, you run 90-130 soldiers — medics, treatment, evac, dental, behavioral health, lab — and you own the orderly room, supply room, training calendar, and readiness reporting. As SGM/CSM on a medical battalion, brigade, or MTF staff, you set the standard for the enlisted medical workforce — credentialing, accession pipelines into W1/F2/IPAP/68WM6, retention, and the senior NCO slate. You sit in the medical strategy conversation alongside O-5s and O-6s.

• 01Run a senior-enlisted command climate in a medical company / battalion that produces certified line medics, IPAP selectees, and warrant officer accessions at rates above the medical force average.
• 02Brief the BCT/Division/MTF CG on enlisted medical readiness in language the CG can defend at the next higher echelon.
• 03Run a senior-enlisted medical posture for a brigade or higher staff during a real contingency (deployment, MASCAL, humanitarian assistance).
• 04Translate the Army Medicine / Surgeon General strategy into enlisted-talent decisions at the unit.
• 05Walk the line during a brigade or MTF medical inspection and identify the broken systems before the surveyor does (Joint Commission, IG, HRC).
• 06Run a Red Cross / casualty notification with the dignity it requires — you are the face the family sees.

• —AR 600-20 — Army Command Policy; AR 27-10 — Military Justice.
• —AR 40-501 / DA PAM 40-502; AR 40-66; AR 40-68; AR 40-3 — Army Medicine's spine.
• —JTS Clinical Practice Guidelines — every senior medical NCO must know this library.
• —AR 638-8 — Army Casualty Program (you will be in the room).
• —Surgeon General publications, MEDCOM policy memos, OTSG enlisted-workforce policy.
• —The 1SG Course / USASMA / SGM-A — and the AMEDDC&S NCO Academy reading list for medical-specific senior leader content.

• —USASMA / SGM-A completion before competing for command CSM slate.
• —Brigade-level / MTF-level medical inspection (Joint Commission, IG, OTSG) passed without senior-NCO-attributable findings during your tenure.
• —IPAP / W1 / commissioning accession pipeline producing 1+ selectee per year from your unit.
• —NCOER profile that the senior rater can defend at brigade and division — your rated NCOs are getting selected.
• —Zero senior-NCO-level integrity, financial, fraternization, OPSEC, or HIPAA incidents. One ends the career permanently.

• —Pretending to be the senior clinical voice on a topic where you are out of date. Senior NCOs lose authority by faking depth.
• —Letting a 1SG-led company drift on credentialing because "the PA / surgeon will catch it." You own enlisted credentialing rates at the unit roll-up.
• —Treating the IPAP / W1 / commissioning conversation as transactional. The careers you mentor at this rank build the medical bench for the next decade.
• —Confusing seniority with clinical authority. Hire / promote / mentor soldiers who are sharper than you and let them shine — that is the senior NCO's job at this rank.
• —Going public with disagreement over a CO's medical-risk call. Take it in the office. Walk out aligned.

The good medical CSM / 1SG / SGM is the senior NCO the brigade and division CG name without thinking. His medical company is the one the BCT loans during real-world contingencies. His enlisted medical talent slate is the one MEDCOM quotes in policy memos. His IPAP / W1 / commissioning accession rate is in the upper third of the Army; his rated NCOs are picking up first sergeant chevrons on schedule.