https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN32215-ARMY_DIR_2021-08-000-WEB-1.pdf
MEMORANDUM FOR SEE DISTRIBUTION
SUBJECT: Army Directive 2021-08 (Implementation and Sustainment of Army Medical
Department Individual Critical Task Lists)
1. References.
a. National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2017,
Public Law 114-328, sections 708(c) and 725 (2016)
b. NDAA for FY 2019, Public Law 115-232, section 712 (2018)
c. Department of Defense Instruction 6000.19 (Military Medical Treatment Facility
Support of Medical Readiness Skills of Health Care Providers), 7 February 2020
d. Army Regulation (AR) 5–22 (The Army Force Modernization Proponent System),
28 October 2015
e. AR 40–68 (Clinical Quality Management), 26 February 2004, including Rapid
Action Revision of 22 May 2009
f. AR 350–1 (Army Training and Leader Development), 10 December 2017
g. Army Doctrine Publication 7–0 (Training), 31 July 2019
h. Training and Doctrine Command (TRADOC) Pamphlet 350-70-1 (Training
Development in Support of Operational Training Domain), 12 February 2019
2. Purpose. This directive establishes responsibilities for implementing medical
individual critical task lists (ICTLs) in support of the Ready Medical Force capability.
Section 725 of the FY 2017 NDAA mandates reforms to the Department of Defense
Military Health System to improve readiness, requiring implementation of measures to
maintain the critical wartime medical skills and core competencies of healthcare
providers. Pursuant to Title 10, United States Code, section 7013, the Secretary of the
Army retains statutory responsibility and authority to, among other functions, recruit,
train, equip, organize, and administer the Department of the Army to provide ready
medical forces and medically ready forces. Individual critical tasks (ICTs) specify the
knowledge, skills, and abilities for each Army Medical Department (AMEDD) Area of
Concentration (AOC) and military occupational specialty (MOS), and serve as the
S E C R E T A R Y O F T H E A R M Y
W A S H I N G T O N
SUBJECT: Army Directive 2021-08 (Implementation and Sustainment of Army Medical
Department Individual Critical Task Lists)
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foundation for maintaining a trained, ready, and deployable medical force in support of
the full range of military operations.
3. Applicability. The provisions of this directive apply to the Regular Army, Army
National Guard/Army National Guard of the United States, and U.S. Army Reserve.
4. Policy. The Assistant Secretary of the Army for Manpower and Reserve Affairs is
responsible for strategic guidance, policy, and oversight for AMEDD ICTL
implementation requirements. The Office of The Surgeon General (OTSG) is the Army
proponent responsible for coordinating AMEDD ICTL implementation. For the terms and
definitions applicable to this policy, see the enclosure.
a. OTSG will—
(1) Ensure that medical and dental ICTL implementation supports tiered clinical
readiness standards and requirements.
(2) Coordinate with the Defense Health Agency (DHA) to ensure that AMEDD
personnel, resources, and medical training within military treatment facilities support
ICTL implementation and sustainment requirements pursuant to reference 1b.
(3) Leverage partnerships and clinical simulation training opportunities with
other military services, the Veterans Administration, civilian medical centers,
universities, and institutional training centers to augment AMEDD ICT sustainment
when practical or efficient.
(4) In coordination with the U.S. Army Medical Center of Excellence, ensure that
all AMEDD ICTLs are included in the Central Army Repository for use Armywide to
monitor and report ICTL training and proficiency of AMEDD Soldiers.
b. No later than 30 September 2021, the Commanding General, TRADOC, in
coordination with the Commanding General, U.S. Army Medical Command, will issue
procedural guidance for implementing and evaluating AMEDD ICTL training programs
across the Army. TRADOC will also take the following action:
(1) In coordination with Army commands (ACOMs) and Army service component
commands (ASCCs), consolidate and integrate expeditionary AMEDD skills readiness
training and validation requirements across the enterprise.
SUBJECT: Army Directive 2021-08 (Implementation and Sustainment of Army Medical
Department Individual Critical Task Lists)
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(2) No later than 30 September 2022, update applicable regulations and
pamphlets with standards for AMEDD ICTL proficiency and sustainment training
requirements.
c. U.S. Army Forces Command (FORSCOM) is responsible for all readiness and
reporting of expeditionary AMEDD specialties for assigned forces and will—
(1) Ensure that AMEDD ICTL training supports tiered clinical readiness
requirements and operational priorities for all FORSCOM units.
(2) In coordination with OTSG and DHA, ensure that AMEDD ICTL training of
assigned AMEDD AOC/MOS personnel is monitored and reported as required.
d. ACOMs and ASCCs are responsible for all readiness and reporting of AMEDD
specialties for assigned forces and will—
(1) Ensure that AMEDD ICTL training supports tiered clinical readiness
requirements and operational priorities for assigned units.
(2) In coordination with OTSG and DHA, ensure that medical and dental ICTL
training of assigned medical AOC/MOS personnel is monitored and reported.
5. Proponent. The Assistant Secretary of the Army for Manpower and Reserve Affairs
is the proponent for this policy. Within 2 years of the date of this directive, OTSG will
ensure that applicable provisions are incorporated in AR 40–68; and DCS, G-3/5/7 will
incorporate applicable provisions into AR 5–22 and AR 350–1.
6. Duration. This directive is rescinded on publication of the revised regulations.
Encl John E. Whitley
Acting
DISTRIBUTION:
Principal Officials of Headquarters, Department of the Army
Commander
U.S. Army Forces Command
U.S. Army Training and Doctrine Command
(CONT)
SUBJECT: Army Directive 2021-08 (Implementation and Sustainment of Army Medical
Department Individual Critical Task Lists)
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DISTRIBUTION: (CONT)
U.S. Army Materiel Command
U.S. Army Futures Command
U.S. Army Pacific
U.S. Army Europe and Africa
U.S. Army Central
U.S. Army North
U.S. Army South
U.S. Army Special Operations Command
Military Surface Deployment and Distribution Command
U.S. Army Space and Missile Defense Command/Army Strategic Command
U.S. Army Cyber Command
U.S. Army Medical Command
U.S. Army Intelligence and Security Command
U.S. Army Criminal Investigation Command
U.S. Army Corp of Engineers
U.S. Army Military District of Washington
U.S. Army Test and Evaluation Command
U.S. Army Human Resources Command
Superintendent, U.S. Military Academy
Director, U.S. Army Acquisition Support Center
Superintendent, Arlington National Cemetery
Commandant, U.S. Army War College
Director, U.S. Army Civilian Human Resources Agency
CF:
Director of Business Transformation
Commander, Eighth Army
Enclosure
DEFINITIONS
Unless otherwise noted, these terms and definitions apply for the purpose of this
Army directive.
Clinical Proficiency: The ability of an individual or team to perform a clinical task to
standard. Assessed clinical proficiency is based primarily on the evaluated task
proficiency rating from the time the task was last trained and the providers’
understanding of the clinical task, factoring task atrophy.
Health Readiness Platform (HRP): Military treatment facilities that enable Soldier
medical readiness and ensure operational medical currency and competency in critical
wartime medical readiness skills and core competencies of military healthcare
personnel.
Individual Critical Task (ICT): A task individuals must perform to accomplish their
mission and duties in a full range of Army operations. ICTs specify the knowledge,
skills, and attributes for each AMEDD modification table of organization and
equipment (MTOE) AOC or MOS. It must be specific; usually has a definite beginning
and ending; may support or be supported by other tasks; has only one action and,
therefore, is described using only one verb; generally is performed in a relatively short
time (with or without a specified time limit); and must be observable and measurable.
Individual Critical Task List (ICTL): A list of tasks that individuals must perform to
accomplish their mission and duties and to survive in the full range of Army operations.
Readiness: The ability to perform a capability at a given time.
Ready Medical Force: A force with the medical capability to support across the full
spectrum of conflict as part of Joint Forces.
Task: A clearly defined and measurable activity accomplished by individuals and
organizations. It is the lowest behavioral level in a job or unit that is performed for its
own sake. It must be specific; usually has a definite beginning and ending; may support
or be supported by other tasks; has only one action and, therefore, is described using
only one verb; generally is performed in a relatively short time (with our without a
specified time limit); and must be observable and measurable.
Tiers: A classification system used to prioritize training resources and opportunities for
medical personnel aligned to operational requirements.
Tier 1 Clinical Readiness: Highest level of readiness. Validated medical and dental
AOC/MOS personnel fully capable of performing, individually or as part of a team,
critical wartime tasks in an operational environment. Each medical Soldier is fully
deployable and meets all Tier 2 and Tier 3 clinical readiness requirements.
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Tier 1 clinical readiness requirements apply to medical AOC/MOS Soldiers (all
components) (a) assigned to support operational units with Global Force
Management Allocation Plan requirements within 12 months (such as the Defense
Support to Civil Authorities; U.S. Homeland Defense Command; and Joint Chemical,
Biological, Radiological, and Nuclear Defense Capability Development Group) and
(b) assigned to U.S. European Command and U.S. Indo-Pacific Command units.
Tier 2 Clinical Readiness: Medical and dental AOC/MOS personnel are deployable and
meet Tier 3 requirements. Each medical Soldier can meet Tier 1 clinical readiness
requirements within 180 days. Minimal requirements for just-in-time training and
post-mobilization training.
Tier 2 clinical readiness requirements apply to medical and dental AOC/MOS personnel
(all components) (a) assigned to operational units, (b) in low-density or high-demand
AOC/MOSs assigned to table of distribution and allowances (TDA) units, and (c) MTOE
Assigned Personnel (MAP) not deploying within 12 months.
Tier 3 Clinical Readiness: Each medical and dental AOC/MOS Soldier is deployable
and can meet Tier 2 clinical readiness requirements within 365 days. Privileged and
non-privileged medical personnel meet requirements in AR 40–68 (Clinical Quality
Management) for licensure, credentials, privileges, and certification.
Tier 3 clinical readiness requirements apply to medical and dental AOC/MOS personnel
(all components) assigned to TDA units and not otherwise designated as Tier 2.