STENNIS INTERNATIONAL AIRPORT, Miss. -- A C-130J Super Hercules touches down on the runway, engines running. As the back ramp lowers, simulated casualties are urgently handed off from Special Operations Tactical Medics to the 36th Aeromedical Evacuation Squadron team, ready to be stabilized and flown to Keesler Air Force Base. For the 36th AES and the 815th Airlift Squadron “Flying Jennies,” this wasn’t just another drill—it was a high-impact, real-world simulation that pushed crews to the edge of their operational envelopes.
On May 29, members of the 403rd Wing’s 36th AES and 815th AS participated in a joint exercise with the U.S. Navy Special Operations Tactical Medic Class 32 during the course’s Final Field Training Exercise May 27–30 at Stennis International Airport, Mississippi.
The SOTM course, a key component of the Naval Special Warfare Command, trains Navy SEALs and Special Warfare Combat Crewmen in advanced medical care to support special operations missions. By combining tactical expertise with life-saving medical skills, the course prepares operators to deliver critical care in the most demanding environments worldwide.
“The Special Operations Tactical Medic course field training exercise provides an essential opportunity for students to apply lifesaving skill under high pressure, realistic conditions. Incorporating a joint environment into the FTX enhances interoperability across the services and ensures our teams are prepared to deliver critical care in any operational environment,” according to a U.S. Navy SOTM Course Senior Enlisted Leader.
“This was a powerful example of what joint training should look like,” said Maj. Trinh Ramirez, 36th AES Operations Support Flight commander and nurse. “We didn’t know how many patients we’d receive. It ended up being five—including a simulated double amputation, a crush injury, respiratory trauma, and even a military working dog casualty. It was fast, realistic, and intense.”
The exercise replicated the chaos and uncertainty of a real-world tactical evacuation, often referred to as “unregulated missions,” where AE crews receive patients from battlefield medics without prior staging or clear numbers. That level of unpredictability is exactly what the team needed, according to Ramirez.
“Typically, we train with a structured plan,” said Ramirez. “This wasn’t that. This felt like the kind of mission we could get tomorrow. And we need to train like that more often.”
Two C-130J aircraft, loaded with 36th AES crews, launched from Keesler and landed at Stennis to simulate emergency medical evacuations under combat-like conditions. With aircraft engines still running and the clock ticking, AES crews had just minutes to assess patients, triage conditions, adjust transport plans, and reconfigure the cabin.
“We had to adapt quickly,” said Ramirez. “We were airborne again in 27 minutes. That’s outstanding, especially considering the complexity of the patients and scenario.”
Maj. Rachel Moore, 36th AES mission lead and nurse, highlighted another critical aspect of the training: unpredictability brought on by having SOTM instructors lead the scenarios.
“They didn’t go easy on us,” Moore said. “They didn’t know our protocols, our medications, or our limits. That made it even better. We had to adjust to what they threw at us—exactly like it would happen in a real-world contingency.”
AES specialized crews typically include a medical crew director, a flight nurse, and three aeromedical evacuation technicians. They routinely transport critically ill or wounded personnel who’ve been stabilized or received damage-control surgery at forward-deployed facilities. Many AE crews also integrate with Critical Care Air Transport Teams and Tactical Critical Care Evacuation Teams, which operate as mobile intensive care units aboard aircraft ranging from C-130Js to KC-135 Stratotankers and C-17 Globemaster IIIs.
The 36th AES, part of the Air Force Reserve’s 403rd Wing, operates with about 150 personnel, including a communications package and roughly 60–70 flying nurses and techs. Their primary aircraft platform, the C-130J, can be reconfigured to transport up to 92 patients in contingency situations.
“We learned a lot,” Ramirez added. “One of our biggest takeaways was realizing we didn’t have enough hands for an unregulated scenario of this scale. In the future, we’ll plan to supplement or augment crews when needed. One tech can’t run up and down the aircraft while three patients are critical—it’s not sustainable.”
More than 88 percent of the Air Force's AE mission is conducted by Guard and Reserve forces. The 403rd Wing alone operates 10 C-130Js with the 815th AS and 10 WC-130Js with the 53rd Weather Reconnaissance Squadron, better known as the Hurricane Hunters.
According to Moore and Ramirez, this joint training event has already shaped future planning. The 36th AES and SOTM cadre are exploring ways to repeat this high-value collaboration every six months.
“This was just the first rep,” Moore said. “It pushed us outside our comfort zone in the best way. Now we know what our gaps are, and what we need to do to close them. This is how we get better—together.”