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tactical crews would greatly benefit from an organic management 
element. 
 
Recommendation. HQ MAC/SGRX should develop UTCs for tactical crews 
which include management personnel. Ratios could be similar to those 
already developed for the strategic AE crew UTCs. 
 
d. Training/Standardization. 
 
(l) AECM Competency. 
 
Observation. Varying levels of aircrew proficiency were demonstrated 
by deployed AE personnel. 
 
Discussion. A wide range of AE aircrew proficiency was evident from 
the onset of the Operation. Some AECMs had a great deal of live 
patient care experience, while others had flown no live patient 
missions at all. Some, in fact, had only been qualified in their crew 
positions for a matter of days. HQ MAC/ SGO authority to permit 
qualification evaluations after just one training flight allowed 
minimally trained AECMs to enter a combat zone where patient loads 
often exceeded 40 patients on C-130s and 90 patients on C-141s. AECMs 
with such limited training were neither confident they could perform 
in a combat environment nor demonstrated an acceptable level of 
competency. Some units deployed AECMs who were completely unfamiliar 
with ECAS and PT LOX systems, in addition to other items of AE 
equipment. In addition, some units displayed a profound lack of 
proficiency in aircraft configuration, checklist discipline, patient 
enplaning procedures, engines running on/off loads, and/or mission 
documentation. The only area of relatively consistent proficiency 
involved direct patient care. This lack of demonstrated competency in 
other areas placed an undue burden on the small training cadre in the 
AOR who were already tasked with orienting over 500 AECHs who arrived 
during a three-week period in January. 
 
Recommendation. We must ensure that realistic training is conducted 
for personnel from all AE units, whether they be active, guard, or 
reserve. AE units should fly livepatient missions whenever possible. 
The units must be adequately equipped with all required aeromedical 
evacuation equipment items. Standardized AE training programs must be 
developed, fielded, and enforced. Most importantly, there should be no 
provision to waive basic aircrew qualification requirements to support 
a real-world contingency. 
 
	.	(2) Integration of Aeromedical Crews. 
 
- - Observation. The concept of integrating AE crews to provide needed 
flexibility, although effective, was not fully accepted by all 
participants. 
 
Discussion. During the early pre-hostilities phase, 
 
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