Questions about tactical emergency medicine and EMS careers in Army special forces.

[MoGhazidoc1990]

Hey there.

I have been doing a lot if research about certain careers in emergency medicine and really am interested about tacmed and ems. Most particularly in special forces.

Now I want to get this out of the way first. I am not trying to be doctor rambo. I do however have a keen interest as I said before tacmed ems and also I counterterrorism as well as teaching and most of all serving my country. The teaching part fits quite well with SF because they actually train indigenous forces how to fight and also how to sustain security. My part would be to train medics meaning SF medics as well as indigenous personel.

Also I realize that I will not be a door kicker necessarily but will be in a support role at an FOB or even in certain cases on site of a raid but only to deliver critical care. Although that may be a medics job it has been done before by docs.
Some of you may be asking yourself why I would want to do something like this. I'll try to answer this here. First off want to serve at the highest levels and also be apart of counterterrorism. Second I want serve in an elite unit as a doc for it is the pinnacle of tacmed.
Some might even ask why not just try to be a doc that is attached to a unit. The reasoning behind that is that you can see chaplains even becoming SF qualified so they can understand the hardships of a group of men. Even though that is very important for morale if a chaplain is in the unit than it makes just as much sense for a doc to do so as well to better understand the people the doctor will treat. IMO it makes you more effective to have that insight.
Here is what I know.
Yes it is possible for a MD to go through the q course although not common.
Also I know that I can be qualified as a green beret based on posts about a COL Farr here on this forum saying It is possible.


Here is my question
Does anyone know the best route to pursue this career path with the highest probability of success?

What courses or qualifications should I have prior to signing on with the army to put me in the best position for consideration for a position that I'm describing?

Does anyone know anybody or have heard of someone personally doing this and know anything about there experiences?

I should also mention that I know 3 languages urdu and punjab included and learning pashto and arabic as well.

I should also mention this that I am an img and can only join up after my residency is complete but can sign on with the army in like an "association" until I can fully take on my duties as an army doc after my residency is done. Also yes I realize that all this is contingent on whether I get a match and also on my physical fitness and ability to get into the q course.

Also want to be an ER physician which is the most deployable doc in the military
Any insight would be great and much appreciated thanks

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[Tenk]

I have a buddy who is former special forces, and I talked to him about this once just out of curiosity.

Basically, you would be too high risk to go on most if not all special ops missions. You would compromise the team security and therefore the mission as a whole. Unless you decided to graduate from buds or ranger school. Good luck with that though, these people are monsters.

Lastly, most of the guys you are talking about rolling with know a lot more about medicine than you would think, and what you can offer in addition to their field knowledge is probably not a whole lot.

You'd do these soldiers much more by helping them in the base and the VA.

 

[Vandalia]

It is a fact that a physicians who are in certain assignments can work their way into some short courses - e.g., military free-fall. But in general, physicians are never involved in actual operations. The individuals who are integrated into special forces units are enlisted "medics", or more specialized Air Force para-rescue jumpers (PJs).

I have heard of physicians who might be on stand-by to support certain operations, but they would never be directly involved. First, they would lack the tactical training to participate and would be a very large weak-link. Second, there is a Geneva-convention issue. Even though it does not technically apply to most of the things we are involved with now, it it still something the military takes very seriously. I know in the cold war days, when deployed to Europe, the physician "Geneva convention" identification card was the most closely tracked identification document the AF issued.

 

[EKGdoc]

It is a fact that a physicians who are in certain assignments can work their way into some short courses - e.g., military free-fall. But in general, physicians are never involved in actual operations. The individuals who are integrated into special forces units are enlisted "medics", or more specialized Air Force para-rescue jumpers (PJs).

I have heard of physicians who might be on stand-by to support certain operations, but they would never be directly involved. First, they would lack the tactical training to participate and would be a very large weak-link. Second, there is a Geneva-convention issue. Even though it does not technically apply to most of the things we are involved with now, it it still something the military takes very seriously. I know in the cold war days, when deployed to Europe, the physician "Geneva convention" identification card was the most closely tracked identification document the AF issued.

 

[MoGhazidoc1990]

O

I have a buddy who is former special forces, and I talked to him about this once out of curiosity.

Basically, you would be too high risk to go on most if not all special ops missions. You would compromise the team security and therefore the mission as a whole. Unless you decided to graduate from buds or ranger school. Good luck with that though, these people are monsters.

Lastly, most of the guys you are talking about rolling with know a lot more about medicine than you would think, and what you can offer in addition to their field knowledge is probably not a whole lot.

You'd do these soldiers much more by helping them in the base and the VA.

Ok so really it goes back to what I said before hand. I will not be a door kicker. But can I still graduate from ranger school or the q course and be ok in the ranks? I have heard it being done before.

 

[MoGhazidoc1990]

So y

It is a fact that a physicians who are in certain assignments can work their way into some short courses - e.g., military free-fall. But in general, physicians are never involved in actual operations. The individuals who are integrated into special forces units are enlisted "medics", or more specialized Air Force para-rescue jumpers (PJs).

I have heard of physicians who might be on stand-by to support certain operations, but they would never be directly involved. First, they would lack the tactical training to participate and would be a very large weak-link. Second, there is a Geneva-convention issue. Even though it does not technically apply to most of the things we are involved with now, it it still something the military takes very seriously. I know in the cold war days, when deployed to Europe, the physician "Geneva convention" identification card was the most closely tracked identification document the AF issued.

So your saying I should give up?

 

[EKGdoc]

Our EM residency has a strong tactical EM/EMS program, including an elective on tactical medicine. Includes firearms training and training with SWAT team. TEMS director is well known and has written major textbook on TEMS. You can PM me for more information.

 

[alpinism]

So y

So your saying I should give up?

You'll see far more action in TEMS and CT ops in a civilian EM program that offers opportunities in these areas.
Usually LICHSIPERs programs (do a search).

Military medicine is not what you think it is.

 

[MoGhazidoc1990]

Our EM residency has a strong tactical EM/EMS program, including an elective on tactical medicine. Includes firearms training and training with SWAT team. TEMS director is well known and has written major textbook on TEMS. You can PM me for more information.

Thank you so much I will definitely take you up on that.

 

[MoGhazidoc1990]

You'll see far more action in TEMS and CT ops in a civilian EM program that offers opportunities in these areas.
Usually LICHSIPERs programs (do a search).

Military medicine is not what you think it is.

Would FBI swat or HRT fall in what you are talking about? How receptive are county programs to IMGs?

 

[The White Coat Investor]

Let me give you a tip that has worked very well for me in my career. There are really three steps to doing something you want to do:

1) Find someone doing what you want to do.
2) Ask them how they did it.
3) Do what they did.

Got me into medical school, into residency, into a great job etc. Got me what I wanted in the military too. If you really want to be involved in that sort of thing in the military, just ask for it and stay in. Eventually you'll get to do it because no one else wants to.

 

[MoGhazidoc1990]

Let me give you a tip that has worked very well for me in my career. There are really three steps to doing something you want to do:

1) Find someone doing what you want to do.
2) Ask them how they did it.
3) Do what they did.

Got me into medical school, into residency, into a great job etc. Got me what I wanted in the military too. If you really want to be involved in that sort of thing in the military, just ask for it and stay in. Eventually you'll get to do it because no one else wants to.

Thanks for that sir. I agree will adopt that strategy

 

[Perrotfish]

Hey there.

I have been doing a lot if research about certain careers in emergency medicine and really am interested about tacmed and ems. Most particularly in special forces.

Now I want to get this out of the way first. I am not trying to be doctor rambo. I do however have a keen interest as I said before tacmed ems and also I counterterrorism as well as teaching and most of all serving my country. The teaching part fits quite well with SF because they actually train indigenous forces how to fight and also how to sustain security. My part would be to train medics meaning SF medics as well as indigenous personel.

Also I realize that I will not be a door kicker necessarily but will be in a support role at an FOB or even in certain cases on site of a raid but only to deliver critical care. Although that may be a medics job it has been done before by docs.
Some of you may be asking yourself why I would want to do something like this. I'll try to answer this here. First off want to serve at the highest levels and also be apart of counterterrorism. Second I want serve in an elite unit as a doc for it is the pinnacle of tacmed.
Some might even ask why not just try to be a doc that is attached to a unit. The reasoning behind that is that you can see chaplains even becoming SF qualified so they can understand the hardships of a group of men. Even though that is very important for morale if a chaplain is in the unit than it makes just as much sense for a doc to do so as well to better understand the people the doctor will treat. IMO it makes you more effective to have that insight.
Here is what I know.
Yes it is possible for a MD to go through the q course although not common.
Also I know that I can be qualified as a green beret based on posts about a COL Farr here on this forum saying It is possible.


Here is my question
Does anyone know the best route to pursue this career path with the highest probability of success?

What courses or qualifications should I have prior to signing on with the army to put me in the best position for consideration for a position that I'm describing?

Does anyone know anybody or have heard of someone personally doing this and know anything about there experiences?

I should also mention that I know 3 languages urdu and punjab included and learning pashto and arabic as well.

I should also mention this that I am an img and can only join up after my residency is complete but can sign on with the army in like an "association" until I can fully take on my duties as an army doc after my residency is done. Also yes I realize that all this is contingent on whether I get a match and also on my physical fitness and ability to get into the q course.

Also want to be an ER physician which is the most deployable doc in the military
Any insight would be great and much appreciated thanks

Military (non-SF, non-EM) doctor here. Answers to questions:

Question: How do you get Special Forces qualified as a doctor ?
Answer: You don't. A special forces training pathway, whether SEALs, Green Berets, or Pararescue, is an approximately 2 YEAR pipeline that does not leave time for anything else. The military will not pay for doctors to do that after they've already paid for your experience as a residency trained physician. Maybe they did it for one guy, once, but the next time it happens I'm willing to bet it won't be you. Ranger school is extraordinarily unlikely but at 10 weeks might be possible as some sort of an incentive to re-up, if by some bizarre chance you both still wanted to do this 4 years after residency and were fine taking a spot from an Infantryman who desperately needs the training for both his career and his survival. For your initial commitment you can probably count that out too. BTW you also don't want this. I feel a little rusty going back to work after a two week vacation. No attending wants to take a 10 week break from practicing. Many military attendings work second jobs in higher acuity populations to keep their skills up. If you attach to the line you may, however, get to go to some cool short courses like wildness medicine, jump school, or even a limited form of flight/diving school.

Question: How do you attach to the Special Forces as a doctor?
Answer: Mostly, you don't. In the Navy the path to this lies through a diving medical officer course, which is 6 months, after your internship. In all other services it mostly just happens after an FP residency. Unfortunately there are a lot of prior-SF in the medical community, and there aren't a lot of these slots, so usually it goes to one of them while you get shunted to a less special operational billet. If you do get it (I know one non-SF ex Pediatric Intern who got a slot with the SEALs) you are still support staff.

Question: Can you associate with the military in some way prior to formally joining after residency?
Answer: No

Question: How can a doctor best serve his country in the military?
Answer: By being a good military doctor. Healthcare is a big part of what makes the military run, and a motivated physician can have a huge impact on the readiness of the servicemen that he sees. Having the dedication to keep up your skills and train your corpsmen at a small MTF can keep a lot of people functional and in the fleet. It doesn't feel very military, though. You will be to the fighting military what the hospital's IT department is to the transplant team. Important support, but 100% in the background.

 

[Vandalia]

O

Ok so really it goes back to what I said before hand. I will not be a door kicker. But can I still graduate from ranger school or the q course and be ok in the ranks? I have heard it being done before.

You will find some physicians who are Ranger School graduates or have various other special forces qualifications. However, almost without exception, they did this BEFORE they were physicians.

For example, a while back I ended up on the USUHS (military med school) admission's committee. One applicant was from an army soldier who did his pre-med basically at night and whose record was filled with ... special .... training and classified evaluation reports and decorations. We joked that we were afraid NOT to admit him. In the Air Force, there are pilot-physicians, but again, almost every one of them was an AF pilot before they went to med school.

The military is not going to take expensive resources (physicians) and put them through expensive training, for no real advantage. And based on my somewhat limited experience, there is not much that a SF medic or a PJ cannot do in the field that a physician would be able to in the same environment.

 

[Perrotfish]

In the Air Force, there are pilot-physicians, but again, almost every one of them was an AF pilot before they went to med school.

They military actually does, weirdly, have a 'pilot physician' program that takes residency trained physicians and trains them to be pilots. Its only a couple of physicians a year, but then again almost no one applies for it so if you want it your chances are pretty good. Its the exception that proves the rule.

 

[MoGhazidoc1990]

Military (non-SF, non-EM) doctor here. Answers to questions:

Question: How do you get Special Forces qualified as a doctor ?
Answer: You don't. A special forces training pathway, whether SEALs, Green Berets, or Pararescue, is an approximately 2 YEAR pipeline that does not leave time for anything else. The military will not pay for doctors to do that after they've already paid for your experience as a residency trained physician. Maybe they did it for one guy, once, but the next time it happens I'm willing to bet it won't be you. Ranger school is extraordinarily unlikely but at 10 weeks might be possible as some sort of an incentive to re-up, if by some bizarre chance you both still wanted to do this 4 years after residency and were fine taking a spot from an Infantryman who desperately needs the training for both his career and his survival. For your initial commitment you can probably count that out too. BTW you also don't want this. I feel a little rusty going back to work after a two week vacation. No attending wants to take a 10 week break from practicing. Many military attendings work second jobs in higher acuity populations to keep their skills up. If you attach to the line you may, however, get to go to some cool short courses like wildness medicine, jump school, or even a limited form of flight/diving school.

Question: How do you attach to the Special Forces as a doctor?
Answer: Mostly, you don't. In the Navy the path to this lies through a diving medical officer course, which is 6 months, after your internship. In all other services it mostly just happens after an FP residency. Unfortunately there are a lot of prior-SF in the medical community, and there aren't a lot of these slots, so usually it goes to one of them while you get shunted to a less special operational billet. If you do get it (I know one non-SF ex Pediatric Intern who got a slot with the SEALs) you are still support staff.

Question: Can you associate with the military in some way prior to formally joining after residency?
Answer: No

Question: How can a doctor best serve his country in the military?
Answer: By being a good military doctor. Healthcare is a big part of what makes the military run, and a motivated physician can have a huge impact on the readiness of the servicemen that he sees. Having the dedication to keep up your skills and train your corpsmen at a small MTF can keep a lot of people functional and in the fleet. It doesn't feel very military, though. You will be to the fighting military what the hospital's IT department is to the transplant team. Important support, but 100% in the background.

I guess I just really want to make a difference and serve at the highest level. Guess it's a no go

 

[MoGhazidoc1990]

This is what I was basing my thought on going into SF on.
http://m.thepilot.com/news/former-a...91c-447b-11e3-a678-0019bb30f31a.html?mode=jqm

 

[Perrotfish]

I guess I just really want to make a difference and serve at the highest level. Guess it's a no go

If you want to be in the special forces, yes its probably a no go. I'll never say never and I'm sure someone pulled it off, but its really unlikely that you'll get to do that 2 year training pathway while simultaneously being an active duty doctor.

You're going to be a doctor. You are going into an elite profession, a profession that makes a huge difference. You don't need another one on top of it.

This is what I was basing my thought on going into SF on.
http://m.thepilot.com/news/former-a...91c-447b-11e3-a678-0019bb30f31a.html?mode=jqm

BTW this guy is not, based on what I'm reading, SF. He is clearly a top performer and an incredible guy (astronaut!) and he obviously acuumulated a lot of other impressive qualifications including ranger school (like I said, maybe second tour) but he's an EM doctor that as far as I can tell is not SF qualified, who was assigned to SOCOM as a physician. Am I reading it wrong? I don't always recognize army stuff.

 

[alpinism]

Would FBI swat or HRT fall in what you are talking about? How receptive are county programs to IMGs?

Mostly local PD SWAT and CT units.

Some are and some aren't. Not any more or less than any US EM program in general.

A few programs in NYC and Detroit tend to be more IMG friendly.

 

[alpinism]

This is what I was basing my thought on going into SF on.
http://m.thepilot.com/news/former-a...91c-447b-11e3-a678-0019bb30f31a.html?mode=jqm

Be careful reading stuff like this. I can almost guarantee that his job is nowhere near as glamorous or badass as the article makes it seem. Being a battalion surgeon or EM physician at a place like Ft. Bragg is essentially working as a glorified primary care/family medicine doctor for the unit. You're not going to be seeing hardly any critically ill or trauma patients there on a day to day basis. Deployments can also be hit or miss, either relatively busy or painfully slow. Not to mention that the chances of deploying are much less now than they were 5 years ago.

If you want to train medics or indigenous personnel you can join the guard/reserve or go to a place like USF in Tampa or VCU in Richmond where they actually train the SF medics (from Fort Bragg no less).

https://hscweb3.hsc.usf.edu/health/now/?p=131

 

[southerndoc]

Yes, you can be on a tactical team with a special forces unit with the military or federal agency. You are more likely to be involved in deployment as a breach team member with a civilian agency (breach team is the team that goes in to effect the assault or "breach" the perimeter).

Most federal agencies, including military, recognize that physicians are a resource that can't be easily replaced. It's much easier to train a tactical paramedic -- many of them to be exact -- to be a part of a breach team and to have a physician serve on the back end (secondary perimeter) or only as a medical director. A paramedic is much easier to replace than a physician as the training, recruitment, and retention costs are much less. I don't mean this to sound uncaring. It's simply a reality.

I have been a part of a secondary perimeter team, but not a part of a breach team. Most of my duties is as a medical director, but I have been requested to be present for some operations with advanced planning (at least a few weeks notice).

Unfortunately, I cannot discuss anything more specific due to security restrictions, but the answer to your question is yes, you can be involved with things like this but they are difficult to obtain due to the small number of opportunities. This can either be from local, state, or even federal military and civilian agencies. Some opportunities will allow you to travel internationally, but you must be willing to sacrifice time away from your family and your primary job. Being an IMG may not necessarily hurt your chances, but you will be required to be a US citizen for a single scope background investigation to obtain a TS security clearance for some agencies/military operations.

 

[MSmentor018]

1. southerndoc is right. you could definitely be on a breech team with civilian law enforcement. I've done it on a few occasions, although you may not be covered by insurance if you get injured so look at the fine print before you start. also they require varying times of (6 mo) law enforcement courses, which is tough on a rotating EM schedule. mainly having to have all your co workers switch/cover the crappy shifts while you're in class. depending on how much you work, your boss may not give you the time off for deployments, call ups....etc. if you're hanging around waiting for residency, then do this now.

2. getting on an operational detachment team-alpha (ODA) to take an 18D slot doesn't really happen for physicians...I know 2 prior 18D that got out, went to med school/residency, gave up their commission to return to the 20th NG in AL to do just that. both work full time otherwise, 1 is EM and other is anesthesia. in the overall scheme of things it's not worth risking a physician in the field like that. you're much more effective as battalion surgeon, FOB, or primary receiving area. the slot you hold is not to hump a SAW, toss grenades or fire the carl gustav. it's your brain-to better the soldier's health and the army knows this. at the most you'll visit/supervise 18D at clinic outposts and train foreign physicians/medics. if you just said screw it and enlist, it's 18x and that's an automatic 3 hr hitch. you could cut that down by CLEPping out of language school. I don't know if you get credit for med school.
have you asked a SF recruiter if it's even possible these days? I've been out a long time

3. entering sfas/q course, unlikely. ranger school, possible! I don't know about now but back then if you're in a ranger bn. you're going to hooah school. you won't be in the s#$t per say but you will be deployed with the bn. most likely assigned to hq company, you'll be the receiving end of the casualty collection points, medivac, supervise sick call, training medics, overall health of the bn....etc. my assumption is enter as a physician, be assigned at X, then request for transfer to ranger bn. I don't believe residency is required. we had a guy that was a GMO, most of them were flight surgeon/FP, one was derm?

4. teaching socom medics in clinical rotations. that's what I do now. it's a huge impact on them and very rewarding. it's a volunteer thing but maybe there's a federal civilian contract to train them at the schoolhouse at bragg? the current commander there is active army EM trained. I've never seen anyone but who know's.

5. you're an IMG. assuming you're us citizen right? otherwise you may not qualify for clearance for socom or civilian LEO

6. go to or contact SOMA (special operations medical association). http://www.specialoperationsmedicine.org/Pages/default.aspx. we use to meet every yr in tampa but it'll be in charlotte this yr. Farr, rocky, Mabry, and other SF legends all show up for it.

7. or just enjoy life after the struggles of residency. do fun stuff on the side like search/rescue team, wilderness medicine, rural international medicine.....etc.

8. married/kids? that changes everything

 

[MoGhazidoc1990]

1. southerndoc is right. you could definitely be on a breech team with civilian law enforcement. I've done it on a few occasions, although you may not be covered by insurance if you get injured so look at the fine print before you start. also they require varying times of (6 mo) law enforcement courses, which is tough on a rotating EM schedule. mainly having to have all your co workers switch/cover the crappy shifts while you're in class. depending on how much you work, your boss may not give you the time off for deployments, call ups....etc. if you're hanging around waiting for residency, then do this now.

2. getting on an operational detachment team-alpha (ODA) to take an 18D slot doesn't really happen for physicians...I know 2 prior 18D that got out, went to med school/residency, gave up their commission to return to the 20th NG in AL to do just that. both work full time otherwise, 1 is EM and other is anesthesia. in the overall scheme of things it's not worth risking a physician in the field like that. you're much more effective as battalion surgeon, FOB, or primary receiving area. the slot you hold is not to hump a SAW, toss grenades or fire the carl gustav. it's your brain-to better the soldier's health and the army knows this. at the most you'll visit/supervise 18D at clinic outposts and train foreign physicians/medics. if you just said screw it and enlist, it's 18x and that's an automatic 3 hr hitch. you could cut that down by CLEPping out of language school. I don't know if you get credit for med school.
have you asked a SF recruiter if it's even possible these days? I've been out a long time

3. entering sfas/q course, unlikely. ranger school, possible! I don't know about now but back then if you're in a ranger bn. you're going to hooah school. you won't be in the s#$t per say but you will be deployed with the bn. most likely assigned to hq company, you'll be the receiving end of the casualty collection points, medivac, supervise sick call, training medics, overall health of the bn....etc. my assumption is enter as a physician, be assigned at X, then request for transfer to ranger bn. I don't believe residency is required. we had a guy that was a GMO, most of them were flight surgeon/FP, one was derm?

4. teaching socom medics in clinical rotations. that's what I do now. it's a huge impact on them and very rewarding. it's a volunteer thing but maybe there's a federal civilian contract to train them at the schoolhouse at bragg? the current commander there is active army EM trained. I've never seen anyone but who know's.

5. you're an IMG. assuming you're us citizen right? otherwise you may not qualify for clearance for socom or civilian LEO

6. go to or contact SOMA (special operations medical association). http://www.specialoperationsmedicine.org/Pages/default.aspx. we use to meet every yr in tampa but it'll be in charlotte this yr. Farr, rocky, Mabry, and other SF legends all show up for it.

7. or just enjoy life after the struggles of residency. do fun stuff on the side like search/rescue team, wilderness medicine, rural international medicine.....etc.

8. married/kids? that changes everything

I read an article about the 528th sustainer brigade and how they are docs for sf. Not berets but they do receive special tactics training. Here is the article. Any thoughts

 

[racerwad]

I read an article about the 528th sustainer brigade and how they are docs for sf. Not berets but they do receive special tactics training. Here is the article. Any thoughts

There is nothing in that article to suggest that anyone, especially physicians, ever leave the wire and provide care under fire. The addendum to the main article, from the perspective of the SORT team medic (who, out of the entire team, is most likely to see any action), is pretty clear:

(the team) often does not experience all of the front line combat trauma action like our brothers in the Ranger Battalions do. At times we find ourselves stuck inside the wire waiting to get elbows deep in some trauma, doing some sick call for the local nationals, listening to some lectures by the Docs

As everyone else has told you, to be operational as a physician in the role of an 18D, PJ (or anyone else, for that matter) is unlikely, especially if you weren't first a member of the community. That said, there are always opportunities for motivated individuals to get dirty in the civilian and military arenas.

 

[MoGhazidoc1990]

There is nothing in that article to suggest that anyone, especially physicians, ever leave the wire and provide care under fire. The addendum to the main article, from the perspective of the SORT team medic (who, out of the entire team, is most likely to see any action), is pretty clear:



As everyone else has told you, to be operational as a physician in the role of an 18D, PJ (or anyone else, for that matter) is unlikely, especially if you weren't first a member of the community. That said, there are always opportunities for motivated individuals to get dirty in the civilian and military arenas.

Your right buy still a pretty awesome job I think

 

[racerwad]

Your right buy still a pretty awesome job I think

Agreed, totally awesome job.