Publishing Disclaimer: In all of its publications and products, NCO Journal presents professional information. However, the views expressed therein are those of the authors and are not necessarily those of the Army University, the Department of the US Army, or any other agency of the US Government.


NCOs Should Prepare Soldiers Prior To EFMB Testing

By Meghan Portillo

NCO Journal

August 07, 2013

Download the PDF

Photo by Sgt. Andrea Merritt

Earning the Expert Field Medical Badge may be one of the most difficult challenges a Soldier will take on during his or her career, and success is directly related to the amount of preparation one has had before testing.The EFMB is awarded to military medical personnel who prove themselves the best of the best during a week-long testing period that begins with a written exam and culminates with a 12-mile road march. They must demonstrate their abilities to perform medical, evacuation, communication and warrior tasks.

With only a 17 percent pass rate, it is clear that most Soldiers arrive for testing with little or no training. But test organizers say NCOs have it within their power to change that and to set their Soldiers up for success.

Organizing a train-up

First, NCOs need to familiarize themselves with the program, said Sgt. 1st Class Kristine Sutton, NCO in charge of the EFMB Test Control Office. How can an NCO help a Soldier prepare if they don’t even know what is involved? Even senior NCOs who earned the EFMB years ago should take a fresh look at the program, because the testing process changed quite a bit in 2008, she said.

The EFMB Test Control Office website,, provides information for units planning to host EFMB testing, for NCOs leading train-ups before events and for participating candidates seeking study guides and training material. An Army Knowledge Online (AKO) login is required.

Sutton said the largest obstacle for Soldiers is a lack of training.

“We always hear, ‘Well, I can’t train my Soldier because when they get there, the standard is going to be different.’ And that’s not true,” she said. “The standard is the standard. We have a grade sheet that lists the step-by-step standards, and NCOs can take those sheets and teach their Soldiers step by step how to correctly perform each task.”

Photo by Sgt. Lance Pounds

Sutton recommends units begin training six months before the testing is scheduled, or as soon as they are informed the testing will take place. Many units may not have the time needed to allocate to EFMB preparation, so after-hours training is key. NCOs need to set up training in the afternoons, at the end of the day, during physical fitness training hours and on weekends, she said. If Soldiers want the badge badly enough, they will attend.

For Staff Sgt. Seamus Bradley, a senior instructor for the Army Medical Department Center and School’s Department of Combat Medic Training at Camp Bullis, Texas, training made all the difference when it came time for him to test at Fort Hood.

“It gave me so much confidence to know what I was walking into,” Bradley said. “And you can have a lot of fun doing it. I know we did. It was pretty informal, a bunch of NCOs, officers and enlisted getting together, pouring over the same material.  Sometimes you would see a private first class educating a captain on how to fix a radio. That’s how everyone learned, and we were better for it.”

Practice makes perfect

Depending on Soldiers’ career paths, they may never have studied topics covered or worked with the vehicles used in EFMB testing. They will still be expected to perform each task to the EFMB standard, Bradley said.

extricates a simulated casualty from a humvee during EFMB testing

“If your entire career has been inside a hospital, you may have done a few field exercises here and there. But just because you did something three years ago doesn’t mean you are truly an expert at that task to the Army standard,” he said. “You may be able to accomplish it, but can you accomplish it within a very precise timeframe, under very precise rules and very strict grading rubrics? If you can’t, then you won’t pass.”

In addition to providing the equipment necessary for Soldiers to practice, NCOs should guide individuals in their studies for the combat testing lanes (CTLs) and for the written exam, which had the lowest pass rate of any individual EFMB task during the past year.

“We always tell them, ‘Don’t go to Google to research, because you will get outdated information.’ Go to our website to get the information,” Sutton said.

There are four references students must study. They include the Soldiers Manual and Trainers Guide (STP 68W13-SM-TG), Unit Field Sanitation Team (FM 4-25.12), Medical Support to Detainee Operations (FMI 4-02.46) and the Soldiers Manual of Common Tasks (STP 21-1-SMCT). Click here to visit the Army Publishing Directorate website. Links to each resource are also provided on the EFMB Test Control Office website, in addition to Jeopardy-style slides designed to help Soldiers study each section.

“NCOs need to get their Soldiers into the references. Quiz them. Test them. Create practice tests,” Sutton said. “If the Soldiers do pass the first written test, they are so motivated through the whole thing.”

That motivation is a huge asset when it comes time for the daytime and nighttime land navigation and the three CTLs, which require Soldiers to demonstrate tasks from four categories: tactical combat casualty care, evacuation, communication and warrior skills.

The EFMB Test Control website provides diagrams of CTLs showing exactly how to set up a lane, giving examples of where the tasks may be situated. In addition to replicating the testing environment, NCOs can use the grading sheets found on the website to teach the standards for individual tasks – from applying a tourniquet to decontaminating a buddy’s mask. Just to put in an IV, candidates must memorize and follow a three-page standard, all while conducting a seven-page patient assessment and adhering to the standards of any other necessary treatments. The smallest mistake – even performing the subtasks correctly but out of order – will cause a Soldier to fail a task. If candidates fail a certain number of tasks in any category, they are disqualified immediately, so any experience they bring with them to the testing site will help.

Physical fitness

Another reason to start training early is the 12-mile road march – something you can’t expect to be ready for without months of conditioning, Sutton said. She expressed her heartbreak at seeing candidates work so hard during testing week, only to fail at the last moment because they were not physically prepared for the road march.

Photo by Spc. Adam Turner

“A lot of times, the candidates will come out there not realizing what the physical strain is,” Sutton said. “They may be just barely passing the 12-mile road march right around the three-hour mark, but they forget that they were refreshed when they did that march back at their unit. Now, at the end of these two weeks, their body is broken down.”

Bradley agreed, recalling how tired he was at the end of each day.

“You study all day at Fort Hood when it’s 90 degrees outside, in the sun,” he said. “Then, you go do a lane that you are mentally taxed on and then physically taxed. You come back from that

lane, barely passed, you’re soaked in sweat and you have to go eat chow and then come right back and study again for the next six hours for the lane tomorrow. If you’re not in decent physical shape, that’s going to zap your energy long before you get to the road march.”

Bradley said his unit at Camp Bullis trained well for the march. They carried heavier packs while completing 6-, 9- and 12-mile marches over hilly terrain in terrible weather. Because of this, he said they were better prepared for the real thing, when they were exhausted after the testing week and faced with a complete downpour and 15-mile-an-hour crosswinds.

“Our guys who made it to the road march had already done this before,” Bradley said. “It wasn’t any different from the training. Whereas others, the only times they had road marched were on nice pretty days on completely flat terrain. So when we hit big hills on tank trails, they weren’t ready for it. It’s just one more variable they hadn’t worked with that stacked up against them.”

Handling the stress

Photo by Spc. Adam Turner

Units can better prepare Soldiers for the mental and physical stress of the testing by replicating those stressful situations in training. Capt. David Vise, officer in charge of the EFMB Test Control Office, warned Soldiers may be proficient in classroom environments but then panic or flounder when faced with the stress of an evaluator scrutinizing their every move.

Many Soldiers today have been downrange and acted heroically in life-or-death situations. Because of this, they may be comfortable working in the testing environment, as they have already had to perform such tasks in real-life situations. For these Soldiers, stressful training may help them identify triggers and cope with symptoms of PTSD.

“Some of these younger Soldiers are doing better at EFMB because they have been downrange and experienced some of this stuff,” Vise said. “They are able to relate that into the EFMB, whereas back before we were deploying, that probably wasn’t the case. But when you throw some of those stressors on them, simulations and some smoke and stuff, it brings back these

memories. I’ve seen it happen where some have had to be removed from testing. It helps some of them because they’ve really done some of this stuff downrange, but it may push others over the edge because of the stress.”

Confidence conquers

Because deployments are slowing down, more and more units are now opting to host EFMB testing, Vise said. However, Soldiers continue to show up for testing without any training.

Photo by Sgt. John Couffer

“Come day one, I realized just how many people had zero train-up,” Bradley said. “They were told, ‘Want to go to EFMB? Awesome. It’s on Monday.’ That’s the wrong way to send someone to EFMB; you are setting them up for failure. If they earn EFMB, it’s because they were awesome beforehand; so don’t take credit for it when they come back with the badge.”

Without training and support from their NCOs, candidates may not have the confidence and motivation needed when they see their peers failing. Bradley said that by the second or third day of testing, when there are fewer and fewer Soldiers participating, candidates have to ask themselves, “Do I have what it takes to be here at the very end?” He recalled seeing so many simply stop studying because they didn’t believe enough in themselves. Perhaps if an NCO had taken the time to prepare those Soldiers, they would have had the confidence and motivation they needed , he said. Maybe they would now be wearing the EFMB.

“NCOs need to know what it is that makes us professional noncommissioned officers,” Bradley said. “That is setting our Soldiers up for success so that they can get that badge and come back with a knowledge base.”

To contact Meghan Portillo, email

Also this week:

Back to Top