NATO Special Operations Combat Medic (NSOCM) Course 


NATO Approved Course


The objective of the NSOCM Course is to transform the International SOF – First Responder into a Special Operations Combat Medic with a scope of practice to effectively treat life threatening injuries in an austere – tactical environment to reduce mortality and morbidity by sustaining life beyond the doctrinal medical evacuation timelines. The intent of the NSOCM course, is to provide training for 24 students on advanced combat trauma management with a special emphasis on Clinical Medicine and Prolonged Field Care. The course meets the standards, given by NATO Special Operations Head Quarters (NSHQ), which defines the NATO standard for the Scope of Practice of the SOCM. This course is IAW the NATO SOF Training Standards Directive NSHQ-MED Directive 75-001 (B) 29 May 2017, using current Committee of TCCC and PHTLS Guidelines.


  • Module 1 Basic Sciences
    • Anatomy & Physiology IAW the UCC Cork curriculum
    • Pharmacology
    • Dead Tissue Practical
  • Module 2 Trauma Fundamentals
    • Kinematics of Trauma
    • Trauma Lectures
    • Trauma Practicals (including moulages)
    • Cadaver Lab (online)
    • Dead Tissue Practical
  • Module 3 Rescue Techniques in Special Environments
    • High Angle Rescue (including moulage)
    • Vehicle Extrication (including moulage)
    • K9 / Military Working Dog
  • Module 4 Operational Medical Planning
    • Operational Medical Planning Lectures and Case Studies
    • Mass Casualty & Triage Theoretical and Scenarios
  • Module 5 Tactical Combat Casualty Care
    • Care Under Fire (theoretical & moulages)
    • Tactical Field Care (theoretical & moulages)
    • Tactical Evacuation Care (theoretical & moulages)
  • Module 6 Clinical Medicine
    • Physical Exam
    • Surgical Procedures
    • Pathophysiology
    • Sports Medicine & Human Performance
    • Dental Emergencies
    • Environmental Medicine
    • Tropical Medicine
    • Operational Medicine
  • Module 7 Prolonged Field Care (PFC)
    • 10 core capabilities of PFC
    • Nursing Skills
    • Wound Management
    • Pain Management
    • Patient Nutrition & Hygiene
  • Module 8 Field Training Exercise
  • Module 9 Tactical Paramedic Certification
  • Module 10 Clinical & Trauma Rotations
    • Emergency Room
    • Operating Room
    • Intensive Care Unit
    • Ambulance
    • Primary Healthcare with GP


Course duration is 24 weeks*.


The ISTC NSOCM Course provides a twenty-four week POI of theoretical classes, demonstrations, hands-on skill stations, trauma lanes, mass casualty scenarios, rescue techniques, prolonged field care clinical skills, FTX, Tactical Paramedic Certification and clinical hospital rotations. The ISTC NSOCM Course will focus on creating a well-versed SOF medic thus building interoperability IAW the standards that match with another SOCM medics graduating from SOF medical courses like USAJFKSWCS, CANSOF and the Nordic SOCM programs.

During the first five weeks of Basic Sciences, the NSOCM students will cover both the NSOCM core curriculum and University College Cork (UCC) curriculum. The Basic Medical Science module begins with an overview of biochemistry, cell structure, and the major organ systems in the human body including: Circulatory, respiratory, digestive, lymphatic, urologic, nervous, reproductive, integumentary, musculoskeletal, and endocrine systems. A Basic Life Support (BLS) class is also covered and the last week covers Pharmacology principles (kinetic/dynamic), dosage/drip rates, and administration routes of medications.

The next three weeks are dedicated to understanding Trauma Fundamentals. We start with cadaveric tissue anatomy, patient trauma assessment and causality management while covering such topics as: Shock, ballistics injuries, airway, thoracic, abdominal, musculoskeletal, head and spinal trauma. Distinctive training days will focus on the MARCH acronym: Massive hemorrhaging, Airway, Respiration, Circulation, Head-Hypothermia with an importance on advance emergency medicine protocols and invasive lifesaving procedures / skills which are also introduced during this module.

One week of specialized Rescue Techniques will follow. Students learn proper rescue techniques on how to conduct high and low angle rescue, confined space rescue, and vehicle extraction. Additional classes on K9 (canines) and veterinary medical support are also covered within this module.

Operational Medical Planning which focus on lessons learned from the Joint-Special Operation Forces medical community on how to best construct medical plans in support of SOF operations and medical evacuation for casualties in remote, hostile, denied, or politically sensitive areas to included DA, SR and MA for SOF operations. Students will use the Military Decision Making Process (MDMP) principles and the NSHQ Special Operations Medical Leaders Handbook.

After Winter Block Leave – Tactical Combat Causality Care (TCCC) module continues where Trauma Fundamentals left-off with individual trauma scenarios, focusing on individual and litter carries, with emphasis on the MARCH protocols within the 3 phases of TCCC: Care Under Fire, Tactical Field Care and Tactical Evacuation Care. The 2nd and 3rd weeks include team based scenarios (MASCAL) where students must react to numerous real-world TCCC situations using skills taught within the TCCC protocols.


The course is intended for SOF operators and enablers serving or designated to serve as SOF team medic or SOF troop/platoon medic.  Students must be graduates of the ISTC AMFR course or of equivalent national level SOF medical training course IAW NSOFAFR critical tasks or have higher medical training.  Students may be officers, NCOs, or enlisted soldiers.  Students will be expected to pass a Medical Knowledge Entry Test, a Physical Training Test, and an English comprehension test.

Pre-course medical study material will be provided on the NSOCM E-Learning platform MOODLE to candidates once they are identified by the nations.  It is recommended that they study all material before attending the course. There will be an optional pre-testing day in Pfullendorf 10 weeks prior to the start of the course. Candidates that are admitted during the pre-testing will not be tested again upon arrival.

Students must score a minimum of 70% on the Medical Entry Test (TCCC) upon arrival.  This test evaluates basic medical knowledge common to all SOF medics or medics trained to the Advanced First Responder level.  Graduates of the Advanced Medical First Responder Course (or similar course) should be familiar with the knowledge needed to pass this test.

Students must score 80% or higher on the Defense Language Institute English Language Centre (DLIELC) English Comprehension Level (ECL) test upon arrival.  Prospective students are encouraged to visit the following websites for additional information on the English test:

The Entry Physical Test will be comprised of a 3000 meter run, pull-ups, push-ups, and sit-ups.  The Physical Fitness standards are listed below. See Enclosure 1 to Annex M.

During the course, any student’s repeated failure to meet the standards (theoretical exams, practical exams, and/or physical tests) will result in a review board, composed of members of ISTC Medical Branch and ISTC Staff, to assess the candidate’s scores and performance. The board will then give a recommendation to the ISTC Commander, who will decide whether the individual will be returned to unit, continue with the course without receiving a certificate / diploma, or continue without any further consequences.

The Entry Physical Test will be comprised of a 3000 meter run, hang-ups (pull-ups), push-ups, and sit-ups. The standard will be delineated to the students upon arrival.

During the course, any student’s repeated failure to meet the standards (theoretical exams, practical exams, and/or physical tests) will result in a board, composed of members of ISTC Medical Branch and ISTC Staff, to assess the individual’s performance. The board will then give a recommendation to the ISTC Commander. The ISTC Commander will decide whether the individual will be Returned to Unit, continue the course without receiving a certificate, or continue without any further consequences.


Dress throughout the course will be working dress.


Visit the NAEMT web site for material related to this course:


Technical information on medical issues can be requested from the following address:

If you have any questions, please E-mail us:

*Further details can be found in the Joining Instructions available at the sending Unit or the respective Ministry of Defense (MoD).