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By MEGHAN PORTILLO
With only a 17-percent pass rate, the Expert Field Medical Badge remains one of the most prestigious and coveted awards a medical professional can obtain in the Army. It is a symbol of excellence, an outward sign of technical and tactical proficiency. Even though by regulation the Combat Medical Badge, awarded to medical personnel who have accompanied infantrymen into combat, is the higher award and must be worn if earned, Soldiers awarded the EFMB show they have distinguished themselves far above their peers.
The badge is awarded to medical personnel, including enlisted Soldiers with an Army Medical Department primary MOS and Special Forces medical sergeants, who demonstrate exceptional competence and outstanding performance during a grueling 120-hour testing event. During testing, hosted throughout the year by units across the country and abroad, candidates are required to exhibit superior physical fitness and mental clarity when faced with life-or-death situations. They must rise above the rest in their abilities to perform medical, evacuation, communication and warrior skills.
Staff Sgt. Seamus Bradley, a senior instructor for the Army Medical Department Center and School’s Department of Combat Medic Training at Camp Bullis, Texas, was one of the few who earned the EFMB after testing from April 27 to May 2 at Fort Hood, Texas. He said the badge’s mystique is legendary in the medical community.
“I’ve done a lot in the Army,” Bradley said. “I’ve been to several different units, been to Afghanistan three times, Iraq once. I already had my Combat Medical Badge. The EFMB has always been this crazy, mystical totem or something. People talk about it as if it’s so elusive, like it’s impossible. I hear people say, ‘It’s just tough — you’ll never get it.’ Many people I know who did get it earned it on their second or third or fourth try.
“I gravitate towards things that are very difficult, and I thought it would be so great if I got it on my first try. So when they asked for volunteers to go, I was the first to raise my hand.”
When participants arrive at the testing site, they begin with a four- to seven-day standardization period. The candidates are shown the standard for each task and how each task should be performed. The testing includes a written exam, combat testing lanes (CTLs), daytime and nighttime land navigation, and a 12-mile road march.
At the conclusion of the standardization period, candidates are given 90 minutes to complete a written test. Sixty questions are gleaned from four resources, covering topics ranging from medical treatment and field sanitation to Warrior Tasks and Battle Drills and medical support for captured soldiers.
“The test is very difficult — there is no way around it. I barely passed that thing, and I studied everything,” Bradley said. “I feel a lot more confident as a medic, though, because it forced me to, quite literally, crack manuals I have only ever perused before and go through them with a fine-toothed comb. … Doing so, I admit, is painful, and it is the driest read on the face of the earth – it makes War and Peace look like Jersey Shore. But it is doable.”
In 2012, only 37 percent of Soldiers passed the written test. Those who fail are given the opportunity to retake it, but not until the end of the testing week, the night before the road march.
After the written exam, candidates are rushed right into the land navigation tests and CTLs. Though EFMB testing has changed very little since its inception in 1965, in 2008, the testing process was altered to better mirror the role medics play in operations today. According to Sgt. 1st Class Kristine Sutton, NCO in charge of the EFMB Test Control Office at the Army Medical Department Center and School at Fort Sam Houston, Texas, the CTLs were added to the testing process to replicate situations Soldiers face downrange. For each of the CTLs, Soldiers are usually given one to two hours to complete the given tasks, all while reacting to obstacles and stressors placed in their path.
“Combat testing lanes are not your typical round-robin training,” Sutton said. “Candidates start at the beginning, and they are given a mission. They have to react the entire time down the lane. … They react to the situation at hand. There will be indirect fire, direct fire at them, and they have to react to that. There are artillery simulators going off; there is smoke going off. So all these stressors are added to it, and they have to react.”
Three testing lanes require Soldiers to complete 42 tasks from four categories: tactical combat casualty care, evacuation, communication and warrior skills. An evaluator shadows each candidate, judging their reactions and their performance of each task without giving any feedback. Simply performing steps in the wrong order, forgetting to check a pulse or not marking a T on a casualty’s forehead after applying a tourniquet will cause a Soldier to fail a task. Soldiers who fail a certain number of tasks from any category are eliminated immediately.
“It was hot. It was tiring,” Bradley said. “Trying to remember every single step, every precise detail— it was mentally taxing more than anything.”
The tactical combat casualty care lane wound through the woods at Fort Hood. Bradley began the lane by clearing, disassembling, reassembling and performing a functions check on an M16-series rifle. While under simulated direct fire, he applied a tourniquet to a “casualty” with a gunshot wound to the leg. After dragging him to safety, Bradley turned his attention to the casualty’s chest wound. He applied dressing to the entry and exit wounds and assessed his breathing. He started the casualty’s IV, called in a 9-line medevac, then continued to conduct a head-to-toe assessment. He treated a shrapnel wound in the casualty’s arm and searched for signs of other injuries, including pupil constriction, burns, lacerations or swelling. After the casualty’s injuries had been addressed, Bradley wrapped him in a hypothermia blanket and loaded him on a litter.
Bradley moved on to treat three other casualties in the lane before carrying them through the smoke and loading them into an ambulance.
“You have only 60 minutes to complete patient assessment and casualty triage, treat four casualties … and you are still carrying casualties and completing your seven-page patient assessment,” Bradley said. “It’s a lot. If you are not really proficient, you can easily get sidetracked. You have to be good at managing time in the environment given.”
The testing culminates with a 12-mile road march, which Soldiers must complete in less than 3 hours while carrying approximately 35 pounds of gear.
Bradley, who was the first to cross the finish line in his road march with a time of 2 hours, 28 minutes, 7 seconds, said the march was the most physically rewarding part of the test.
“I ran for 12 miles with a ruck on my back,” he said. “I wasn’t sure I was first for a while, because there was somebody else who wasn’t in EFMB road marching half a mile ahead of me on the last portion of the course. He was in the same uniform and everything, so I was convinced someone had passed me somehow and I didn’t realize it in the dead of the night. I was sprinting that last bit to catch up to him, and then he just turned off the course and went back to his barracks.”
Approximately 360 started the testing with Bradley at Fort Hood. About 60 made it to the road march, and only 40 finished in time to earn their EFMB.
In addition to the sheer difficulty of the testing, the EFMB remains such a coveted award because there is no compromise when it comes to upholding the high standard. The EFMB Test Control Office validates each site before testing begins and oversees each stage of the process. The test board and test board chairperson from the hosting unit make most decisions and monitor the evaluators, and if there is a discrepancy, there is a rebuttal process.
“If Soldiers say they did something right, but the evaluator says they did something wrong, they have the ability to file a rebuttal, and they go in front of that board,” said Capt. David Vise, officer in charge of the EFMB Test Control Office. “We oversee that process to make sure they are making the right decisions based off the standards.”
Because the standards are meticulously followed during testing, Soldiers are able to study and prepare themselves beforehand. Candidates are encouraged to concentrate their studies on the areas with which they are least familiar, in addition to the areas of their own expertise. Nonetheless, the tasks Soldiers fail often involve duties required of them in their jobs every day.
“The grading I had was exactly verbatim from the standard in the book,” Bradley said. “I failed three tasks in total, and they were 110 percent my fault. It wasn’t a question of grading. On one task, I failed to deactivate the ‘no go’ switch on the humvee during an evacuation task. Surprisingly, this is what I work with all the time. I’ll swallow my pride. It’s the simplest thing. They even call it the ‘no go’ switch. If you don’t hit it, you’re going to get a no-go… It even goes click and makes a sound. I looked at it and thought, ‘Yep, I’m good,’ but I got ahead of myself.”
Thorough studying of the references, intense training for the CTLs and land navigation, and rigorous physical preparation for the road march are essential for a candidate’s success. Though some units provide train-ups months before testing begins, unfortunately, not all Soldiers are given this advantage. Soldiers seeking training material and NCOs looking to start a train-up will find the information they need at the EFMB Test Control Office website, www.us.army.mil/suite/page/140048. An AKO login is required.
An NCO’s job is to set their Soldiers up for success, and earning the EFMB is a sure way for Soldiers to set themselves apart, Sutton said. Though 14 percent of active-duty enlisted personnel have the CMB, only 6 percent have earned the EFMB. NCOs can encourage Soldiers to earn the badge by showing them what it represents and how it will brighten their future in the Army, she said.
“It’s promotion points. It sets you above your peers,” she said. “If it’s a young PFC looking to become a specialist, and there are five PFCs looking to be promoted, that one PFC who gets EFMB is most likely going to get the promotion.”
Because of the low pass rate, there are many more in the Army who have tried but failed than those who have successfully earned the badge, Vise said.
“If an NCO is not successful, that changes their attitude about it,” he said. “If it’s not important to them, they don’t make it important to younger Soldiers.”
Sutton said NCOs, whatever their personal experience, should always encourage Soldiers to pursue the badge and should help them train beforehand. Without the support of their NCOs and thorough preparation, a Soldier has very little chance of earning the badge.
“The NCO Corps needs to be motivated and positive,” Sutton said. “You never know what career path that younger Soldier is going to have. It’s important to show them what the badge is and motivate them to get it, even if the NCOs can’t themselves.”
As an instructor for other combat medics, Bradley wanted to earn the badge to lead the way for his students, several of whom were also testing for the badge.
“Unfortunately, a lot of them didn’t make it. But I know one did for sure,” Bradley said. “It was really awesome to see one of the Soldier medics I had trained finish and get her EFMB the same time I did.”
Earning the EFMB is no simple feat, but once earned the badge is a permanent award. The confidence recipients gain through the testing process will help them throughout their entire career, Vise said.
“One of the most important things EFMB does is give you a sense of accomplishment — probably more than anything else these young Soldiers have done in the military, maybe even in life,” he said. “You can watch young Soldiers who are just barely skating by, maybe getting into some trouble and who don’t even want to be in the military … they will go out and earn their EFMB, and they will completely turn around. They will go from being a substandard Soldier to one of the best Soldiers you have seen just from that sense of accomplishment.”
Bradley added that the knowledge gained will aid Soldiers in their day-to-day duties at home and while deployed. Even if they fail to earn the badge, the experience broadens their knowledge base and solidifies the skills they learned in basic training.
“In the middle of nowhere operating as a medic, the expertise I learned on the EFMB would have been really useful to me, especially field sanitation,” Bradley said. “As a PFC, I was putting into practice what I studied later to earn the EFMB … controlling flies, digging trenches, processing latrines and cooking equipment for a battalion. … It’s worth it. … It will build confidence in your skills. It’s definitely helped me.”
- Eligible enlisted personnel include those with an Army Medical Department (AMEDD) primary MOS and Special Forces medical sergeants.
- Other eligible personnel include officers assigned or detailed to an AMEDD Corps, warrant officers with an AMEDD primary MOS and aero medical evacuation pilots assigned to an air ambulance unit.
- Other service and allied candidates must be medical personnel or serving in comparable positions.
- Additional prerequisites include weapons qualifications and CPR certifications.
- Soldiers who have profiles or who are not able to pass the Army Physical Fitness Test are not eligible for the EFMB. However, if an injured Soldier is able to pass an alternate PT test, they can use that test to qualify.
- Click here to visit the EFMB Test Control website. An AKO login is required.
To contact Meghan Portillo, email firstname.lastname@example.org.
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