JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas – Naval Medical Forces Development Command (NMFDC) launched a new Tactical Combat Casualty Care (TCCC) Tier 4 Combat Paramedics/Providers (TCCC CP/P) bridge training course for Navy Medicine providers, now available through Joint Knowledge Online (JKO) as of Jan. 12, 2026.
This innovative model moves a significant portion of the training online, setting a new standard for efficiency, readiness, and cost-savings that could be adopted across all branches of the Armed Forces. The new approach marks a fundamental shift away from the traditional, time-intensive training model. Previously, military medical providers—physicians, physician assistants, nurses and senior enlisted IDCs—were required to spend up to two weeks in a classroom setting for their recertification. The new hybrid course allows them to complete the academic portion remotely, dramatically increasing their availability for patient care and slashing the significant costs associated with travel and temporary duty.
“Online or hybrid learning is often better suited for medical professionals than traditional classroom settings because it offers unparalleled flexibility for demanding schedules, allows for self-paced learning, and removes the need for time-consuming, expensive travel," said U.S. Navy Cmdr. Thomas Sather, the U.S. Navy’s TCCC program director. "Our course offers small, focused segments that are ideal for quick, efficient learning and helps avoid the fatigue of long, in-person sessions.”
This initiative is more than just a logistical improvement; it represents a strategic enhancement of military medical readiness. TCCC is the DoD-wide standard for battlefield care, and Tier 4 providers are the critical assets who perform life-saving interventions at the point of injury. By making their training more efficient, the military can ensure more of these highly skilled individuals are ready to deploy at a moment's notice.
“In a material way, this accomplishment fits firmly in line with the Fighting Instructions recently issued by the Chief of Naval Operations,” said James Ohman, NMFDC’s deputy chief of staff for operations. “This is part of the ‘Foundry’ that drives our warfighting advantage by building Naval Power at best speed.”
TCCC is the DoW-wide standard of care for pre-hospital battlefield medicine. Tier 4 is the most advanced level, designed for medical providers who perform life-saving interventions at the point of injury, often far from a hospital or clinic.
This online course is not a standalone certification. Instead, it serves as a mandatory bridge, taking personnel with a Tier 3 corpsman level certification and upgrading them to the elite Tier 4 provider level. It covers advanced "MARCH PAWS" topics including hemorrhage, airway, respiration, circulation, head injury, pain management, antibiotics, wounds, splinting, and evacuation, focusing not just on the "how," but the critical reasoning behind each intervention. On average, an experienced provider can complete the online training in about three days and the in-person testing in two to five.
This academic knowledge is then validated through rigorous, in-person testing. After completing the online modules, providers report to a Joint Trauma System-approved site for proctored exams, hands-on skills validation, and a final trauma assessment in a simulated combat environment. This crucial "Train like you fight" phase ensures that skills are honed under pressure, building the muscle memory and mental resilience needed to save lives in the chaos of battle.
This new model is a particular game-changer for the Reserve component. It allows medically proficient Sailors and soldiers—many of whom are top trauma surgeons and paramedics in their civilian lives—to refresh and advance their skills without the disruptive burden of extended training periods.
“This streamlined model is a force multiplier, enabling training sites to double their class throughput with the same funding,” said U.S. Navy Senior Chief Hospital Corpsman Jeff Bruderer, the TCCC Program Manager for the Navy Reserve. “It is a more efficient training platform and increases the warfighter readiness of the Fleet.”
Developed in a collaborative effort that included the Defense Health Agency’s Joint Trauma System, this Navy-led initiative was designed from the ground up with the Joint Force in mind. By creating a more agile, adaptable, and integrated training system, this hybrid blended learning model produces a more capable warfighter prepared for mobilization. It stands as a landmark achievement and a clear path forward for modernizing medical training across the entire U.S. military.
The transition to a blended learning model for TCCC recertification is a significant step forward for Navy Medicine, demonstrating a commitment to innovation, readiness, and the well-being of its most asset: its people.
NMFDC is the headquarters element designated within the Bureau of Medicine and Surgery as a direct subordinate to the Surgeon General of the Navy, charged with leading and managing all medical training, education, professional development, and instruction to produce highly trained and ready medical personnel.