MARINE CORPS BASE CAMP LEJEUNE, N.C.-- 
At the Battle Skills Training School on Marine Corps Base Camp Lejeune, North Carolina, a new generation of U.S. Navy medical officers and corpsmen are learning how to save lives where it matters most, on the battlefield. 2nd Medical Battalion, 2nd Marine Logistics Group, hosted the second iteration of a Tier IV Tactical Combat Casualty Care course from Sept. 29 to Oct. 10, 2025. 
 
Tier IV TCCC training is introducing a new era of field medicine for military providers within 2nd MLG, bridging the gap between clinical expertise and combat realities. The training is geared toward providing medical personnel real world training to inoculate them to combat medicine, specifically equipping students to save lives on the battlefield. 
 
For U.S. Navy Lt. Soterios Stroud, a medical officer with 2nd Medical Battalion, 2nd MLG, this training marks a major shift from the hospital halls he’s used to. 

“I’ve just worked in hospital settings my whole career,” said Stroud. “Everything I’ve learned has been civilian-side medicine. It’s awesome to be here and learn what our corpsmen go through on the battlefield.” 
 
Tier IV TCCC training is designed to do exactly that, take physicians, nurses, and advanced corpsmen out of controlled clinical settings and immerse them in the chaos of combat medicine. The goal is to prepare students in the course to treat injured personnel in austere environments with limited supplies, intense pressure, and minimal support.
 
 
Unlike tiers I through III, which focus on basic lifesaving and trauma stabilization, tier IV expands into advanced, invasive skills and leadership under fire. U.S. Navy Lt. j.g. Anthony Reddick, a physician associate and battalion surgeon with 2nd Battalion, 8th Marine Regiment, 2nd Marine Division, has taught TCCC from tier I to tier III, but nonetheless, still claims that tier IV pushes even seasoned providers out of their comfort zones. 
 
“The algorithm, the MARCH-PAWS process, doesn’t really change,” Reddick explained, referring to the sequence used to assess trauma patients: Massive hemorrhage, Airway, Respiration, Circulation, and Head injury/Hypothermia, followed by Pain, Antibiotics, Wounds, and Splinting. 
 
“What changes is what we can do within that algorithm. Tier IV gives us the ability to perform procedures like chest tubes and finger thoracostomies, things corpsmen don’t practice in lower tier courses.” 
 
These advanced interventions are critical in combat environments where a medical evacuation could be delayed for hours or even days. Tier IV students learn to provide prolonged casualty care, stabilizing wounded individuals until higher-level treatment becomes available. 
 
“Out here you’re not working out of a hospital,” said Reddick, “You’re working out of your pack.” 
 
According to U.S. Navy Lt. Jacob Berg, a Tier IV TCCC instructor with 2nd Medical Battalion, 2nd MLG, “The training isn’t just technical, it’s physical and mental as well,” said Berg. “Tier IV incorporates high stress, simulated battlefield environments with noise, smoke, and tactical movement.”  
 
“It’s this stress inoculation that makes the difference, at this level, we’re not just teaching skills,” said Berg, “We’re building confidence and decision-making in high-threat environments.” 
 
This vital part of tier IV TCCC training teaches Navy medical personnel to remain calm in an intense, demanding work setting and is precisely what makes tier IV a completely new and unique level of training in the Department of War’s TCCC program.  
 
“You’re running, your heart’s pounding, you’re managing patients under pressure,” explained Reddick, “The hardest part is keeping calm and checking your own pulse before you check the patient’s.”  
 
It’s impossible to know everything that can go wrong on the battlefield. Therefore, tier IV focuses on normalizing chaotic situations and preparing Navy medical personnel both mentally and physically for the challenges they will face in an ever-evolving combat environment.  
 
To make the training even more realistic, tier IV includes live tissue exercises, allowing providers to perform real procedures and witness their effectiveness in real time. For many, like Reddick, “it’s a transformative experience.” 
 
“You don’t always get that opportunity in a hospital,” Reddick added, “Being able to conduct those procedures and see them work gives you confidence. Now I know, if I have to do it on a Marine or Sailor, I can.” 
 
Beyond the hands-on training, tier IV strengthens the connection between medical officers and their enlisted corpsmen. Bridging the gap between combat medicine and hospital medicine and helping medical officers understand how their corpsmen operate in austere environments.  
 
At the end of the course, students must bring everything together in a final 30-minute assessment made up of multiple injuries, chaos, and limited time. 
 
The final assessment, a culminating event created by the instructors, is based off a variety of potential real-world scenarios. It is designed to encourage students to not only learn how to manage stressors, but to work and lead through stressful situations.  
 
“One of the biggest benefits of the tier IV training is that it allows providers to understand how their corpsmen are trained, to speak their language,” said Berg. “The battlefield doesn’t come with an instruction manual, just a set of principles, honed by blood and experience.”  
 
This shared understanding saves time and lives in combat and is especially vital for independent duty corpsmen and physician associates.  
 
According to Reddick, “Knowing how my corpsmen operate means I can train them better and lead more effectively,” he added, “If they’re treating a casualty under fire, I need to know exactly what they’re thinking and doing. Everything we learn in TCCC comes from lessons written by those who came before us, figuring out what worked and what didn’t. This training carries that legacy forward.” 
 
Tier IV was created to emulate combat realities and has been developed and refined through years of real-world TCCC battlefield medicine. As tier IV continues to evolve, now in its second iteration at Camp Lejeune, instructors see it becoming a cornerstone of Navy medical readiness. 
 
Battlefield medicine is changing, and those changes start with training. 
 
For Stroud, “The experience is more than professional development; it’s personal empowerment,” he said. “I’m expecting to walk away confident, knowing that no matter where I am, hospital, field, or battlefield, I can take care of whoever needs me.” 
 
The tier IV course isn’t just about treating wounds; it’s about cultivating the mindset necessary to bring every Marine and Sailor home safely. For those who complete it, the training is not just a professional milestone, but a transformative experience that will shape their approach to both military and civilian medicine. 
 
“The goal is for all providers: doctors, nurses, and advanced corpsmen alike, to be tier IV certified,” said Berg. “That ensures we’re ready to operate in modern combat environments, where the front lines are closer, and the timelines are tighter. In the end, the tier IV course isn’t just about medicine. It’s about mindset: learning to stay calm under fire, make critical decisions under pressure, and fight to bring every Marine and Sailor home alive.”