U.S. Army Capt. Michael Johnson, a brigade nurse with the 173rd Airborne Brigade, demonstrates a medical procedure during training at Caserma Del Din in Vicenza, Italy, on Jan. 9, 2026. The training was held in preparation for the Army's Best Medic Competition, which evaluated military medics representing Ghana, Liberia, Italy and the U.S. (Tamia Lee/U.S. Army)

NAPLES, Italy — The Army is testing the ability of its combat medics to keep critically injured soldiers alive on the future battlefield, where they no longer will be able to rely on quick medical evacuations.

That new reality was the hallmark of the Best Medic Competition at U.S. Army Garrison Italy in Vicenza this week as 24 Army and international competitors faced two grueling days that tested their fortitude and expertise.

The U.S. Army Southern European Task Force, Africa event featured service members from Ghana, Liberia and Italy alongside American counterparts.

The competition, which ended Thursday, included a four-hour test designed to assess and reinforce medics’ ability to sustain life, prevent further deterioration and make sound clinical decisions, said Sgt. Maj. Shanett Robinson, SETAF-AF’s chief medical noncommissioned officer and lead planner for the competition.

“Ultimately, this focus ensures medics are prepared to save lives when evacuation timelines are uncertain, reinforcing readiness for the complex operational environments they are likely to face,” Robinson said.

The competition reflects a departure from the “golden hour” benchmark of stabilizing and readying a seriously wounded service member for transport within 60 minutes of injury to increase survival chances.

Participants were divided into teams of two. Sgt. Rishabh Jishnu and Spc. Michael Andress, both from the 173rd Airborne Brigade, earned first place in the competition, receiving an Army Commendation Medal, SETAF-AF said in a statement Thursday.

Fellow 173rd members Sgt. Kaitlin Flynn and Spc. Jean Sagesse came in second and earned an Army Achievement Medal. Sagesse also had the highest individual score on the Army Fitness Test portion of the competition, according to the statement.

Sgt. Cornelius Adagbe and Leading Seaman Ato Amonoo-Rockson of Ghana came in third, receiving a certificate of achievement, SETAF-AF said.

The Army is working quickly to develop new protocols and strategies aimed at ensuring that combat medics can quickly assess injuries and keep wounded soldiers alive for hours, even days, until they can be moved to a higher level of care.

Along with medical advancements, the golden hour standard saw the U.S. military’s lowest case fatality rate in history during counterinsurgency operations in the Middle East, experts say.

But recent conflicts such as the Russia-Ukraine war have yielded lessons about the impacts of congested logistics, denied communications and other challenges on the modern battlefield.

The U.S. military is preparing for the likelihood that it won’t be able to rely on air and technological superiority in large-scale operations against peer adversaries to pull off swift battlefield medical rescues.

“Evacuating casualties to operating rooms within the Golden Hour of injury will be a forgone luxury in large-scale combat operations and other austere operational environments,” an article published last summer in the Army’s Military Review said.

The authors noted that the current expectation for medics is to stabilize casualties for as long as three days on the battlefield.

In Vicenza, that potential necessity was reinforced in a delayed evacuation scenario. Programmed dummy patients tested the acumen of the medic teams in skills such as hemorrhage control, airway and breathing management, pain control and infection prevention.

Participants also were measured in their ability to spot, assess and respond to changes in a patient’s condition while under stress and with limited resources.

That need for critical thinking is key in helping combat medics interpret changes in vital signs that could indicate a wounded soldier is in trouble, said Staff Sgt. Travis Dionne, a grader for the delayed evacuation scenario.

Scorers also evaluated participants’ ability to apply appropriate life-saving medical treatments quickly in response, he said.

For Sgt. James Deboo, a medic from the 173rd who will go on to compete later this month in the Army’s Best Medic Competition at Fort Sam Houston in Texas, the SETAF-AF event was an opportunity to set an example for his junior soldiers.

He said his goal was “to promote a mentality of getting out there and doing something that makes them feel uncomfortable so that they’re more comfortable in the future with that next experience.”