Category: US Airforce

The training consisted of 16 stations and substations that ranged from spinal immobilization to infection control to post-mortem protocol, all scenarios that are critically important for a medic to know but unlikely to experience in a clinical setting such as the clinic at Holloman Air Force Base.

“Gone are the days when a medic would only be expected to perform duties within their specific specialty – our medics need to be versatile and better equipped to provide speedy and effective support to the warfighter,” said U.S. Air Force Chief Master Sgt. Jason Estrada, 49th MDG senior enlisted leader. “That versatile mindset is what our medical group education and training team has used to shape our Medic-X and other hands-on training.”

The Air Force is one of the most lethal parts of the Department of Defense, and the flipside of lethality is the medical skill needed to keep the warfighters in the fight downrange. This more hands-on approach to training was brought about after an education and training member went through the intense two-week Tactical Combat Casualty Care Tier 3 course and realized how important it would be to bring lessons learned to the entire medical group.

“We’re focusing on operating in an austere environment where it’s not going to be calm, it’s not going to be like day-to-day clinic operations,” said U.S. Air Force Capt. Natasha Lindbloom, 49th MDG education and training flight commander. “You could tell somebody to recite the alphabet, but if it’s stressful, they’re going to mess it up. We want our people to be able to do this until they can perform these simple tasks under pressure.”

Although we cannot mirror a battlefield environment, we can put our medics in situations where critical thinking and a sense of urgency fuels their training to ‘kick in.’Chief Master Sgt. Jason Estrada, 49th MDG senior enlisted leader

Coupled with the chance to exercise underutilized but combat-effective skills, the exercise served to underscore the importance of medics who are fit to fight and capable of doing what’s needed when it’s needed in a stressful and possibly deadly environment. A low-crawl obstacle course was put together using furniture and gear inside the clinic, streamlining the flow of training and simulating a more realistic urban environment.

“Although we cannot mirror a battlefield environment, we can put our medics in situations where critical thinking and a sense of urgency fuels their training to ‘kick in,’” Estrada said. “Since so few of our current medics possess the real-world experience, it’s our training team that brings these scenarios to life with realism and pressure-induced decision making, which results in the desired sets & reps our teams need to build muscle memory.

Constant Improvement

Medic-X training exercises are not a new concept for medical personnel; in fact, Medic-X was rolled out across the enterprise two years ago and has provided quarterly training objectives to all Defense Health Agency members. The ever-changing global environment and nature of future warfare were other driving factors in the 49th MDG collectively getting ahead of the curve and practicing these critical wartime skills on top of staying adept at their daily clinical duties.

“I’m hoping this gives people the mindset of ‘Hey, I know I’m in this job right now and I’m comfortable, but I’m not always going to be comfortable if we’re put in these situations in real life,’” said U.S. Air Force Senior Airman Claire Pruitt, 49th MDG education and training program manager.

All Airmen take TCCC Tier-1 training that covers the basics of what was formerly known as self-aid and buddy care, while all medics are required to take Tier-2 training to gain more expertise in the ability to treat wounds sustained in combat. Tier-3 training is optional but available for all medics and provides a realistic, grueling experience of austere field conditions and the physical limits that medics can be pushed to in wartime.

“There’s going to be a bit of a shock factor for people working in a clinic, where even though we’re incredibly busy, a lot of it is just administrative work instead of intense, hands-on medical practice,” Pruitt said. “I’m trying to integrate some of the things that they did with us in a physical aspect at the Tier 3 training so that these Airmen have more experience and understand that if they have to do this in real life tomorrow, it’s not going to be easy. They’ll have to think about getting the patient out of the combat zone, treating their wounds, stopping the bleeding, loading them onto a helicopter, etc.”

The success of the first iteration of integrated field work with Medic-X has laid the groundwork for an ever-improving series of exercises to better prepare Team Holloman’s medics for unpredictable and challenging fights of future conflict.

“Today’s potential adversaries are better equipped and more prepared than any potential foe has ever been,” Estrada said. “For that reason, every uniform-wearing member of our military needs to understand that he/she is one bad day, one ill-guided decision, one perceived threatful action away from finding themselves, in support of our country, inside a combat environment where the old rules may not apply.”

“The AFRICOM AOR is a challenging environment,” Flosi said. “You continue to operate in a low-resource setting, executing the mission with focus and flexibility to counter threats in the region.”

The senior leader then traveled to Camp Simba, Manda Bay, Kenya, where the deployed team is embodying the “Mission Ready” mindset. Airmen are stepping outside their core Air Force Specialty Codes to fill mission gaps, support each other and sustain forward operations, often in joint and host-nation integrated environments.

Chief Master Sgt. Ben Weavers, senior enlisted leader of the 475th Expeditionary Air Base Squadron, said the visit highlighted the growing strategic relevance of Manda Bay.

“It was great to highlight the strong partnership we share at Manda Bay with our host nation Kenyans, sister services and tenant units,” Weavers said. “They were impressed with what our Airmen are doing in support of our nation.”

Weavers said the visit helped reframe the narrative of Manda Bay from a site that was formerly attacked by enemy combatants to a vital node of partner engagement and operational readiness.

“We’ve moved beyond the legacy of the 2020 attack to a stronger security posture that allows us to focus on partnership building,” he explained. “We’ve conducted weekly knowledge exchanges with our Kenyan partners across disciplines like medical, maintenance, air transportation, civil engineering, and more.”

Lt. Col. Michael S. Ryan, commander of the 475th EABS, described the visit as a success, noting the valuable engagement between deployed personnel and senior leadership.

“CMSAF was able to interact with our deployed Airmen. The question-and-answer session allowed for two-way communication between Department of the Air Force leadership and our Airmen accomplishing the mission,” Ryan said. “We provided CMSAF the importance of Manda Bay and the mission here,” he added.

“We showcased our Airmen and the uniqueness of this deployment. Everything we do here is by, through and with the Kenyans.”

He also noted the positive response from his team.

“Multiple Airmen thanked local leadership for the opportunity to interact with CMSAF,” Ryan said. “This allowed them the opportunity to speak what is on their minds to our highest level of leadership.”

On the final day of the tour, Flosi visited Chabelley Airfield, where Airmen support critical intelligence, surveillance and reconnaissance operations. Here, he helped build a laser-guided bomb and observed how Airmen and Soldiers are detecting and deterring UAS threats with advanced counter-sUAS systems.

These missions play out just miles from the People’s Liberation Army Support Base in Djibouti, a visible reminder of the region’s strategic weight and the importance of maintaining a consistent, capable U.S. presence.

A consistent theme across locations was the deployment of small Unit Type Codes rather than fully aligned teams. Leaders noted that aligning future rotations with the Air Force’s Unit of Action concept, sending cohesive, trained teams that arrive and operate together from day one, may help improve readiness and continuity in the region.

“The missions you support are vital to regional security,” Flosi said. “You’re holding the line, and your work underscores the strategic significance of this region and the importance of a consistent and capable U.S. presence.”

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The Royal International Air Tattoo is not only the largest air show in the world – it is a convention of lethality, ingenuity, and partnership. The U.S. Air Force, alongside NATO allies and partners from around the globe, showcased what the strength of multinational relationships can achieve.

“America’s international partners are one of its greatest strengths,” said U.S. Air Force Capt. Mercer Martin, 99th Expeditionary Reconnaissance Squadron U-2S pilot. “Spending our time meeting our partners in person while forging bonds and friendships is an extremely important addition to the relationships we have with our allied nations around the world.”

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Exposing both the U.S. and partner-nation personnel to diverse strategies and training methods strengthens the goal of a cohesive, interoperable force. These relationships play a key part in times of peace as much as they do in the theater of war.

“I enjoy flying an aircraft that’s so close in league with our American colleagues. It’s a real change of pace,” said an RAF Rivet Joint pilot. “Your training systems and operational focus into different deployable locations make it so U.S. Airmen are more versed on how it all works in different areas of the world. It’s nice to be exposed to that and fly more often with pilots who have different techniques.”

As in years past, one of RIAT’s greatest strengths this year was the access it provided allies, partner nations and the public to U.S. aircraft, aircrew, and the stories behind them. It was a rare chance for global audiences to witness both the capabilities and the humanity behind modern airpower. This visibility builds confidence, strengthens support, and reinforces the value of continued collaboration.

“As aircrew stationed in the United Kingdom, I’m flying tanker missions and working with NATO allies while refueling them in the air,” said U.S. Air Force Capt. Tobin Nelson, 100th Air Refueling Wing pilot. “Being on the ground and meeting them face-to-face at RIAT is amazing. Knowing I’ve worked with their people gives me the ability to network, plan new training missions, and forge new bonds through flying.”

RIAT 2025 served as a powerful reminder that diplomacy and military strength go hand in hand. By bringing together allies and partners in a shared celebration of innovation and skill, the air show fostered trust, mutual understanding, and camaraderie that extended far beyond the runway. The relationships built not only enhance all nations’ operational readiness but also promote a culture of cooperation and respect that is vital in today’s complex environments.

RIAT’s ability to inspire generations also underscores the profound impact of bringing military aviation into the public eye. For many attendees, witnessing these aircraft in action and hearing firsthand accounts from dedicated personnel sparks a passion for service and a belief in the importance of teamwork.

“When you come here and see participants and children from every walk of life with a sparkle in their eye, you don’t ever want to stifle those dreams,” said U.S. Air Force Tech. Sgt. John Stortecky, 337th Airlift Squadron flight engineer. “Hopefully one day someone will say, ‘I had that tour through the aircraft and I saw them fly – and it inspired me to become who I am today.’”

The event featured aircraft from both nations, including a JASDF UH-60J helicopter and U-125A search-and-rescue coordination aircraft, as well as a U.S. Air Force HC-130J Combat King II from the 102nd Rescue Squadron.

“The goal of the capabilities briefing and aircraft tours was to enable partner nation integration and foster mutual understanding among our rescue squadrons,” said U.S. Air Force Tech. Sgt. Richard Conner, 130th Rescue Squadron HC-130J rescue loadmaster. “This lays the groundwork for future collaboration in the INDOPACOM area, which is a part of our unit’s mission.”

The static display was one of many engagements conducted as part of REFORPAC, a Pacific Air Forces-led contingency readiness exercise nested under the Department of the Air Force’s new Department-Level Exercise series. This DLE is a first-in-a-generation approach to preparing for operations in contested, dynamic environments, spanning more than 50 locations and involving more than 12,000 joint and coalition personnel and over 400 aircraft.

Throughout the display, participating Airmen discussed aircraft capabilities and differences in personnel recovery methods.

“One notable difference is in the pararescue insertion methods,” Conner said. “JASDF Pararescue typically insert via hoist from the UH-60J, since their fixed-wing aircraft belong to the Airlift Command. Meanwhile, our HC-130J enables personnel airdrops, which allows our Pararescue to get to the fight.”

Conner also pointed out technical details that stood out during the tour.

“I was surprised to see the UH-60J outfitted with external fuel tanks — that really extends its loiter time,” he added.

More than a showcase of equipment, the event fostered personal relationships, improved operational communication and strengthened shared tactics.

“This event is extremely important in building a framework for further cooperation,” Conner said. “It puts faces and names to specific units and enables us to fly real-world missions together during REFORPAC. By briefing and mission planning together, we’re able to execute helicopter air-to-air refueling and speak the same language and brevity terms while flying in close formation over the Sea of Japan.”

The visit concluded with a group photo symbolizing shared commitment among the rescue units. A common thread across all participating squadrons stood out: their shared motto, That Others May Live.

“Everyone got a kick out of the fact that our units all share the same motto,” Conner said. “It’s a powerful reminder that no matter the uniform, our mission is the same.