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Combat Casualty Care Course (C4)

Format: In-person

C4 is a continuing medical education program designed to enhance the operational medical readiness and pre-deployment trauma training skills of tri-service, medical officers.  Training includes a 3-day course designed to enhance medical readiness of physicians, physicians assistants, nurses, dentists, and other medical specialties by providing training in field leadership that prepares medical officers with the knowledge critical in conducting Role I and Role II healthcare operations in an austere, combat environment.  Students progress through the phases of TCCC from Care Under Fire, Tactical Field and Tactical Evacuation Care, through the roles of care, from point-of-injury to Role II scenarios.  Lanes simulate mission-oriented medical scenarios of Village Stability Operations (VSO), Mass Casualty (MASCAL) events, Military Operations on Urban Terrain (MOUT), and a simulated Role II facility utilizing simulator technology. Students encounter combat scenarios in varying roles of leadership and team organization and participate in the planning, rehearsals, and execution of the medical mission. After successful completion of C4, students receive the National Association of Emergency Medical Technicians (NAEMT) TCCC Certification.  The NAEMT TCCC course is the only TCCC course endorsed by the American College of Surgeons.


The student must be a medical department officer and have one-year service obligation and/or retainability after completion of this course.  The target audience is new accession officers.  International military students, that meet the requirements for their military services, may attend on a space availability basis.  Students must meet medical worldwide qualification and cannot be on a temporary or permanent medical profile.  Students must have a concurrent reservation in 6A-C4 (ATLS), Advanced Trauma Life Support; 6A-C4 (TNCC), Trauma Nursing Core Course; or 6A-PHTLS), Prehospital Trauma Life Support.  Reservations in the concurrent courses are based on student's medical specialty:  Physicians (MC) attend ATLS, Nurses (ANC/NC/AFNC) attend TNCC, and Dentists (DC) and Physician Assistants (SP/BSC/MSC) may attend ATLS if seating is available, otherwise all other medical specialties attend PHTLS.  Nurses are allowed to attend PHTLS, if they have a current certification in TNCC. 


At the conclusion of the professional programs, the course moves to the field as students rotate through various training stations in an operational environment.  Areas of instruction and practical evaluation are varied and complex. 

Course Links:

Upcoming Courses

If you enrolled into the C4 course less than 40 days from the course start date, or have not already been contacted by the C4 registrar, please contact our Academic Support Branch to confirm course attendance and receive further instructions.

Course dates can be located in ATRRS in the course catalog, school code 767.

    All courses are located in San Antonio. The C4 and associated professional courses are taken together. They may not be taken separately.

    • Day 1: Report date  
    • Days 2-4: Professional courses (ATLS, PHTLS, TNCC)
    • Days 5-8: C4 field training (also depart on day 8)

    All course dates may be rescheduled if the minimum student quota requirement has not been met.  In the rare event of course cancellation or date change, DMRTI will notify all students as soon as changes are confirmed.  Confirmed registered students will have priority in the next course.

    *Course dates cancelled due to COVID-19 travel restrictions.  Dates may be rescheduled once approved.

    Class  Report Date  Start Date  End Date 
    198  15 Sep 2019 16 Sep 2019 19 Sep 2019
    201  20 Oct 2019  21 Oct 2019  24 Oct 2019 
    202  17 Nov 2019  18 Nov 2019  21 Nov 2019 
    203  08 Dec 2019  09 Dec 2019  12 Dec 2019 
    204  26 Jan 2020  27 Jan 2020  20 Jan 2020 
    205  23 Feb 2020  24 Feb 2020  27 Feb 2020 
    206 * 05 Apr 2020 06 Apr 2020 09 Apr 2020
    207 * 26 Apr 2020 27 Apr 2020 30 Apr 2020
    208 * 17 May 2020 18 May 2020 21 May 2020
    209 * 07 Jun 2020 08 Jun 2020 11 Jun 2020 
    210  20 Sep 2020  21 Sep 2020  24 Sep 2020 

    DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

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