Exercise Tests Large-Scale Patient Movement From Indo-Pacific Region

Published Aug. 1, 2025
By David Vergun

Exercise Ultimate Caduceus 2025, involving about 1,000 military and civilian personnel, began July 21, 2025, and continued until today.

Medical personnel treat a patient lying on a gurney on a tarmac with troops in camouflage uniforms looking on.

"The exercise created realistic crisis scenarios that prompted a large-scale military patient movement response from within the Indo-Pacific region," said Air Force Col. Christopher Backus, command surgeon, U.S. Transportation Command. "Ultimate Caduceus will assess Transcom's ability and capacity to conduct global patient movement at scale and in a field training environment."

A German shepherd wearing a mask sits on a hospital bed with a handler beside her.

Patients were received at Joint Base Pearl Harbor-Hickam, Hawaii, and Travis Air Force Base, California, and then transported to federal coordinating centers and medical facilities in and around Honolulu, Sacramento, California, and Albuquerque, New Mexico, said Army Maj. Latoya Toler, exercise branch chief, Transcom surgeon general.

Troops in camouflage uniforms adjust medical equipment inside an airplane.

Besides Transcom, other personnel involved in the exercise are from U.S. Northern Command, U.S. Indo-Pacific Command, Air Force aeromedical evacuation crews, Army Reserve Medical Command critical care air transport teams, Department of Veterans Affairs, Defense Health Agency, Department of Health and Human Services, as well as other regional health care and emergency response teams.

"Ultimate Caduceus is a great opportunity for DHA to highlight our ability to deliver both health care to warfighters and capability to combatant commanders as a combat support agency. At the enterprise level, we remain focused on aligning military health and private sector resources against warfighter requirements and optimizing patient demand on transportation assets," said Anthony Ross, Defense Health Agency liaison officer to Transcom.

Two women dressed in camouflage uniforms, sit inside an airplane reviewing notes.

Troops remove patients from a ramp in back of an airplane.

This exercise actively tested how the emergency response teams work together as part of the National Disaster Medical System to save lives during a potential national crisis.

"Success to me is to increase interoperability across medical teams and systems so we can provide the highest level of care to those who need it most," Backus said.

Airmen in camouflage uniforms offload a small shipping container from a flatbed truck.

As the DOD's sole manager for global patient movement, Transcom leads aeromedical evacuation missions using high-capacity aircraft and en route care teams to transport personnel from the field to definitive care anywhere in the world.

"This joint and combined DOD, interagency and civilian partner medical team is something to be proud of and you can be assured they'll move mountains to bring premier care to those who need it," Backus said.

More than 20 civilian hospitals participated, which is the most integrated into an Ultimate Caduceus exercise, said Nicole Hardy, Transcom's Ultimate Caduceus program manager.

Medical personnel chat beside the door of a hospital room with a patient inside.

"There was also significant rotary wing participation from civilian emergency response teams," Hardy said.

MIT Lincoln Laboratory participated in the exercise to streamline patient movement data using artificial intelligence and machine learning, said Mark Barnes, Transcom's liaison to MIT Lincoln Laboratory.

"We're working to build an interconnected bridge between systems allowing for instantaneous data aggregation and dissemination," Barnes said.

"Ultimate Caduceus is an annual patient movement exercise," Hardy added. "Exercises have focused on troop patient transfer from the Indo-Pacific in the past, as well as patient movement from the Middle East and Europe."