Navy Medicine Readiness and Training Command San Diego (NMRTC SD) conducted a first-of-its-kind simulated Role 2 training exercise on Oct. 22 and 29, 2026, designed to prepare expeditionary medical units for high-intensity operations in austere environments. While the realistic training was hosted on-site at Naval Medical Center San Diego (NMCSD), the active participants belonged strictly to expeditionary squads preparing for future deployments.

The exercise focused on preparing Expeditionary Medical Unit 3 (EMU-3), Casualty Receiving Treatment Ship 8 (CRTS-8), and En-Route Care System (ERCS) personnel. Role 2 medical operations represent a critical tier in the military's chain of survival, providing field surgery, basic laboratory work, and advanced trauma stabilization close to the front lines, bridging the gap between basic battlefield first aid and a full-scale hospital. The training targeted point-of-injury mass casualty incident event management, triage, ERCS integration, and Role 2 operations to ensure total mission readiness.

The exercise highlights the specialized training mission of the Bureau of Medicine and Surgery (BUMED). While the Defense Health Agency’s (DHA) Combat Support Agency Medical Operations (CAMPO) Line of Effort (LOE) 1 remains focused on the medical readiness of the warfighter, this specific training exercise at NMCSD emphasizes Navy Medicine’s organic role in projecting medical power.

"This exercise represents a critical milestone for our teams," said Cmdr. Jericho H. Ramirez, a senior nurse of the Directorate of Medical Services at NMCSD and the Expeditionary Medicine (EXMED) Command Training Officer. "By synchronizing the training of EMU-3, CRTS-8, and our ERCS personnel, we are ensuring that when these teams deploy, they do so as a highly cohesive, high-performing unit. This is about validating our clinical readiness under simulated stress so that we are ready for the high-end fight."

The tactical training took place at the NMCSD softball field, where participating teams managed simulated casualty scenarios. By using high-fidelity simulators, the Expeditionary Medicine Training Team (ETT) evaluated the participants on their knowledge, skills, and abilities (KSAs) during high-pressure triage and treatment scenarios.

"Our focus is entirely on the readiness of our personnel to operate and deliver life-saving care in dynamic, austere environments," said Cmdr. Ellis Banks, director of expeditionary medicine for Naval Medical Center San Diego and Navy Medicine Readiness and Training Command San Diego. "Exercises like this Role 2 training are vital for ensuring our medical units can integrate seamlessly and provide the highest standard of trauma and en-route care to our warfighters."

The exercise is a critical part of the basic phase training cycle, helping the units align with the Fleet Response Training Plan and meet Navy Mission Essential Task Lists.

"Our primary goal is to provide realistic, high-fidelity simulation training that prepares our personnel for the realities of deployment," said Capt. Nancy Miller, NMCSD director for professional education. "There is a documented risk in sending medical personnel into real-world missions without rigorous evaluation. By using these advanced training tools and simulation scenarios, we ensure that our team has the knowledge, skills, and abilities to perform critical clinical interventions under pressure, protecting both patients and ensuring our providers' readiness."

By integrating multiple medical disciplines and simulating the transition of care from point of injury through transport, the command continues to refine its tactics and techniques ahead of upcoming deployments.

"Navy Medicine’s priority is operational readiness," said Capt. Jerry J. Bailey, commander of NMRTC SD and director of NMCSD. "By conducting this realistic, simulated training right here at NMCSD, we are directly supporting BUMED's mission to project medical power. While we support the DHA's Combat Support Agency Medical Operations Line of Effort 1 to keep our warfighters in the fight, this exercise highlights the unique role NMRTC San Diego plays in training Navy medical forces for expeditionary operations."

NMRTC San Diego's mission is to prepare service members for deployment in support of operational forces, deliver high-quality health care services, and shape the future of military medicine through education, training, and research.

NMCSD employs more than 5,600 active-duty military personnel, civilians, and contractors in Southern California to deliver exceptional care.