LANDSTUHL, Germany - From a snake bite to engaging targets and responding to threats, nearly 400 medical personnel from Landstuhl Regional Medical Center, 30th Medical Brigade and the German Armed Forces (Bundeswehr) participated in Operation Courageous Defense, a combined training exercise designed to showcase integrated medical operations in the European theater, March 3-6.The exercise aimed to train and certify personnel on essential qualifications, to include Army Warrior Tasks and Individual Critical Tasks Lists which tests both Soldier skills and medical competencies."We are Soldiers first," said Command Sgt. Maj. Anthony Forker, command sergeant major, Troop Command, LRMC. "We have to ensure a ready medical force and through this exercise we will achieve it."According to section 702 of the National Defense Authorization Act for Fiscal Year 2017, the drive for operational readiness and support of operational and war fighting missions take priority over the delivery of clinical/health care services and the execution of business operations in an MTF. Meaning, Soldiers, Airmen and Sailors must be capable of performing their duties both on and off the battlefield. This affords the Army, Air Force and Navy to train personnel not only on medical aptitude in a military treatment facility, but also their capability to provide patient care in war fighting and operational environments.For over two years, LRMC implemented training to drill various roles of medical care in combat settings, from immediate lifesaving measures to evacuating patients to higher levels of care."OCD is an innovative, adaptive way of training our Soldiers within the MTF without disrupting patient care," said Lt. Col. Christina Buchner, commander, Troop Command, LRMC. "It shows we can train as Soldiers and make sure we're ready for any mission, whether that's global or local."According to Buchner, the training also helps achieve the objective of synchronizing and providing support to combatant commanders and allies."(The exercise) ensures we are aligned with combatant commander objectives of providing medical capabilities to maximize their performance on the battlefield."For LRMC personnel, opportunities in a field environment provide needed experience for clinical providers."In a hospital we get really comfortable and familiar with our jobs, and some of our other skills we might have learned earlier in our careers could use more attention," said 1st Lt. Addison Montiel, a nurse at LRMC's Medical Surgical Ward. "Training like this allows us to keep those skills sharp for when the time comes for us to use them."Because some medical roles are interchangeable between different levels of care, the exercise also provided Soldiers insight into medical roles outside of MTF environments.For Soldiers with the 30th Medical Brigade, Operation Courageous Defense afforded them the opportunity to ensure the unit is at its highest state of readiness in order to support DEFENDER-Europe 20, the largest deployment of U.S. Forces to Europe in 25 years. The large scale Army-led exercise aims to build military readiness and interoperability with allies and partners to enable the movement of a large force across the theater.Aside from validating combat and medical skills, Operation Courageous Defense empowered unit-level leaders to develop and execute their roles as noncommissioned officers and company-grade officers."For most of these Soldiers this may be their first duty station, and it's different if you're in (combat arms units) than a MTF," said Sgt. 1st Class April Luikart, noncommissioned officer in charge, Division of Medicine, LRMC. "So (Operation courageous Defense) is not only setting them up for success to go to their next duty station, but if they deploy or go to any type of different unit, this is their foundation, this is what they need to know."LRMC's exercise was one of the first of its kind for any Army military medical treatment facility."We are setting an adaptive model for all military treatment facilities to demonstrate they can implement this type of training at their facilities without disrupting patient care," said Buchner. "By doing so with other units, it's making us a more joint force with operational partners within the medical field."As a Role 4 theater hospital, LRMC is responsible for the medical care of wounded, ill or injured warfighters evacuated from the U.S. European Command, U.S. Africa Command, and U.S. Central Command areas of operation.