New arduous medical standards process this year

In 2024 USFS employees with arduous quals will do the arduous exam. Firefighters with moderate or light duty will have the OF 178 exam if they mark one box in Part A or three in Part B. If you have questions you can email the help desk at

Arduous Medical Exam (AME) or Self-Certification or (HSQ)

What is the difference between the AMP and the HSQ?

      • The Arduous Medical Process is for those taking the arduous WCT.
      • The HSQ is for those employees taking the moderate and light WCTs.

What about the AMP Exam (AME) and Self Certification?

      • eMedical AMP runs on a 3-year cycle for employees.
      • Year one is the AME: a thorough health screening questionnaire followed by a physical exam with a medical provider. The exam results are reviewed by a USFS Medical Officer (RMO) before the employee can get medical clearance to take the WCT.
      • Years 2 and 3 are the self-certification process, which requires a shorter screening questionnaire plus a blood pressure check by an EMT or other qualified individual. The results are reviewed by HSQC’s and, based on the answers, may be routed to the RMO or cleared to the WCT.

NOTE that this is a gradual rollout over the next few years, not just in 2024 and not all regions are shifting the AMP at the same time. Here is the rollout schedule (subject to change):


      • Those with arduous qualifications who have not completed the arduous process yet will continue using the current system with the HSQ, alongside all moderate and light quals.
      • In those areas that are implementing the AMP, Acuity International will  assist with scheduling and payment for exams, at the employee’s request. This is a completely optional service.

The NWCG Risk Management Committee provides interagency national leadership in firefighter risk management, health, and safety. The Federal Interagency Wildland Firefighter Medical Standards establish minimum medical fitness for arduous duty. Light or moderate duty firefighters may be required to do a medical screening process.

The USFS uses Federal Interagency Medical Standards for employees who engage in firefighting duties.

Firefighters with arduous duty quals must complete a physical exam every three years, and it is required before that year’s work capacity test.

You must fill out a medical history form in eMedical and then you can schedule your exam with your doctor; your supervisor can initiate this for you. If you are approaching three years since your last exam, you should get started at least 45 days before your work capacity test. You can log into eMedical and request a packet.

USDA Forest Service

Annual Self-Certification

A questionnaire and blood pressure check are required each year between your in-person exams. The self-certification form FS-5100-42 is not the same as the HSQ/OF-178. It can also be completed in the eMedical system.

Details on additional exam requirements are posted [HERE].

  • eMedical Public Site for Temporary, AD, and new employees (available through ConnectHR) — this requires a username and password.

Medical Provider Documents (ALL PDF)

NWCG announces recipients of the 2020 Wildland Fire EMS Awards

water tender fire rollover wildfire
File photo, transporting the victim of a water tender rollover in 2018. A total of 30 people—using a combination of standard carry and caterpillar carry, depending on the incline—transported the victim from the accident site down to the road via the pathway that the Type 2 Hand Crew constructed, where an ambulance was waiting. (Not associated with the awards below.) Photo from the report.

The National Wildfire Coordinating Group’s Emergency Medical Committee annually recognizes individuals and groups who have demonstrated outstanding actions or accomplishments that are above and beyond the expectation of one’s normal mission or job duties. The 2020 awards honor seven individuals and three crews:

Burns Interagency Fire Zone and Malheur National Forest T2IA Crews
Outstanding Wildfire EMS Crew of the Year
On Aug. 5, 2020, while the 20-member Burns Interagency Fire Zone and Malheur National Forest crews were providing initial response to a fire in the Malheur National Forest in eastern Oregon. A rock rolled downhill and struck their EMT on the head, rendering him unconscious with heavy bleeding. Just days prior, that same EMT had trained the crew on what to do if their EMT were incapacitated. The Burns Interagency Fire Zone crew immediately worked to stabilize the patient with the assistance of the Malheur National Forest crew. They were able to transport the patient to an ambulance within 20 minutes. The crew member had a severe head laceration and a skull fracture that required emergency surgery. According to the neurosurgeon, this type of head injury is typically not survivable. Due to the quick actions of both crews on the scene the EMT was able to get medical attention in time, make a full recovery, and be released to light duty. A report about the incident was developed to help train other crews on what to do in a similar situation.

Heather Wonenberg
Outstanding Wildland Fire EMS Individual of the Year
As the Assistant Helitak Foreman on Yosemite Helicopter 551 for the National Park Service, Heather Wonenberg provides supervision of the helitak crew, serves as a spotter, and is a park medic. At the height of the COVID-19 pandemic in 2020, Wonenberg led required CPR training, ensuring employee safety with small class sizes, and adapting her teaching style to meet the needs of each student. Through her efforts, Wonenberg helped to prepare wildland firefighters for emergency medical situations while implementing pandemic safety measures.

Jayson Coil
Outstanding Wildfire EMS Distinguished Service Award
The COVID-19 pandemic poses unique challenges for the wildland fire management community. As a paramedic with the Sedona Fire Department in Arizona, Jayson Coil disseminated information and helped to inform decisions in the field, not only for his department but for numerous agencies and the Wildland Fire Medical and Public Health Advisory Team. To ensure he could provide accurate, meaningful information, Coil completed 15 courses in epidemiology and public health from the University of Washington and a specialization in Epidemiology in Public Health from Johns Hopkins University. He engaged wildland fire leaders at multiple levels to address challenges with maintaining operations amid the pandemic. Coil’s efforts improved safety for wildland firefighters across agencies at a critical time.

Idaho Panhandle National Forest Helitack Crew (Eric Krohn, Jacob Hacker, Katherine Babcok, Matthew O’Neill, Maurice Theard, Rob Cole, and Randy Gaulrapp)
Excellence in Wildland Fire EMS/Rescue
Three members of the Forest Service Panhandle Helitack Crew were hiking into the Bonehead Fire in Aug. 2020 when the crew’s EMT inhaled a foreign object. She soon developed trouble breathing and exhibited signs of shock. She continued to provide guidance to her crew members as they ordered a Life Flight and coordinated with dispatch. The remainder of the crew, from a helicopter, lowered medical equipment the EMT had staged nearby. The crew hiked in to render aid while additional helicopter and engine crews provided contingency planning and communication support. After an hour, the EMT was hoisted off the fire and taken by Life Flight to a hospital. The crew member made a full recovery and returned to her firefighting duties a few days later. The employees who stepped up across multiple divisions and operated outside their normal roles to support the emergency medical response made this rescue operation successful.

John Dentinger, Nathan Navarro, Riley Currey, and Austin Lattin
Award of Excellence in Wildfire EMS/Rescue
In Sept. 2020, a firefighter at the Bureau of Land Management (BLM) Vale District Office collapsed from a heart attack. Nearby BLM staff acted promptly to summon help and provide life-saving measures. The employee was rushed to the local hospital and then flown to a cardiac hospital. His doctors informed him that he would have experienced permanent damage or death had CPR started just one minute later. The crew was nominated by the survivor, who said, “Without these guys and their quick response, I would have died.”

MaryJo Lommen
The Jannette Peterson Lifetime Achievement in Wildland Fire EMS Award
MaryJo Lommen has served in the Forest Service’s Region One medical programs for about 40 years. She started as an attendant in a field first aid station. She eventually became the Program Manager responsible for maintaining the region’s medical programs. Even after her retirement in 2016, she continues to assist the current Program Manager with annual training and records maintenance. Her unbridled passion and dedication have been a catalyst for a higher standard of care to employees as they work in the field and respond to wildfires.

More information about the awards program and a link to the nomination form can be found on the NWCG EMC webpage.

Suggestions for a medical program on a hand crew

wildfire in Alaska
File photo of wildfire in Alaska. BLM Alaska Fire Service.

Crew Medical Program — Structure and Guidelines

By Liam DiZio, Pioneer Peak Interagency Hotshot Crew

Lacking from documents outlining wildland fire crew structure are guidelines for a crew medical program. With 20+ crewmembers, crews are often their own best resource for coordinating patient care and extraction. Crew medical programs, then, must be based on this principle of self-sufficiency. This document aims to outline a sample crew medical program structure defining personnel structure, training, equipment, and standard operating procedures (SOPs) to support a strong crew medical program. The goal of this document is to serve as a resource for crew medics and further the goal of standardizing robust crew medical programs in wildland fire. This document applies to any regularly organized wildland fire crew.

Medical Program Personnel Structure

Structuring a crew’s medical personnel ensures a consistent product of patient care and equipment accountability year to year. The suggested structure looks as follows:

Lead Medic
Assistant Medic
Line Medic                    Line Medic

Duties of above personnel are described below.

Lead Medic

The lead medic is the top of the accountability hierarchy for crew medical equipment and care. The lead medic begins the season by coordinating early season medical training and supply logistics. They then then maintain and inventory crew medical equipment and ensure the correct complement of crew medical gear makes it to the fireline daily. The lead is also responsible for patient care and associated medical paperwork. Lastly, the lead medic maintains a relationship with support personnel, taking advantage of training opportunities and organizing seasonal medical supply orders. Success in this position requires daily effort and expertise in a side of fire unknown to most. This role is most appropriate for senior firefighter or below.

Assistant Medic

The assistant medic is responsible for assisting the lead in all duties. The assistant serves as an additional point of contact for crewmembers and assumes lead’s function in their absence or in split squad configuration. Assistant medics should be familiar with all crew medical equipment, medical paperwork, medical supply logistics, and training needs. This role is most appropriate for senior firefighter or below.

Line Medic

Line medics are additional designated medical personnel on the crew. Having two additional line medics ensures that medical knowledge is spread throughout squads and tool/saw teams. Line medics are accountable for crew medical gear on the fireline and patient care in a trauma scenario. Line medics are familiar with contents and function of crew medical equipment. This role is most appropriate for senior firefighter or below.

All four designated medics should hold current EMT-B qualifications or above, ideally supplemented with real world experience. Successful crew medics come from various backgrounds such as civilian EMS, military medicine, and ski patrol. Further qualifications and endorsements allow the crew to carry additional equipment such as IV/IO fluids, various drugs, and advanced airway products.


At the beginning of each season, all crewmembers require some form of medical refresher. This training can occur over one or more days of critical training. Training evolutions should include lecture, hands on skills practice, CPR certification, and medical scenarios.


Taught by the lead and assistant, a medical lecture should include information on the crew’s medical equipment, medical mentality, medical incident SOPs, basic trauma care, common fireline medical emergencies, and minor fireline medical issues. Crewmembers should also be briefed on who their lead/assistant/line medics are and the crew SOP for calling out a medical incident on the radio.

Skills Practice

Following the lecture, crewmembers cycle through skills stations learning hemorrhage control and crew extraction platform procedures. These are the skills non medically trained crewmembers are most likely to perform in the field. The hemorrhage control station should include hands on tourniquet and wound packing training. The extraction platform station should include simulated carries and lessons on proper platform set-up and storage.


Professional CPR training can fit anywhere in the crew’s critical training and can be taught by outside resources or qualified crewmembers.


Continue reading “Suggestions for a medical program on a hand crew”

Firefighter physical exams can save lives

Physical exam firefighter save life
Screen grab from the video.

As we reported earlier today, the Bureau of Land Management is beginning to provide medical exams for federal Emergency Firefighters (EFFs) in Alaska. The goal is to increase safety by identifying pre-existing conditions that could be aggravated by the arduous duty of wildland firefighting.

These two videos, each about two minutes long, tell the stories of firefighters who discovered during the physicals that they had life-threatening medical conditions. They were then able to take actions which probably saved their lives.

Alaska emergency firefighters to undergo medical exams starting in November

Alaska EFF firefighters
The Kobuk River #2 Type 2 EFF Crew working on a fire in the Lower 48 in 2018. AFS photo.

The Bureau of Land Management Alaska Fire Service in partnership with the Department of Interior Medical Standards Program (DOI MSP) will soon provide medical exams to federal Emergency Firefighters (EFF). The goal of the exams is to increase safety by identifying pre-existing conditions that could be aggravated by the arduous duty of wildland firefighting.

The medical exams will be provided in approximately 28 Alaska villages through mobile medical units and by scheduled appointments at 18 facilities throughout the state.

Starting in November EFFs in Alaska who are hired on an as-needed basis will need medical exams once every three years and self-certify in between years. The medical screening established by the DOI MSP will screen EFFs for any disqualifying medical conditions prior to participating in the Work Capacity Test (WCT), otherwise known as the pack test. Only wildland firefighters performing arduous duties are required to undergo medical exams and pass the WCT.

Schedules for the exams will be posted on the BLM AFS EFF webpage .

For the past two years, Alaska EFFs were granted exemptions to these medical screening requirements. The first phase of implementation of the medical exams began in 2015 and only included regularly employed Department of the Interior wildland firefighters. Applying the requirements to Alaska EFFs was originally planned to begin in 2017, but implementation was delayed until measures were in place to provide mobile units in rural Alaska to conduct the medical examinations. The exams do not include drug testing or affect State of Alaska EFFs.

There is no cost to the EFF for the examination, however, if the individual chooses a location other than their local village BLM AFS will not cover the associated travel costs. After the exam is completed, a determination will be made regarding the candidate’s eligibility to participate in the pack test and the arduous duty of wildland firefighting.

The BLM AFS provides wildland fire management for the Department of the Interior and Native Corporation lands in Alaska and provides oversight of the BLM Alaska aviation program. Firefighter safety and the safety of the public are core values and are fundamental in all areas of wildland fire management.

For more information, EFF candidates can email or call EFF Program at 1-833-532-8810 or (907)356-5897.