DoDI 1322.24

Department of Defense

INSTRUCTION
NUMBER 1322.24
July 12, 2002

ASD(HA)

SUBJECT: Medical Readiness Training
References: (a) DoD Instruction 1322.24, "Military Medical Readiness Skills Training,"
December 20, 1995 (hereby canceled)
(b) DoD Directive 1215.6, "Uniform Reserve, Training and Retirement
Category," March 14, 1997
(c) DoD Directive 1322.18, "Military Training," January 9, 1987
(d) Chairman of the Joint Chiefs of Staff Memorandum of Policy (MOP) 11,
"Status of Resources and Training System Reports," December 24, 1992
(e) Title 10, United States Code

1. REISSUANCE AND PURPOSE
This Instruction reissues reference (a), implements policy, assigns responsibilities, and
prescribes procedures for developing and sustaining comprehensive systems for
providing, assessing, and monitoring medical readiness training and medical skills
training for deployable military medical personnel.

2. APPLICABILITY
This Instruction applies to the Office of the Secretary of Defense, the Military
Departments, (including the Coast Guard, when it is not operating as a Military Service in
the Department of the Navy, by agreement with the Department of Transportation), the
Chairman of the Joint Chiefs of Staff, the Combatant Commands, the Inspector General
of the Department of Defense, the Defense Agencies, the DoD Field Activities, and all
other organizational entities within the Department of Defense (hereafter referred to
collectively as "the DoD Components").

DODI 1322.24, July 12, 2002

3. DEFINITIONS
Terms used in this Instruction are defined in enclosure 2.

4. POLICY
It is DoD policy that the appropriate training of military medical personnel is the
foundation for effective force health protection. Training must encompass all aspects of
medical support in combat, humanitarian, and homeland defense contingencies and
military medical personnel must be able to provide health service support in all types of
environments.

5. RESPONSIBILITIES
5.1. The Assistant Secretary of Defense for Health Affairs, under the Under
Secretary of Defense for Personnel and Readiness, shall:
5.1.1. Oversee and direct the programs and policies specified in this
Instruction.
5.1.2. Review medical readiness training annually.
5.1.3. Review the Military Services' program objective memorandum (POM)
projections and budget, and recommend reprogramming training funds, as required.
5.1.4. Ensure joint/interoperability medical readiness training meets the
Combatant Commanders' requirements.
5.1.5. Oversee the Defense Medical Readiness Training Institute (DMRTI).
While the Military Services have the responsibility for conducting Service-specific
training, the DMRTI facilitates joint training activities by:
5.1.5.1. Evaluating joint medical readiness training to identify and exploit
efficiencies.
5.1.5.2. Coordinating development of joint medical readiness
competencies based on the Executive Skills Competencies Medical Readiness Domain.
5.1.5.3. Developing, coordinating, evaluating, and facilitating valueadded joint medical readiness training initiatives and exercises.

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DODI 1322.24, July 12, 2002
5.1.5.4. Operating an Advanced Distributed Learning Center, acting as
the office of primary responsibility for distributed learning and/or technology-assisted
training in joint medical readiness.
5.1.5.5. Ensuring active and Reserve medical readiness training meet the
same standard.
5.1.5.6. Conducting and/or facilitating joint medical readiness programs
to prepare DoD medical personnel for a wide range of operations.
5.2. The Assistant Secretary of Defense for Reserve Affairs, under the Under
Secretary of Defense for Personnel and Readiness, shall:
5.2.1. Monitor whether medical readiness training standards and policy are
applied to Reserve personnel. When appropriate, review Services' POM projections and
budget submissions to ensure that they include Reserve component medical readiness
training.
5.2.2. Recommend to the Assistant Secretary of Defense for Health Affairs
(ASD(HA)) the length, organization, frequency, and content of military medical
readiness training courses that Reserve component members conduct or receive.
5.3. The Chairman of the Joint Chiefs of Staff shall advise the ASD(HA) on the
priorities for medical joint training requirements identified by the Combatant Commands.
5.4. The Secretaries of the Military Departments shall:
5.4.1. Issue policy and establish procedures to ensure both active and Reserve
components comply with section 4., above, to include:
5.4.1.1. Identifying and developing medical readiness training standards
to meet Military Service and the Combatant Commanders' missions and requirements.
5.4.1.2. Ensuring the Service member's commander is responsible for the
completion of both military and medical readiness skills training.
5.4.1.3. Periodically assessing and inspecting appropriate medical
readiness training to ensure that it is in accordance with Service policies.
5.4.1.4. Establishing a method to monitor and report the status of medical
readiness training, including the monthly review of medical personnel's certification and
unit medical readiness training.

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DODI 1322.24, July 12, 2002
5.4.1.5. Maintaining regional medical field training sites, including
ARNG Medical Company Training Sites (MCTS), and local operational training sets to
maximize the tri-Service use of these sites.
5.4.1.6. Ensuring medical units participate in realistic training through
joint and combined exercises so that they meet the Combatant Commanders'
requirements for health service support (HSS).
5.4.2. Program, budget, and account for the costs of implementing this
Instruction across all the DoD Components.
5.4.3. Ensure that medical skills training shall be conducted according to this
Instruction and the criteria in DoD Directive 1215.6 and DoD Directive 1322.18
(references (b) and (c)). Non-medical instructors who have completed first aid
instruction may conduct the training where appropriate.
5.4.4. Ensure that all military personnel shall be able to perform basic first aid
(commonly referred to as Self Aid/Buddy Care).
5.4.5. Ensure that medical personnel and medical units shall receive initial and
sustainment medical readiness training for their primary duties within the HSS mission.
5.4.6. Ensure that medical personnel shall complete all Military Service and
Combatant Command requirements for initial medical readiness training within 12
months of arriving to their first permanent duty station. The exception is Reserve
component split option training, which shall be completed as soon as practical.

6. PROCEDURES
6.1. Military and medical skills training shall focus first on early deployers and
ensure that the major theater operation and contingency plans meet medical support
requirements.
6.2. During each training cycle, medical personnel receive an operational unit
mission briefing on the member's assigned billet for mobilization or deployment.
Preferably, it shall be conducted in a like environment and with the type of equipment
that the member shall use. This may be included in the 5 days of operational platform
medical readiness training.
6.3. Following the criteria for the medical readiness training certification and
documentation process in enclosure 3, the Commander to whom the Service member is
normally assigned shall ensure documentation of medical readiness training in:
6.3.1. The medical readiness training record.
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DODI 1322.24, July 12, 2002
6.3.2. The Centralized Credentials Quality Assurance System (CCQAS) for
medical personnel with clinical privileges.
6.3.3. The appropriate records for all other personnel with deployment
assignments.
6.4. Unit commanders shall review the medical readiness training status of military
personnel periodically and, when requested, provide it to the ASD(HA), the Assistant
Secretary of Defense (Reserve Affairs), or the Deputy Under Secretary of Defense
(Readiness).
6.5. Medical personnel with deployment assignments or identified as M+1
augmentees shall perform a minimum of 5 days (preferably consecutive) of medical
readiness during each training cycle. The goal is to conduct training in the environment
and with the type of equipment that the member will use and with a similar unit with
which the member is scheduled to deploy or backfill. Training shall address the
individual, collective, unit, and leadership skills required to perform individual
assignments.
6.6. The Military Departments shall program for medical personnel to physically
train, at least once every other training cycle, with their designated operational unit and
equipment assemblages according to this Instruction.
6.7. The U.S. Joint Forces Command (USJFCOM) shall include (during one of the
Chairman of the Joint Chiefs of Staff-sponsored exercises) as a minimum on a biennial
basis an exercise objective to conduct interoperability training of early deploying Service
medical forces. The USJFCOM and the Military Departments shall program to support
the participation of medical units in this exercise. Typically, each Service will exercise a
Level II unit capability and at least one Service will exercise a Level III unit capability.
The respective medical evacuation and Aeromedical Evacuation (AE) units will be
required from each Military Department. This exercise objective shall include the Active
and Reserve component in order to exercise HSS requirements (e.g., backfill, AE
interface, and bed expansion).
6.8. Combatant Commanders shall include medical requirements in the Joint
Mission Essential Task Lists. The Commander-in-Chief, USJFCOM, shall program,
plan, and provide forces for at least one exercise annually that meets the criteria in
paragraph 6.7.
6.9. The Service member's Commander responsible for training shall ensure that
documentation of training is completed as outlined in enclosure 3. The Commander shall
ensure validation of training status, capabilities, and readiness is reported in the Status Of
Resources and Training System (SORTS) report (reference (d)).

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DODI 1322.24, July 12, 2002
6.10. Readiness training programs shall include realistic individual and collective
medical skills training and maximize the use of emerging technology, such as distance
learning, computer simulation, and virtual reality.
6.11. Medical personnel projected to serve on a Joint Task Force/Joint Force
Commander's (JTF/JFC) or Service (Air Force forces (AFFOR), Army Forces (ARFOR),
Navy Forces (NAVFOR), Marine Forces (MARFOR), or Special Operations Forces
(SOF)) Component Headquarters' staff shall receive training required to prepare them for
their assignment. Training strategies for Combatant Commander/Service Component
staff personnel who deploy early shall address mission-critical interoperability and joint
tasks during annual training. If possible, early-deploying staff personnel shall exercise
annually with their designated organization.
6.12. See enclosure 3 for examples of sustainment training.

7. EFFECTIVE DATE
This Instruction is effective immediately.

Enclosures - 3
E1. Definitions
E2. Medical Readiness Training Certification
E3. Sustainment Training Activities

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DODI 1322.24, July 12, 2002
E1. ENCLOSURE 1
DEFINITIONS

E1.1. DEFINED TERMS
E1.1.1. Air Force Forces (AFFOR). Air Force component of a joint force.
E1.1.2. Army Forces (ARFOR). Army component of a joint force.
E1.1.3. Early Deployer. Those units, as defined by the Service component, that
deploy to an operation within the first 30 days.
E1.1.4. Headquarters Mission Support Training. Courses, training, and exercises
that orient and develop medical personnel assigned to deployable joint and Service
component surgeon staffs. This includes personnel assigned to patient movement,
command and control, blood program, medical logistics, medical intelligence, and
medical surveillance functions.
E1.1.5. Initial Medical Readiness Training. Service-specific requirements and
training given to medical personnel during the first 12 months of assignment to their
mobility unit/platform. This training shall concentrate on individual development and
include:
E1.1.5.1. Surviving and operating in a combat environment and is not limited
to weapons qualification or familiarization. Training shall include chemical/biological
warfare defense training, site security, and fire fighting.
E1.1.5.2. Completing mobility requirements for individuals assigned to a
deployment position, including routine immunizations.
E1.1.6. Joint Training. Military training based on joint doctrine to prepare forces
and/or joint staffs to respond to the Combatant Commands' operational requirements to
execute their assigned missions. Training has as its outcome:
E1.1.6.1. Recognizing of the interoperability of forces.
E1.1.6.2. Understanding of individual Service capabilities and limitations.
E1.1.6.3. Synchronizing and integrating force capabilities.

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DODI 1322.24, July 12, 2002
E1.1.7. Medical Personnel. Healthcare delivery personnel assigned to all units in
support of all aspects of the health services support mission, and/or support of operational
health services support throughout all military operations.
E1.1.8. Marine Forces (MARFOR). Marine Corps component of a joint force.
E1.1.9. Medical Readiness Training (MRT). Courses, hands-on training programs,
and exercises designed to develop and enhance survival skills and maintain military
medical skills. MRT includes individual, collective, and unit training, both initial and
sustainment, required to ensure healthcare personnel and units are capable of performing
operational missions.
E1.1.10. Medical Readiness Training Certification. A process that verifies
healthcare personnel (officer and enlisted) are prepared for operational requirements.
The Commander reviews and verifies individual, collective, and unit medical readiness
training, education, and experiences as a critical element of the process.
E1.1.11. Military Indoctrination Training Date. The date an officer completed
Service-specific entry-level training, such as Officer Basic Course for the Army, Officer
Indoctrination Course for the Navy, and Commissioned Officers Training Course for
medical service officers in the Air Force, that meets deployability requirements under
Title 10, U.S.C. (reference (e)). For enlisted personnel, the date Service-specific entrylevel training, such as Basic Training, Basic Military Training, or Boot Camp is
completed.
E1.1.12. Military Medical Skills. Skills and tasks necessary for medical personnel
to accomplish mission-essential tasks to support the full spectrum of military operations.
E1.1.13. Navy Forces (NAVFOR). Navy component of a joint force.
E1.1.14. Operational Billet. A manpower position authorized for mobilization or
deployment.
E1.1.15. Operational Platform. Any operational, deployable unit, unit-type code or
pre-positioned asset(s). This includes personnel and Deployable Medical Systems
equipment.
E1.1.16. Operational Unit Mission Briefing. Detailed explanation of the unit's role
during mobilization or deployment that shall, at a minimum, include concept of
operations for all operational plans the unit is scheduled to support; deployment sequence
(e.g., time phased force and deployment list (TPFDL) C-date); medical unit commander's
intent; mission-essential tasks; SOPs; medical equipment; medical information
capabilities; and action plan to correct unit training weaknesses.

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DODI 1322.24, July 12, 2002
E1.1.17. Reserve Component. The non-active Service component. Examples are
the Army National Guard, the Army Reserve, Naval Reserve, Marine Corps Reserve, Air
National Guard, Air Force Reserve, and Coast Guard Reserve.
E1.1.18. Special Operations Forces (SOF). Those active and Reserve component
forces of the Military Services designated by the Secretary of Defense and specifically
organized, trained, and equipped to conduct and support special operations.
E1.1.19. Sustainment Medical Readiness Training. Sustainment training is the
training required to maintain or enhance the proficiency of individual and unit/platform
skills.
E1.1.20. Training Cycle. That period of time, as defined by each Service
component, that all mandatory medical readiness training shall be completed.
E1.1.21. TRICARE. A tri-Service managed care program that provides all
healthcare for DoD beneficiaries within a DoD geographical region.
E1.1.22. Wound and Casualty Management. Wound management refers to medical
skills that are needed to care for trauma, disease, or non-battle injury patient conditions.
Casualty management refers to those skills that are needed to triage and regulate
casualties, including medical land and air evacuation, and staging.
E1.2. OTHER TERMS
The following terms, used in this Instruction, are defined in DoD Directive 1322.18
(reference (c)):
E1.2.1. Training.
E1.2.2. Individual Training.
E1.2.3. Collective Training.
E1.2.4. Unit Training.
E1.2.5. Institutional Training.
E1.2.6. On-the-Job Training.
E1.2.7. Leadership Training.

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DODI 1322.24, July 12, 2002
E2. ENCLOSURE 2
MEDICAL READINESS TRAINING CERTIFICATION

E2.1.1. Military personnel records shall document whether each member has
completed military indoctrination training consistent with Service doctrine. In addition,
units shall document in individual medical readiness training/mobility records the
completion of initial and sustainment medical readiness training.
E2.1.2. The Commander shall ensure all training and administrative requirements
are met. The chain of command shall exercise oversight responsibilities in concert
coexistent with this Instruction.
E2.1.3. Minimum medical readiness training requirements are:
E2.1.3.1. Initial Medical Readiness Training Completed. Active duty medical
personnel shall complete their Service-specific initial medical readiness within 12 months
of arrival at their first permanent duty station. The date of completion shall be
documented in medical readiness training records. This training shall concentrate on
individual development and shall as a minimum include:
E2.1.3.1.1. The ability to survive and operate in a combat environment
includes, but is not limited to weapons qualification or familiarization,
chemical/biological warfare defense training, site security, and fire fighting (fire fighting
does not pertain to Naval Reserve medical officers).
E2.1.3.1.2. Individuals assigned to a deployment position including
completion of administrative requirements and medical/dental screening.
E2.1.3.2. Sustainment Medical Readiness Training Certification Date. The
date an individual has performed operational sustainment training, as the Service and
operational chain of command determines, within the training cycle. This information
shall be maintained in the medical readiness training records.
E2.1.3.3. Sustainment Medical Readiness Training. This training shall focus
on continuing individual development, maintaining Military Service-specific training and
emphasizing collective, unit, and possibly platform training:
E2.1.3.3.1. All military medical personnel shall train to maintain
proficiency in military medical readiness skills.
E2.1.3.3.2. All medical personnel assigned to a medical operational
platform or unit shall:

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DODI 1322.24, July 12, 2002
E2.1.3.3.2.1. Maintain medical readiness skills through completing:
E2.1.3.3.2.1.1. Military Specialty Sustainment Training.
Training required to perform critical military tasks appropriate for the operational
assignment. Training will include:
E2.1.3.3.2.1.1.1. Threat and future battlefield environment.
E2.1.3.3.2.1.1.2. Operational command and control.
E2.1.3.3.2.1.1.3. Communications systems in wartime.
E2.1.3.3.2.1.1.4. Wartime conceptions of operations as
well as chemical and biological warfare defense measures.
E2.1.3.3.2.1.1.5. Weapons training.
E2.1.3.3.2.1.2. Medical Specialty Sustainment Training.
Training to perform critical medical tasks appropriate to the operational assignment. The
minimum requirements include training in:
E2.1.3.3.2.1.2.1. Gunshot, vascular, orthopedic, burn,
neurological, maxillofacial, and hypo/hyper-thermal stress injuries.
E2.1.3.3.2.1.2.2. Infectious diseases.
E2.1.3.3.2.1.2.3. Combat stress control.
E2.1.3.3.2.1.2.4. Hypovolemic shock and the use of blood
fluids.
E2.1.3.3.2.1.2.5. Wound and casualty management.
E2.1.3.3.2.1.2.6. Triage and initial evaluation.
E2.1.3.3.2.1.2.7. Emergency airway management.
E2.1.3.3.2.1.2.8. Field sanitation and hygiene.
E2.1.3.3.2.1.2.9. Disease prevention.
E2.1.3.3.2.1.2.10. Aeromedical evacuation and staging.
E2.1.3.3.2.1.2.11. Recognition and treatment of chemical,
biological, radiological, nuclear, and explosive injuries.

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DODI 1322.24, July 12, 2002
E2.1.3.3.2.2. Complete required sustainment medical readiness
training in accordance with the Military Service-specific training cycle.
E2.1.3.3.2.3. Complete requirements for mobility, including theaterspecific immunizations.
E2.1.3.3.2.4. Participate in realistic individual, collective, and unit
medical readiness training, including joint and combined exercises or deployment.
E2.1.4. The following data shall be recorded in the medical readiness fields in
CCQAS for healthcare providers with credentials as well as in the medical readiness
training records for all personnel:
E2.1.4.1. All members shall record the date they complete a military
indoctrination course.
E2.1.4.2. Members assigned to operational billets or platforms shall record:
E2.1.4.2.1. Current mobilization platform unit identification code, if
known.
E2.1.4.2.2. The date they complete Military Service-specific initial
medical readiness training.
E2.1.4.2.3. The date of sustainment medical readiness training.
E2.1.4.2.4. Practice specialty for deployment and/or mobilization.
E2.2.5. Minimum training requirements for JTF/JFC Component Headquarters
Staff:
E2.2.5.1. Initial Headquarters Mission Support Training. Training (and/or
certification) required for individuals to direct or work on a JTF/JFC Surgeon staff or
Service component (ARFOR, MARFOR, NAVFOR, ARFOR, or SOF) headquarters
surgeon staff. Training includes:
E2.2.5.1.1. Knowledge in command relationships.
E2.2.5.1.2. Command and control processes.
E2.2.5.1.3. Joint planning and execution.
E2.2.5.1.4. Medical intelligence.
E2.2.5.1.5. Service and Joint operations.

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DODI 1322.24, July 12, 2002
E2.2.5.1.6. Logistics.
E2.2.5.1.7. Health service doctrine.
E2.2.5.1.8. Specific subject matter expertise skills (aeromedical
evacuation, blood management, medical logistics, medical regulating, etc.).
E2.2.5.2. Sustainment Headquarters Mission Support Training. Training
required to remain certified to direct or work on a JTF Surgeon staff or Service
component headquarters surgeon staff.

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DODI 1322.24, July 12, 2002
E3. ENCLOSURE 3
SUSTAINMENT TRAINING ACTIVITIES

E3.1.1. Mutual Support. Those activities performed by Reserve component medical
personnel in active duty medical treatment facilities (MTF) during Inactive Duty training
(IDT) and/or Annual training (AT).
E3.1.2. Affiliation Agreements. Formal written agreements negotiated between
military and non-military MTFs such as civilian or Veterans Affairs hospitals, where
military medical personnel are permitted to perform patient care duties in a clinical
environment.
E3.1.3. Classroom Instruction. Lectures, conferences, and/or practical exercises
conducted in a classroom environment. This includes classes given in the unit as well as
those outside the unit, such as at a regional training center, an active duty training center,
a local university, or junior college.
E3.1.4. Field Exercises. Training conducted outside the classroom, normally
employing unit equipment, and operating under simulated combat conditions. An
example of a field exercise is where a unit sets up its medical equipment and simulates
the transportation, reception, and treatment of casualties.
E3.1.5. Mission Support. Activities performed by medical personnel to accomplish
the unit's peacetime mission, such as conducting physical examinations, giving
immunizations, providing medical support during weapons qualifications and physical
fitness testing, conducting routine sick call or sick bay, providing services in support of
TRICARE, and other similar activities.
E3.1.6. Specialty-Specific Sustainment Training. Medical readiness training that is
unique to an individual's specialty and may involve performing duties in a deployed
setting. Individuals identified to remain at home station in wartime (i.e., nongenerational/non-deployable personnel) shall train to perform their duties under the most
demanding wartime scenario.

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ENCLOSURE 3