By Lennart Bongartz & Denys Surkov. Post 2 of 7 in the MPP-CMPEC3 series.
The most dangerous sentence in military medicine is “we’ll figure it out when casualties arrive.” Step 1 of the MPP exists to prevent exactly that — by forcing the medical mission to be defined before the first shot is fired.
The Medical Planning Process begins not with equipment checks or route planning, but with a question: what is the medical mission?
This matters most when medical personnel are not involved in mission planning, as is the often the case in Ukraine (and maybe to some degree in NATO partner forces as well?). Without a defined medical mission, medics respond to events rather than preparing for them. Commanders assume medical support is available; medical teams assume permission to act. Neither assumption holds under fire.
First, understand the combat mission
In many circumstances, the medical commander will not be given a precise medical mission statement. Therefore, it may be necessary to start by deriving a medical mission statement. Step 1 mirrors the TLP’s “Receive the Mission” step. It begins by understanding the combat Commander’s Intent. If absent, formulate a mission statement using the five framing questions — Who, What, When, Where, and Why? This process guarantees that the medical team follows the tactical commander’s strategy, preventing medical units from making independent plans or acting outside those orders.
Then, shape your medical mission
The second element that shapes the medical mission statement are a set of goals and/or specified clinical and evacuation timelines. These should be concrete and grounded in human pathophysiology. The best known example is the NATO “10 minutes-1 hour-2 hour” timeline for POI-care, DCR and DCS, respectively, while SOF is motivated to adhere to “Immediate-30minutes-60 minutes”
Although these timelines can be demanding, failing to define them—or relying on vague terms such as “as soon as tactically feasible”—creates ambiguity. This establishes unclear expectations, and hinders effective coordination with the combat units. “Letting things slide” because of (expected) friction serves no-one.
Balance priorities
The mission statement also forces explicit resolution of three competing imperatives: prioritizing evacuation, prioritizing treatment in place, and prioritizing safety of medical personnel. No single imperative can dominate unconditionally — overemphasis on any one degrades the others. The mission statement defines their balance for the specific operation.
With the medical mission defined and clinical timelines set, the planner proceeds to CMPEC3: the structured analysis of the mission variables. Later, assessment of the medical support plan (by wargaming or TTX) will uncover gaps in planning, identify whether above goals can be achieved and which adjustments are needed.