Survival Protocol: The role of tactical medicine in the updated Basic General Military Training (BGMT)
Every service member must possess the skills required to stabilize a casualty until transfer to professional medical personnel. Under the updated General Staff programs, the duration of Basic General Military Training (BGMT) has increased to 51 days, while the volume of medical training has tripled to 30 hours of intensive training.
What service members are trained in
Tactical medical training is based on the international TCCC (Tactical Combat Casualty Care) protocol, a standardized training program for tactical battlefield casualty care, with the M.A.R.C.H. algorithm at its core.
M.A.R.C.H. represents a precise sequence of actions (algorithm), where each letter corresponds to a critical life-threatening condition. The first priority (M – Massive Hemorrhage) is the control of massive bleeding, as it accounts for approximately 60% of potentially preventable battlefield deaths. Service members are trained to apply a tourniquet to a limb within 20–30 seconds, acting through muscle memory even under extreme stress. Subsequent steps include checking airway patency (A - Airways), sealing penetrating chest wounds with occlusive dressings (seal) to support breathing (R - Respiration), assessment and management of circulation and signs of shock (C – Circulation), and necessary prevention of hypothermia using thermal blankets (H – Hypothermia). The use of a unified M.A.R.C.H. algorithm creates a shared operational language between the service member providing first aid and the combat medic receiving the casualty. This eliminates chaos and reduces critical errors during the handover of information about the casualty’s condition.
The training process is divided into phases that reflect the actual dynamics of combat. Under simulated enemy fire, service members learn only the most essential skills — self-aid and tourniquet application. Training is conducted using the soldier’s individual first aid kit (IFAK). The core rule is simple: use your buddy’s IFAK to treat them, so that you do not leave yourself without a life-saving kit. A more detailed walkthrough and talk-through of the M.A.R.C.H. algorithm is conducted in hard cover. A key constant in training is the “two-hour rule”: a properly applied tourniquet is considered safe to remain on a limb for up to two hours without causing irreversible tissue damage. This provides a critical window for evacuation.
Why this matters
The effectiveness of this training is based on a service member’s ability to act quickly and accurately at the most critical moment following injury. To reinforce these skills, complex tactical training exercises lasting up to three days are used, during which medical care is practiced under conditions of physical exhaustion and simulated shelling and indirect fire. In addition to training process on training areas, service members have access to theoretical training modules through the “Army+” application, allowing for the standardization of medical knowledge across all units. As a result, tactical medicine within the BGMT framework transforms every soldier into an autonomous medical responder, capable of significantly extending a casualty’s survival time until a professional medical care team arrives.