U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement Published April 2, 2025 By Airman 1st Class Dylan Myers 86th Airlift Wing SOFIA, Bulgaria -- The U.S. Air Forces in Europe - Air Forces Africa Office of the Command Surgeon organized a medical engagement with Bulgarian medical service members to help Bulgarian Multilateral Medical Simulation Training Engagement participants foster multilateral training skills and practices through their simulation center at the Bulgarian Military Medical Academy in Sofia, Bulgaria, Feb. 24-28, 2024. The Military Medical Academy of Bulgaria was established in 1989 by a government decision to emphasize the national importance of providing outpatient and inpatient care for Bulgarian Armed Forces’ personnel and their families, as well as supporting military research, training and expertise. The Military Medical Simulation Center was designed on a U.S. model with the goal of creating an interoperable training ground for Bulgarian medical personnel and allied partners in the region. “In the end, the goal is to use facilities like this so soldiers have the same level of knowledge and expertise and continue to learn from one another,” said Slovenian Army Maj. Danijel Andoljsek. His colleague, Slovenian Army Lt. Col. Damjan Remskar, added, “In simulation centers, you can control the environment whether it’s raining, dark or loud and being able to control these variables with great mannequins is the biggest advantage.” U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement Bulgarian Multilateral Medical Simulation Training Engagement participants unify medical practices at the Military Medical Simulation Center in Sofia, Bulgaria, Feb. 26, 2025. Providing soldiers with advanced medical training can increase their survivability, ensuring that forces remain combat-effective despite potential threats in the region. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement An Armed Forces of Montenegro medical doctor tends to a simulated wounded military personnel in a later stage of the mass casualty simulation during the Bulgarian Multilateral Medical Simulation Training Engagement at the Military Medical Simulation Center in Sofia, Bulgaria, Feb. 27, 2025. With realistic combat scenarios, this training can sharpen decision-making under pressure, a critical factor in sustaining mission effectiveness across the European theater. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement Bulgarian Multilateral Medical Simulation Training Engagement participants tend to a simulated wounded military personnel at Military Medical Simulation Center in Sofia, Bulgaria, Feb. 26, 2025. This training enhanced mission readiness in the European theater by ensuring that military personnel can provide immediate and effective medical care in austere and high-threat environments. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res The ability to train in a controlled, high stress environment like the simulation center is crucial for ensuring readiness across the European theater, allowing forces to adapt to various combat situations while improving communication with NATO allies. Places like this create a shared understanding of medical practices, which enhances the ability to respond quickly and effectively during operations, ultimately strengthening the collective effectiveness in the region. “Learning how to improvise with limited resources in collaboration with other countries has been very interesting,” said Sgt. Maria Milenova Tsekina Nurse in the Aeromedical Evacuation Department of the center for aviation. Her colleague, Lt. Veselin Penchev Nikolov, Bulgarian Army senior doctor and head of medical post in medical formation, added, “The center allows us to create different scenarios and repeat them over and over to learn how to do them right.” U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement Bulgarian Armed Forces personnel, students, physicians, nurses, and doctors represent their countries during Bulgarian Multilateral Medical Simulation Training Engagement at the Military Medical Simulation Center in Sofia, Bulgaria, Feb. 25, 2025. This training enhanced mission readiness in the European theater by ensuring military personnel can provide immediate and effective medical care in austere and high-threat environments. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res 250226-F-VH914-1011 Medical equipment is laid out at an intubation station at the Military Medical Simulation Center in Sofia, Bulgaria, Feb. 26, 2025. By utilizing state-of-the-art medical simulators, the center ensured personnel can practice complex trauma interventions under conditions that mirror battlefield stress. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res U.S., NATO, partner nations participate in Bulgarian Multilateral Medical Simulation Training Engagement U.S. Air Force Col. Mike Kersten, United States Air Forces in Europe - Air Forces Africa office of the command surgeon medical readiness division chief, talks to medical doctors from Kosovo at the Military Medical Simulation Center in Sofia, Bulgaria, on Feb. 24, 2025. By reducing preventable combat deaths, this training maximized personnel availability for strategic objectives, strengthening deterrence and defense posture in the European theater. (U.S. Air Force photo by Airman 1st Class Dylan Myers) Photo Details / Download Hi-Res U.S. Air Force and Army medical personnel collaborated with allied partners from across Eastern Europe and parts of Eurasia in talking circles to highlight some of their countries’ unique challenges, whether regional, systematic or logistical. They also shared key best practices involving intubation techniques, Tactical Combat Casualty Care, and foil blanket wrapping that other countries may not be familiar with to create a more unified medical force. As the Military Medical Simulation Center continues to develop, it will serve as a vital hub for advancing medical interoperability and strengthening collective readiness among NATO allies and partners. By fostering collaboration and innovation in battlefield medicine through repetitive practice, this training ensures that military medical personnel remain prepared to save lives and sustain mission effectiveness in an evolving security landscape.