Medical Skill Set Comparison 18D and AF Course

“They truly didn’t understand what they had, or why it was necessary.”

Two of the few that did understand was then MAJ Frank Toney, in charge of SF Department Training Committees; and COL Richard Potter, the USAJFKSWCS executive officer formerly with Delta.

Two of my favorite officers to this day.
 
“They truly didn’t understand what they had, or why it was necessary.”

Two of the few that did understand was then MAJ Frank Toney, in charge of SF Department Training Committees; and COL Richard Potter, the USAJFKSWCS executive officer formerly with Delta.

Two of my favorite officers to this day.
Neither of whom, nor none of the medical visionaries ever returned.

My casual observation of most officers is it takes them a year to understand what they’re looking at, then another year to figure out what to do with it. But then it’s too late as they typically only stay in an assignment for 18-24 months.

Amazing anything ever gets done ...
 
I am curious to see what specific skill sets are taught at to the members of 18D specialty and PJ's.

Does anyone has a up-to-date detailed list of skills taught?
Sorry for jacking your thread ...

Short version - SF Medics are one step shy of being a physician’s assistant. They are trained in trauma medicine, sports medicine, family care, preventive medicine and public health, as well as animal husbandry (veterinary medicine).

The nature of their missions range from unconventional warfare (the original and most important mission of Special Forces), foreign internal defense, special reconnaissance, direct action, and counter-terrorism. Other duties include combat search and rescue (CSAR - similar to PJs), counter-narcotics, counter-proliferation, hostage rescue, humanitarian assistance, humanitarian demining, information operations, peacekeeping, psychological operations, security assistance, and manhunts.

Sorry, won’t comment on PJs - I’ll leave that to you guys.
 

Yukon

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my accredited comment was to the live tissue training at Wilford Hall. Accreditation for emt, paramedic and live tissue training wasn't a requirement of concern for enlisted skills and qualification requirements until the 1980s.

There was much change occurring to all sorts of occupation/vocation credentialing, certifications and even licensure to practice a profession (physician, lawyer, etc) that began happening in the mid 1970s and actually continued into the 1990s. several scandals making the newspapers involving high ranking AF physicians and lawyers have back story to these changes that never got attention in the news (simple explanation was they believed they were grandfathered under old polices and having rank and position to protect them). All the branches had these problems, but my familiarity is with the AF scandals that made the news late 1980s and early 1990s.
 
Animal rights activists shut down SF Medic live tissue training a couple of times over the years. DoD noticed, and wrote a regulation pertinent to all branches of the service stating that any training program using animal models needed to be AAALAC accredited. That got turned into a paragraph by the Army saying see this DoD regulation and comply. Of course SF was paying close attention, turned to the USAJFKSWCS veterinarian and said make it happen. CPT Gary Coleman addressed the veterinarian aspects of facility and procedures with animals - the facility was upgraded accordingly, and lesson plans changed as needed. I did the final write up for submission. They came to inspect, we passed with flying colors.

Again, prior to us in 1987, supposedly there were no facilities within DoD accredited - not Army, Air Force, Navy, etc. I have no way to verify this, only going on what we were told.

That sort of set the stage for getting the medics credentialed as EMT for entry level, and Paramedic for senior medics, as the hospitals were being pissy, so we bypassed the driftwood. We were in the process of changing our part of the instruction from 9 to 13 weeks, so we just included it in our changes because Ft Sam was also being a pain. Simultaneously we had to develop the course for senior medics, so again. It was entertaining when we had to scrub it (do a review) at Ft Sam. Ft Sam kept trying to insist some of the training necessary to be able to take the EMT or Paramedic exams weren’t within the scope of duty of our medics. We fired back with foreign internal defense, humanitarian assistance, etc.

Heads exploded as not only could they not refute our training, but we also had the only accredited facility where ATLS could be done within regulations.
 
I am curious to see what specific skill sets are taught at to the members of 18D specialty and PJ's.

Does anyone has a up-to-date detailed list of skills taught?
Maybe should add that an SF Team also called an “A-Team” (B is company level, C is battalion level) consists of two weapons sergeants(18B), two comms sergeants (18E), two medics (18D), two engineers (18C) (demo experts), one intel specialist (18F), one operations sergeant(18Z), a warrant officer (180A), and a team leader (a captain, 18A). Minimum SF and jump qualified, additional is HALO and SCUBA.
 

Yukon

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Pararescue medical training is self contained under the Pararescue School at Kirtland AFB, New Mexico. It has been self contained at the Pararescue school since 1976 (use of AF IDMT prerequisite course at Sheppard AFB, discontinue) and other than the Live tissue training being done for a short period at Wilford Hall, ca. 1989-1995 and required entry-level medical training for award of Pararescue Specialty (AFSC) transferred to the Special Operations Forces Medical Skills Sustainment Program (SOFMSSP) at Ft Bragg during the period from 1995 to 2000.

It is DOD Directive number 3216.1 April 17, 1995, Use of Laboratory Animal in DoD Programs, implementing: 1-2. Designates the Secretary of the Army as DoD Executive agent to issue Service regulations to implement this directive. DOD Directive was reissues as an Instruction in 2010. DODI 3216.01, September 123, 2010, Use of Animals in DOD programs states: Reference (a) designation of the Secretary of the Army as the DoD Executive Agent to develop and issue Service regulations to implement Reference (a) has been cancelled pursuant to Deputy Secretary of Defense Memorandum (Reference (c)).

Current DOD Policy is DODI 3216.1, March 20, 2019.
 

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Yukon

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The consolidation of medical training with a few exceptions began happening in 2011 with Army-Air Force consolidation and by 2012 Navy and USMC began integrating its medical training in what is called the Medical Education and Training Campus (METC) on Fort Sam Houston. To the best of my knowledge Pararescue medical training conducted at Kirtland AFB, NM isn't a field training element of the U.S. Army Medical Center of Excellence (MEDCoE), headquartered at Fort Sam Houston.

I'm uncertain of what affiliation training locations have with Army at Ft Sam and other accreditation agencies as It's a full time job keeping track of such changes happening within even the Air Force.

It is even difficult to decipher accuracy of info on various official websites as for example: United States Army School of Aviation Medicine.

This training location is a field element of the U.S. Army Medical Center of Excellence (MEDCoE), headquartered at Fort Sam Houston. USASAM is the Army’s center of excellence for training Army Flight Surgeons, Aeromedical Physician Assistants, Flight Medics, and Aeromedical Evacuation Officers. Concurrently, USASAM provides initial and sustainment aeromedical training in 32 Training and Doctrine Command Programs of Instruction for both fixed and rotary wing flight students. USASAM also provides high altitude physiology training for Aviation, Special Operations, and Aeromedical personnel in the Army`s only training hypobaric (altitude) chamber and is the proponent for the DoD’s only Aeromedical Psychology Training Course.

Psychology is emphasized by me in red as the casual reader may consider it reading as physiology. As the Army doesn't have high performance fighter, bomber, and other aircraft operated by Air Force, Navy, and USMC proponent of the only DOD Aeromedical Psychology Training Course is a suspect claim. The potential for other courses of similar nature is USAFSAM readies operational mental health care providers. This press release make no mention of the U.S. Army Medical Center of Excellence (MEDCoE), headquartered at Fort Sam Houston or the United States Army School of Aviation Medicine at Ft Rucker.

Enlisted medical training began getting connected to civilian EMT/Paramedic standards in the late 1980s. Air Force medics have option to get Paramedic but the required minimum is EMT. Air Force IDMTs gained official endorsement to acquire the National Provider Identifier; Type I as “Military Health Care Provider/Independent Duty Medical Technician” in 2009. The intent of this summary is having some civilian NGO or State certification and training accreditations didn't start as a small rolling down hill as being encouraged until 1972 and transitioned to an avalanche of being required until the late 1980s. Keeping track of when and where for all potential medical occupations in all of the military services is almost a full time job. As I was a PJ I have a good grasp of when and why for pararescue and somewhat the Air Force.

Combat Paramedic Course (CPC) Pilot Program, est 2020.
 
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pjbluetogreen

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So, there has been a lot of information presented in this thread. About the Skills set differences between PJ and 18Ds.
Yukon has some absolutely amazing historical points. Love the Research And data.

I am one of the few guys that has been both, (a PJ at the 48th 06-08 and the 321 09-11, and I have been Senior 18D since 2017.) As well, I have worked as a CTM instructor at SOCM.

I my experience and opinion, “the skills set” difference is almost completely based on the 18Ds lab set. Which in reality after SFMS is realty used. 18Ds and PJs run almost a reverse trajectory in medical skills and knowledge as their careers progress. If I was given a choice between a PJ and an 18d to be my jr medic straight out of the school house (without any additional training) I would pick a PJ hands down. However, within a short time frame a PJ will often lose their medical knowledge that I want as a Jr.
As a PJ 3 level becomes a 5 level Medical knowledge is often replaced with Tech Rescue. A new PJ out of the course is like a good Fire medic, the 5 level is a Fire Engineer that is still good at most medic, and 7 and 9 level is a good Fire Captain, great at the tech rescue, scene management but aside from emergency trauma skills their medical skills have likely dwindled. All levels of PJs are paramedics but the longer further in time they areaway from the school house the more limited the knowledge base becomes.

Now, if I need to pick a new senior medic 2-4 yrs post training time, I am looking a 18Ds almost exclusively. The training/knowledge 18d receive from the direct mentorship of Sr 18Ds and Battalion Docs specifically on medicine is extensive. Their deployment and forward care experience in PFC have often expanded their scope and ability to do good medicine.

As I said this is my opinion that I have developed having been both a PJ and 18D.
cheers

CL
 
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Yukon

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Unfortunately, the intensified requirement to get promoted under the AF enlisted PME model combined with lesser need in numbers of (using the flre department terminology) of Fire Engineer and and Fire Captain) is problematic particularly with CCT, PJ, SR and SOF TACP competing for the same Fire Engineer and Fire Captain Positions within the AF Special Warfare organization and authorized funded manpower structure. The most visible result of this is how many enlisted CCT/PJ holding award of 9-skill level are in Senior Enlisted Advisor positions and joint staff positions and a few have progressed to the 0-skill level. The 0-skill level if researched was the warrant officer until eliminated from the Air Force force structure in late 1950s and 1960s).

However at the 7-level, if one actually competent and proficient in being mission ready, the knowledge base is quite extensive. The best resource to use to making comparisons is the Air Force Career Field Education and Training Plan (CFETP) for Pararescue and whatever the Army's 18d Equivalent is.
 

Yukon

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Unfortunately, the intensified requirement to get promoted under the AF enlisted PME model combined with lesser need in numbers of (using the flre department terminology) of Fire Engineer and and Fire Captain) is problematic particularly with CCT, PJ, SR and SOF TACP competing for the same Fire Engineer and Fire Captain Positions within the AF Special Warfare organization and authorized funded manpower structure. The most visible result of this is how many enlisted CCT/PJ holding award of 9-skill level are in Senior Enlisted Advisor positions and joint staff positions and a few have progressed to the 0-skill level. The 0-skill level if researched was the warrant officer until eliminated from the Air Force force structure in late 1950s and 1960s).

However at the 7-level, if one actually competent and proficient in being mission ready, the knowledge base is quite extensive. The best resource to use to making comparisons is the Air Force Career Field Education and Training Plan (CFETP) for Pararescue and whatever the Army's 18d Equivalent is.

Pararescue CFETP
 

pjbluetogreen

Operator
One other major update with the Army SOCM program as of this year, Paramedic is now a requirement for graduation but is it not required to maintain it afterwards at this time.
The certs of being a Paramedic or not have some but little to due with my above comment.
 
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