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NEWS | July 2, 2024

Combat medics use M249 light machine gun during field observational assessment

By Guy McSweeney U.S. Army Medical Test and Evaluation Activity Test and Evaluation Division Chief

A dynamic shift in the way the Army operates, from counterinsurgency to large-scale combat operations, has been occurring for almost a decade.

Soldiers need to remain lethal, and medics need to keep warfighters on the objective. Prolonged field care initiatives will help keep patients alive for longer periods of time, in the absence of evacuation options.

But what about patient security, and the security of the unit? Security assets may not always be available, and M4 carbines and M9 pistols may not provide the firepower needed to ensure the protection of the patients.

In 2022, Lt. Gen. R. Scott Dingle, the U.S. Army Surgeon General at the time, requested the U.S. Army Medical Center of Excellence at Joint Base San Antonio-Fort Sam Houston, Texas, conduct a holistic assessment of the employment and use of the M249 light machine gun, or LMG, in other medical formations.

In response to the surgeon general’s request, the MEDCoE Fielded Force Integration Directorate engaged the U.S. Army Medical Test Evaluation Activity to conduct an operation assessment of medical units at echelons above bridge employing the M249 within their formations.

USAMTEAC, aligned under MEDCoE, is responsible for the operational testing and assessments of medical materiel, medical-related materiel, and medical information technology systems.

The purpose of the assessment, conducted at Fort Liberty, North Carolina, from March 8-15, 2024, was to collect data on the M249’s impact on medical soldiers as they complete daily mission requirements. This included if soldiers were impeded by physical, logistical, or any other factors, while equipped with the squad automatic weapon.

The M249 operational assessment consisted of multiple scenarios and was supported by the 550th Medical Company Area Support and the 274th Forward Resuscitative Surgical Detachment, 261st Multifunctional Medical Battalion, 44th Medical Brigade, and 3rd Platoon, C Company, 1st Battalion, 508th Parachute Infantry Regiment, 3rd Brigade Combat Team, 82nd Airborne Division.

Prior to the start of the assessment, the Soldiers from the1-508 PIR provided training to the 44th Medical Brigade 68W Combat Medics on the M249, including weapons familiarization, weapon employment tactics and techniques, live fire familiarization, and qualification events.

The following week, the combat medics then proceeded to the live-fire portion of the operational assessment, which consisted of a probability of hit lane. The soldiers engaged targets, ranging from 50-300 meters in various firing positions while the MTEAC test team observed and recorded data. The assessment was conducted under day, day chemical, biological, radiological, and nuclear, night, and night CBRN conditions.

For Spc. Dawson Caruso, a 68W Combat Medic, this was his time firing the M249. Assigned to the 550th MCAS, 261st Med. BN, 44th Med. BDE, he described how this weapon compares to the M4 rifle he qualified with while at basic combat training.

“It [the M249] is heavier, with less recoil, but other than that, it is pretty similar to the M4,” he said. Dawson was also impressed with the accuracy and tactical advantages of the weapons system.

The next portion of the assessment included three situational training exercise lanes, with the same Combat Medics from the 44th Medical Brigade conducting medical missions with Paratroopers from the 1-508th PIR acting as the opposing force.

Soldiers utilized the multiple integrated laser engagement system, or MILES gear, to simulate battle conditions.

During the first STX lane, the combat medics encountered an anti-tank blast mine during convoy operations, causing a mobility kill. The medics had to evacuate their vehicle, secure their equipment, and transport one casualty to a nearby operational vehicle.

During the second STX lane, medics established an ambulance exchange point, which came under fire. The ambulance crew had to engage targets, break contact, and report their situation to higher to receive new missions and AXP locations.

Sgt. 1st Class Kyle Peterson, a capability developer at FFID, was pleased with the enthusiasm of the participating units.

“All the people here are playing their part and are very motivated about possibly having a new capability,” Peterson said. “It’s something new and they are very excited about the opportunity to be a part of this experience.”

For the third STX lane, medical teams from the 550th MCAS and 274th FRSD received two urgent casualties while conducting tailgate medicine at an isolated location. The medical teams treated casualties until they came under attack from the OPFOR and had to protect and load their patients into their vehicles and displace to a safe location.

The final portion of the operational assessment was a 72-hour field training exercise with the 550th MCAS and 274th FRSD establishing a Role 2 to conduct area support operations.

During the FTX, they established manned AXP’s, conducted convey operations, and maintained perimeter defense in a contested environment while the OPFOR conducted disruptive operations. The 72-hour continuous operations culminated with the relentless OPFOR attacking the Role 2.

Sgt. Mitchell Mullen, an 11B Paratrooper from the 1-508th PIR, talked about his part during the STX.

“We are doing OPFOR for the 44th Medical Brigade, giving them a realistic look at what this may look like in a combat scenario.”

Mullen is experienced with the M249 and says it is a high precision weapon system.

“I think the [M249] could be implemented with some further training and more familiarity,” he added. 

The USAMTEAC test team observed all elements of the operational assessment, collecting detailed data for the final report. 

Eddie Fields, a USAMTEAC test officer, observing the assessment, described the conditions.

“The operational realism is very key, and having the 11B Infantry Soldiers serving as OPFOR makes it even more realistic.”

Fields stated Fort Liberty was perfect for testing and was enthusiastic about the support his team received.

“The support has been outstanding,” Fields said. “USAMTEAC likes conducting tests as operationally realistic as possible. You can’t get more realistic than this. You have the range, the weapons, the vehicles going down the dirt road; it’s almost like being in a combat zone. You have all the elements, environmental conditions, and logistics to make it more realistic. You can’t beat that!”

Sgt. 1st Class James Wilcox, a USAMTEAC test officer, further expanded on the importance of conducting realistic tests to gather data.

“We gather objective data for our customers and provide that data feedback so they can make a fielding decision,” he said.

After the assessment is complete, USAMTEAC will compile all data and write an objective test report. Once that report is approved by the MTEAC Executive Director, the report will be forwarded to the Fielded Force Integration Directorate, for review and a final determination of the use of the M249 by EAB medical units.

The USAMTEAC mission is a unique one in that it is the sole independent operational test and evaluation agency for medical-related materiel and medical information management/information technology products.

USAMTEAC is charged with the mission of directly supporting the U.S. Army in the Department of Defense’s acquisition process.

Residing at Joint Base San Antonio-Fort Sam Houston, the installation that serves as the Army’s bastion of medical excellence, USAMTEAC is a small unit of approximately two dozen military and civilian personnel tasked with the mission of helping to ensure that medical personnel are equipped with suitable and effective equipment.

Learn more about USAMTEAC at