The Bridgewater-Vaccaro Medical Simulation Training Center, or MSTC, teaches medical doctrine, developed through lessons learned during combat and garrison operations, to all levels of military medical professionals. "The MSTC supports all medical providers that you would find in the Army," said Capt. Ryan Murphy, Medical Simulation Training Center officer in charge. "When I say all, I mean all the way from role one through role three is taught here." He described role one as first responders who provide basic first aid and role three as physicians who are able to perform complex operations in a hospital environment. They also provide perishable skills and recertification training, which Soldiers assigned to the 2nd Brigade Combat Team, 10th Mountain Division (LI), and the 804th Medical Brigade, Fort Devens, Mass., took advantage of Feb. 1-5. "Today is the final day of the Mountain Medic Course," explained Staff Sgt. Hector Hernandez, 2nd BCT's medical operations noncommissioned officer in charge. "This course is geared towards all medics who need to recertify their National Registry Emergency Medical Trauma Basic requirements." Hernandez explained that the course is a relatively small investment for the Army to ensure their medics are proficient and able to provide the highest level of care to injured Soldiers. "For the rest of the Army, this means that we have a higher number of Soldiers coming back from the battlefield and surviving their wounds," he explained. "Our medics today have come a long way from what we were or knew 10 years ago. Our skills have evolved exponentially." Living proof of these changes is lifelong health care provider and Army Reservist 1st Sgt. Carlos Beato, a health care specialist with 804th Medical Brigade, Fort Devens, Mass., who quickly volunteered his Soldiers to attend the recertification course. "I wanted us to integrate with active-duty (personnel) when we do this type of training," Beato explained. "Right now (our Soldiers) are stuck in the 'Reserve bubble.' I want them to intermingle with active duty so they see that we do the same things." Beato explained one change he has experienced that new Soldiers see as standard practice. "I've seen where we have gone from putting direct pressure on a wound first; now we slap a tourniquet on first," he said. "It's now common sense. Every Soldier in the Army knows that." Beato, a civilian registered nurse at the Veterans Affairs in Boston, said that in many ways, military medicine allows a broader scope of practice. "We do a lot of intravenous injections (IVs), intubations (opening of the airway) and stuff like that. When I went through civilian registered nurse school, they didn't even teach us IVs," he explained. "Advanced airways are kind of out of our scope of practice on the civilian side, but the IVs are not." He explained that while similar training is offered at Fort Dix, N.J., he wanted to increase his Soldiers' exposure to active-duty practices and see how the 10th Mountain Division operated their training center. Beato applauded the training he and his Soldiers received here at Fort Drum, but he also expressed concern for those who are not near an active-duty installation. "The Army needs more of these centers localized," he explained. "There are a lot of areas where we have tons of Reservists and National Guardsmen, and there is nothing around them. They have to go on orders for this type of training." Murphy explained that while training differs slightly from service to service, the importance of unifying medical training will always equate to increased survivability on the battlefield. "Anyone who's been around the military in the last five to 10 years knows that combined operations are really the future," he said. "Everything we are doing is combined, and you're seeing that on both the training side of the house and doctrinally." While all combined training is important, Murphy noted one aspect as paramount in receiving higher levels of medical care. "Getting all of our medics on the same page across the forces would mean we could conduct combined training on medical evacuation operations -- that would be the biggest benefit," he explained. While much of the training is focused on controlling bleeding and stabilizing patients on site, their "bread and butter" is tailoring events to meet individual unit training objectives. "Units come to us with training objectives, and we build a program around them," Murphy said. "We get simulators on site, we involve the Light Fighters School to provide tactical training, and we incorporate our high-fidelity mannequins to provide the most realistic training for their events." Experiencing firsthand the realism the MSTC has to offer were infantrymen assigned to A Com- pany, 2nd Battalion, 14th Infantry Regiment, 2nd Brigade Combat Team, who learned the basics of combat lifesaving. "This really showed me how to apply my medical knowledge in a real scenario," said Pvt. Christian Pagan. "The pressure during testing definitely made it that much more satisfying to learn. I know that whenever push comes to shove I can really use this training to help somebody." The facility offers a centralized college type of setting similar to those within the region. The MSTC is complete with approximately 100 acres of practical exercise space for students to test standardized medical techniques. Training also is available to Navy, Marines and allied forces -- something Murphy feels is paramount in creating interoperability across the medical fields