JOINT BASE SAN ANTIONIO, Texas -- Doctors at Brooke Army Medical Center realize the importance of training new emergency medicine physicians to face the difficult conditions they see when deployed. BAMC conducts an annual joint emergency medicine exercise to ensure their readiness.The 2019 Joint Emergency Medicine Exercise hosted by BAMC and Naval Medical Center Portsmouth, was recently conducted at Joint Base San Antonio-Fort Sam Houston and Camp Bullis. This year, 28 Navy, Marine Corps, Army, and Air Force emergency medicine doctors participated."I think it is vital that we give newly graduated military physicians the opportunity to understand how care is delivered in deployed and combat environments from the point of injury, to advanced resuscitative and surgical capabilities before they arrive there," said Dr. Paul Allen, assistant professor, Department of Emergency Medicine, University of Texas Health Science Center San Antonio.Allen is a former Special Forces medic who returns every year to help with the exercise. Some of the other volunteers travel to San Antonio at their own expense assist. This year, physicians from Fort Hood, Fort Lewis, and the University of North Carolina School of Medicine, as well as UT Health-San Antonio participated."Newly graduated resident physicians have been exposed to how medical care is delivered in the best possible environment available -- the hospital," Allen said. "Taking the crucial step toward how to apply the concepts and methods of patient care from the hospital environment to the forward deployed, austere environment should not be a journey of discovery or trial and error.""We have a treasure trove of combat medical experience in our senior leader population and the newly retired population here in San Antonio, who can assist in making the learning curve less steep for these new graduates," he added. "Which, in turn, may translate into saving the lives of young Soldiers, Sailors Airmen and Marines."The exercise started by focusing on the point of injury and prioritizing field medical care under strenuous conditions, explained Army Maj. (Dr.) John Knight, JEMX project officer for BAMC.Next, the participants were introduced to the challenges that come with special evacuation circumstances and movement. They also encountered critically traumatized patients in limited-resourced work environments."In these scenarios, our goal is to push each of them to the edge of their comfort zone with expectations to deliver the same optimum care as though they were functioning in a Level I trauma facility," Knight said.Navy Cmdr. (Dr.) Peter Cole, department chair, Emergency Medicine at Naval Medical Center Portsmouth agrees."JEMX is an important send-off to our graduating residents," Cole said. "It is an opportunity for them to focus their skills to the operational environment in which they may soon find themselves. It is invaluable training that sets them up for success as they prepare to practice medicine in some difficult places."