Lifesaving knowledge, TCCC, Leadership are Key Components of Advanced Combat Medical Experience

Three military medical students take cover behind a flimsy tent. One holds a gun while they look around the side of the tent. Students secure the area before treating ‘injured’ volunteers. (Photo by Tom Balfour)
 By MC3 Robert Ferrone

For medical students, on the job training is a necessity. Being able to apply all the things learned from books to real-life situations is an essential skill. However, most medical students don’t experience anything quite like the training at the Uniformed Services University of the Health Sciences (USU).

One male and one female student treat a "patient" in a cutsuit in a forested area.
Volunteers wear cutsuits that allow students to practice treating
 injured service members in the field. (Photo by Tom Balfour)
From across campus, you can hear shrill screams from the woods. The cries for help may sound genuine to a visitor, passerby or new student. But anyone who has been at USU for a while knows every August, this is commonplace.

It marks the Advanced Combat Medical Experience, or ACME; a four-day exercise that all second-year USU medical students complete, featuring interactive panels with wounded warriors, small group pain management sessions, hands-on casualty care and in-depth testing. For students serving as peer teaching assistants, the experience lasts nearly a month.

The medical students’ experiences prior to USU range widely from previous military or medical work to recent college graduates with no medical background. Creating a curriculum that benefits students no matter their previous training, without leaving anyone behind or rehashing already known information, is no small task.

Enter Dr. Craig Goolsby, vice chair of education for USU’s Military and Emergency Medicine Department, and ACME course director.

“USU graduates should understand modern battlefield medicine,” Goolsby said. “ACME teaches medical students the life-saving knowledge and skills of tactical combat casualty care, while educating them about their responsibility as future military medical leaders to ensure excellent care for wounded warriors at the point of injury.”

One female military medical student writes something on a pad while another male student holds a medical instrument over a volunteer wearing a cutsuit, awaiting her response.
Applying techniques they've learned, students treat an ‘injured’ service member. (Photo by Tom Balfour)

Whether it’s treating patients in a dark, smoky room simulating a recent explosion, or in the woods while being bombarded with paintballs, ACME is sure to put students in a situation they aren’t familiar with. And that’s the point.

2nd Lt. Joel Schirding, second-year student at USU, is no stranger to the military or medical field. He is an ROTC graduate who commissioned as an Army nurse in 2008, also training as a paramedic.

“Since I worked in the military health system for years, I feel like I got a good perspective of what my patient population was and the culture of the Army,” Schirding said. “I tried working civilian health care as an ER nurse and paramedic for a short time and it was nothing compared to the military system.”

But while anticipating the start of ACME in August, Schirding wasn’t sure what to expect.

“I was a little unsure of what ACME was going to be like before starting,” he said. “Up to this point my perspective on health care has been from either the role of a paramedic or a nurse and it was refreshing to begin thinking more like a physician.”

Two military medical students treat a volunteer wearing a cutsuit. They are in semi darkness with only red headlamps for light
In the SimCenter, students treat patients low-visibility
environment. (Photo by Tom Balfour)
It’s difficult to recreate combat scenarios without risking the safety of everyone involved. ACME is set up with all this in mind, whether you’re a student holding a scalpel, or a cut suit actor under the knife.

Schirding, with his years of experience in military medicine, had no problem taking away new skills and information from ACME.

“I better appreciate the larger responsibility a military physician has in healthcare,” he said. “It isn't just to provide direct care to patients, but also provide guidance, administration, training, leadership, research, etc.”

But, ACME is just the beginning. The culmination of all the students’ training comes to a head each fall at Bushmaster, an exercise for fourth-year students that takes place in Pennsylvania. Performance at ACME is integral to successful completion of Bushmaster, and they go hand-in-hand.

“ACME is part 2 of a 4 step processes, culminating in Bushmaster,” Schirding said. “Therefore, go into the course expecting to learn. ACME gives you an appreciation for pre-hospital/combat care, and by the end of it you will . . .  [have] a solid foundation and hopefully [be] thirsting for more.”