Tactical Medicine Advances in the Kingdom of Saudi Arabia

Three and a half years ago, a small group of leaders within the Kingdom of Saudi Arabia’s (KSA) military began talking about a different future for their wounded.

Drawing on Dr. Frank Butler’s vision for Tactical Combat Casualty Care (TCCC), they imagined a system where every military medic was trained to the same lifesaving standard as their counterparts in the United States and its allies. The goal was simple but ambitious: build a cadre of instructors capable of bringing the Kingdom’s military medical providers fully in line with TCCC principles.

Progress was deliberate and sometimes slow, but that early vision became reality on November 19, 2025, in Riyadh, Saudi Arabia.

At the 4th International Military Medical Congress, attendees watched as Saudi providers demonstrated their new capabilities on the trauma lanes—culminating in a graduation ceremony attended by Kim Mace, Director of Education Administration for NAEMT, who witnessed firsthand how far the program had come. More than 15 other nations were represented at the Congress, and several of these international delegations expressed serious interest in partnering with NAEMT to bring TCCC training to their own militaries and emergency services in the future, with some already exploring opportunities to return to the MMS training site in Riyadh for that training.

The courses were conducted by three NAEMT Affiliate Faculty for TCCC—Daniel McGarrah (course coordinator), Lance Lopez, and Joseph Ogershok—who traveled from the United States to support the initiative. They were joined by three Gulf State TCCC instructors, Mohammad Alsharairi, Sumaia Khlaif Al Ruhaiba, and COL Essam, who helped teach the inaugural Tactical Combat Casualty Care – Combat Medic/Corpsman (TCCC–CMC) course for the Military Medical Services in the Ministry of Defense of Saudi Arabia (MMS–MOD–KSA). Word of this effort quickly spread. The Ministry of Interior (MOI), recognizing the value of this training, requested that the same team conduct Tactical Emergency Casualty Care (TECC) courses with a similar goal: to build a cadre of TECC instructors for their paramedics and police forces, particularly female police officers.

By the end of the initial training effort, three TCCC–CMC and three TECC classes had been completed.

The first cohorts of students were carefully evaluated for instructor potential, and those selected stepped into the role of co-instructors, teaching portions of the program to the subsequent classes. In all, 106 TCCC students completed training, with 46 of them certified as TCCC instructors. The TECC program trained 29 students, 11 of whom were certified as TECC instructors, laying the groundwork for a sustainable, locally led training pipeline.

Along the way, we gained deeper insight into the Saudi military and the broader culture in which these medics serve.

New horizons are opening for women in the Saudi armed forces, driven in part by Saudi Vision 2030, the national transformation initiative led by the Crown Prince. This training cohort included female soldiers, and their participation required thoughtful coordination—Sumaia, our female instructor, worked closely with them during skills sessions to ensure both cultural respect and high training standards. Mohammad specifically played a crucial role in bridging language and cultural gaps, especially in the second and third TCCC classes, helping concepts land clearly across English and Arabic. For the Saudis, investing in this level of medical training is one way they are taking Saudi Vision 2030 seriously, ensuring they are better prepared for the upcoming Asian Cup in 2026–28, the World Cup in 2034, and many other international events that will take place within Saudi Arabia.

We also experienced Saudi traditions up close. The egal, which holds the keffiyeh—the traditional headscarf—on a man’s head, traces its origin to a simple tool used to tie up a camel; today, both remain symbols of formal dress for Saudi men. Small cultural details like this reminded us that we were not just exporting a curriculum but partnering with a nation that brings its own rich history and identity to the table.

The hospitality extended to us was unforgettable. We were invited to numerous dinners by military leaders and colleagues, including traditional meals shared while sitting on the floor and eating with our hands. As guests, we learned that the meal ends when the guest of honor finishes eating—but dessert is always served. As one host explained with a smile, “There is always room in your heart for dessert.” Moments like these built trust, friendship, and a shared sense of purpose that went far beyond the classroom.

For NAEMT, this collaboration with the Kingdom of Saudi Arabia represents far more than a successful series of courses.

It is a tangible example of our mission in action: advancing prehospital care worldwide through high-quality education, partnership, and the development of local instructor capacity. By empowering 46 TCCC instructors and 11 TECC instructors within the Saudi military and Ministry of Interior, NAEMT has helped establish a foundation that will continue to grow long after the initial faculty have gone home. These new instructors will carry forward the principles of evidence-based trauma care, adapt them to their operational environment, and ultimately save the lives of their fellow service members and citizens. NAEMT is honored to stand alongside the Kingdom in this effort and looks forward to continued collaboration as TCCC and TECC take deeper root across the region—and to supporting other interested nations that first heard this story at the International Military Medical Congress.

About the authors:

Daniel McGarrah is a former Special Operations Medic, with deployed experience in the Middle East and Latin America. He has been an NAEMT instructor since 2015. He recently retired from the US Army with 23 years of service. He is the owner of Armory Consortium LLC in Tampa, Florida.

Joseph Ogershok is a former Special Forces Medic, with deployment experience to Iraq and Afghanistan as a civilian provider. He has been an NAEMT instructor since 2017. He currently serves with Hollidaysburg American Ambulance Service in Hollidaysburg, Pennsylvania.