The primary role of 68W healthcare specialists in the U.S. Army is providing medical treatment to wounded soldiers. Other nations and services also have similarly-trained personnel, but this discussion and the following details apply only to those within the United States Army. These medics serve as the basic or first tier of the Army medical system accompanying units as small as platoons (approximately 12-40 soldiers) during training and deployments. Medics provide initial emergency medical care, evacuation, and supervision to other soldiers with medical training (such as Combat Lifesavers) as well as provide medical advice to unit chains of command.
In addition to first responder or combat medical support, medics provide paraprofessional care in medical treatment facilities—battalion aid stations, clinics, hospitals, etc.--to soldiers, military dependents, and authorized civilian personnel. In this capacity, healthcare specialists work under the supervision and purview of physician assistants and physicians and alongside other medical professionals.
Healthcare specialists are initially trained as Nationally Registered Emergency Medical Technicians (at the EMT-B level) with additional training in trauma and Army specific techniques and procedures. Maintenance of civilian accreditation is currently required and further education is commonly offered including the opportunity to add additional skill training or—with acceptable civilian education—application to the Inter-service Physician Assistant Program.
Civilian equivalents are difficult to assess given the broad range of skills and training healthcare specialists may have but most healthcare specialists without additional specialized training are trained in or work in areas overlapping civilian EMTs, medical assistants, patient administration personnel, office managers, schedulers, ambulance drivers, pharmacy technicians, phlebotomists, patient care assistants, and others.
Advanced level healthcare specialists who have not specialized generally assume more administrative duties in medical sections or treatment facilities as well as training and supervisory duties while maintaining perishable treatment skills.
Skill levels are appended to the MOS to identify positions a soldier may be assigned to and are followed by a letter code, Special Qualification Identifier, identifying special skills such as parachute qualification ("P") or Airborne Ranger qualification ("V"). When no appropriate skill modifier is used, a letter "O", erroneously read as a zero "0". For example, a healthcare specialist would be awarded MOS 68W1O.0 is an untrained medic prior to school completion.
1 is the basic entry level medic with ranks of Private through Specialist/Corporal (E-1 through E-4)
2 is a medic with the rank of Sergeant (E-5)
3 is a medic with the rank of Staff Sergeant (E-6)
4 is a medic with the rank of Sergeant First Class (E-7)
5 is a medic with the rank of Master Sergeant/First Sergeant (E-8) or Sergeant Major (E-9)
Skill identifiers are awarded to personnel with additional training in a particular specialty and affects what positions a soldier holding the skill identifier may be assigned to. Most require formal school training.F2 is an Army Critical Care Flight Paramedic (Awarded after completion of the Flight Paramedic Course 300-F1/F2)
F3 is an Army Flight Medic
M6 is the Army's Licensed Practical Nurse (No longer an ASI of 68W, M6 is now identified as 68C)
P1 is an Orthopedics specialist (No longer an ASI of 68W, P1 is now Identified as 68B)
Y8 is an Immunization-allergy specialist (clinical, lab)
N3 is the Army's Occupational Therapy Assistant (No longer an ASI of 68W, N3 is now identified as 68L)
N9 is a Physical Therapy Technician (No longer an ASI of 68W, N9 is now identified as 68F)
Y2 is the code used to identify those who have not finished the upgrade classes
18D is a Special Forces Medical Sergeant
W1 is a Special Operations Combat Medic (SOCM)
W2 is an Army Civil Affairs Medical Sergeant
W4 is an Army Civil Affairs Trauma Medical Sergeant
P3 is an Optometry specialist(No longer an ASI of 68W, P3 is now identified as 68Y)
Y6 is a Cardiovascular specialist (Cardiac Catheterization Technologist and Echocardiographer)(No longer an ASI of 68W, Y6 is now identified as 68N)
P2 is an Ear Nose and Throat (ENT) specialist (No longer an ASI of 68W, P2 is now identified as 68U)
Currently known as 68W, the Army's basic medical MOS was changed, effective October 1, 2006. During the Vietnam War era, the MOS codes 91W (91 Whiskey, nuclear medicine specialist), 91B (91 Bravo, medical NCO) and 91A (91 Alpha, medical corpsman) were used.
The Department of the Army Deputy Chief of Staff for Personnel issued a notice for future change for the MOS 91B and 91C (Licensed Practical Nurse) in September 1999. The notice established the transition of personnel holding both MOSs to 91W to begin on 1 October 2001 and end on 30 September 2007. The 91W MOS required additional training and the maintenance of civilian EMT certification which was previously optional for soldiers. Army personnel holding MOS 91C would become 91Ws (and later 68Ws) with an additional skill identifier of M6. During the transitory period, all 91B and 91C classified soldiers were given the Y2 identifier until completion of additional training to become 91W, reclassification to a different MOS, or discharge from the US Army.
Later—as part of an ongoing administrative revision of Army Enlisted MOSs—MOS 91W was redesignated 68W.
After completion of Basic Combat Training, soldiers training for 68W10 ship to Fort Sam Houston, Texas for Advanced Individual Training (AIT). The AIT or job training may last for 16 to 68 weeks, depending what additional skill training is completed. Training includes a combination of lecture, hands-on, and practical field exercises with many skills—including starting intravenous lines—practiced on each other. The first part of the course focuses on CPR and EMT-Basic training and concludes with certification tests for both skills. Further training is on Army specific tasks.
After assignment to a unit, 68Ws may, at the request of their unit's Physician Assistant (PA), attend any number of advanced topics. Topics are generally prescribed per each unit's functional role. For example, front-line combat medic (aka "line medic") may learn about advanced trauma treatments including venous cutdowns, placement of chest tubes, or use of specialty hemorrhage control methods. In the case of those attached to medical units, they may learn to administer medications which result in more definitive treatment than their civilian counterparts are allowed to.
Unlike civilian hospitals, field hospital units usually do not have a large number of 68WM6 (LPN), and instead use the combat medic who is readily available and partially trained. Some medics opt for EMT-I or EMT-P certification or additional certifications through civilian education.
Medics completing the equivalent of a bachelor's degree with required science prerequisites may apply for the Interservice Physician Assistant Program (IPAP). The intensive two-year program results in a Master of Physician Assistant Studies degree from the University of Nebraska Medical College, an officer's commission, and the opportunity to sit for civilian certification.
Healthcare specialist also serve as the primary source for recruiting for special operations medics including "18D" Special Forces Medical Sergeant and Ranger Medics. Those completing the assessment course for Special Forces, 160th SOAR, or the 75th Ranger Regiment are required to complete the Special Operations Combat Medic (SOCM) course ("W1"). SOCM qualified medics are assigned to the 75th Ranger Regiment (Ranger Medic), 160th Special Operations Aviation Regiment (SOAR Flight Medic), 96th Civil Affairs Battalion (CA-Med SGT), Special Operations Support Command, and in direct support positions of these United States Army Special Operation Command (USASOC) positions. The training is an intensive 10month Special Operations Combat Medic Course/18D located at Ft.Bragg, NC to be awarded the W1 identifier. The SOCM 68W is currently the most independent-duty enlisted medical personnel in the CMF 68 field.
SOCM medics work independently within specific protocols; the scope of practice may be expanded during the absence of a medical officer. SOCM medics assigned to special operations units regularly attend advanced medical and military training after the SOCM course to maintain interoperability with special operations forces.
SOCM (W1's) Credentials include:EMT Basic
BTLS/PHTLS (Basic Trauma Life Support/Prehospital Trauma Life Support) now called ITLS
ACLS (Advanced Cardiac Life Support)
PALS (Pediatric Advanced Life Support)
SOCOM ATP (Advanced Tactical Practitioner)
Current Tactical Combat Casualty Care (TCCC)guidelines
Advanced trauma surgical procedures
Health Care Specialists may be awarded the Combat Medical Badge (CMB) and Expert Field Medical Badge (EFMB), if they meet qualification requirements. The EFMB is awarded following successful completion of an extensive 2 week-long test of field medical skills (Many excellent medics fail this test). The Combat Medic Badge is given only to those medical personnel who are assigned or attached by appropriate orders to an infantry unit of brigade, regimental, or smaller size, or to a medical unit of company or smaller size, organic to an infantry unit of brigade or smaller size, during any period the infantry unit is engaged in actual ground combat are eligible for award of the badge, provided they are personally present and under fire during such ground combat.(AR 600-8-22)
The Health Care Specialist is primarily responsible for providing emergency medical treatment, limited primary care and health protection and evacuation from a point of injury or illness. Some of the duties as a Health Care Specialist may include:Administering emergency medical treatment to battlefield casualties
Assisting with outpatient and inpatient care and treatment
Interviewing patients and recording their medical histories
Taking patients' temperature, pulse and blood pressure
Preparing blood samples for laboratory analysis
Keeping health records and clinical files up-to-date
Giving shots and medicines to patients
Preparing patients, operating rooms, equipment and supplies for surgery
Initial stabilizing treatment and triage
Plan and conduct evacuation from the field of battle and en route life support
Supportive care in the event of delayed transport
Plan and Provide instructions for unit Combat Lifesaver programs
A Combat Lifesaver (CLS) is non-medic soldier with moderate emergency medical training to provide care at the point of wounding. Combat Lifesaver skills are intended for use in combat; however, the skills may be applied to soldiers in non-combat situations. The Combat Lifesaver is instructed in various techniques to treat and stabilize injuries related to combat. To include, but not limited to, blast injury, amputation, severe bleeding, penetrating chest injuries, simple airway management, and evacuation techniques. The Combat Lifesaver doctrine was developed as an effort to increase survivability in combat environments where the combat medic may not be readily available. The Combat Lifesaver is a bridge between self aid or buddy aid, and the Combat Medic (68W). The Combat Lifesaver can augment the Combat Medic, as needed. The 68W trains the Combat Lifesaver. It is a requirement that all IET (Initial Entry Training) soldiers complete the CLS (Combat Lifesaver) course, and pass the CLS exam during BCT (Basic Combat Training). Those IET Soldiers who fail to complete the course, or pass the exam are recycled to another Troop that is beginning the CLS Course.Basic casualty evaluation
Chest injury and tension pneumothorax management
Requesting medical evacuation