The RAMP is a unique hybrid medic, whose baseline knowledge and skill sets begin with meeting the cognitive and psychomotor requirements for certification as an Emergency Medical Technician, and then progressively expands to focus on a myriad of both medical and trauma management problems that are typically well above the scope of practice of many other prehospital care providers.

As there is no universally accepted certification process that authorizes the procedures, skills, and degree of autonomy required by medics who provide treatment in remote and austere conditions in developing nations or in disaster zones, we developed a comprehensive training program based on the United States Special Operations Command’s (USSOCOM) Advanced Tactical Practitioner (ATP) program to fill this gap. Our RAMPs have the knowledge, skills, and experience needed to provide the highest level of emergency, extended, and primary medical care required after natural disasters, in third world countries, and regions torn by conflict.

Because RAMPs can be needed virtually any place on the planet, regardless of the season, time of year, or given weather conditions, they must be multifaceted. We know that the survival rate of trauma victims, for example, depends largely on the close proximity and timing of a patient receiving definitive care. Moving a critically injured patient to a hospital, particularly in disaster or combat zones, is often impractical or impossible. Accordingly, RAMPs are well trained and equipped to treat a variety of medical emergencies to include those commonly found in combat zones, harsh desert and wilderness, and other settings where communities and tribes generally have no heath care providers to assist when people become sick and injured.

Combined with very limited resources, RAMPs must be able to think both inside and outside of the typical medical box, and work to solve complex medical problems while taking into consideration the unique operational environment they may be in. RAMPs are not only qualified EMTs, but also maintain significant other certifications such as prehospital trauma life support (PHTLS), advanced cardiac life support (ACLS), and pediatric education for prehospital professionals (PEPP).

The training pathways that RAMPs engage in are broad, deeps, and controlled. Once certified, RAMPs are capable of treating patients in all environmental extremes, they practice preventive medicine, dispense and administer medications, perform multiple complex procedures, and provide lifesaving care to those in need.


Fully certified and registered RAMPs have progressed through a strict regimen of academic and hand-on training, and hold multiple component and ancillary certifications. We currently have five levels, and each level identifies the abilities and limitations of the holder with the context of our standard operating procedures.

RAMP-Recruit is a non-certified entry-level position for individuals accepted into our RAMP training program. All candidates are 18 years or older and most have already completed an EMT course, or are currently enrolled. This is the beginning phase of training that leads to Step 1 certification.

RAMP Step 1 is the basic certification level required by BOTG to provide support to DMATs on deployments. RAMP 1s are generally EMT-B certified and have at least three years of pre-hospital care training and experience, in addition to having successfully passed RAMP Phase 1 training.

RAMP Step 2 is the intermediate certification level required by BOTG to act as assistant team leaders while on deployments. Generally, Step 2 holders have three to five years of experience and are EMT-I or P certified or equivalent, in addition to having successfully passed RAMP Phase 2 training

RAMP Step 3 is the advanced certification level required for autonomous deployments and to act as a team leader. Most RAMP 3s have five to ten years of experience and hold an EMT-P certification or higher (such as PAs or NPs), in addition to having successfully passed RAMP Phase 3 training.

RAMP Step 4 is our highest designated certification level. RAMP 4s are generally EMT-Ps who have passed SOF ATP certification, our RAMP Phase 4 training, or both. In addition, they have had significant deployments under their belt to multiple countries in a variety of environments, and have demonstrated leadership ability.

There are also RAMP ranks that are positional in nature, and are based on leadership ability, experience, and functionality within the organization.


There are several different paths new recruits that can be taken to become a BOTG certified RAMP eligible for deployments under our organization’s umbrella. All candidates must pass a background investigation, oral board, physical and written examination regardless of service, previous education, current medical certification level, deployment experience, or background. Please read the following explanations to identify which best describes your current circumstance. If you require further information, feel free to get in touch with a recruiter by emailing: recruitment AT

Recent and Current SOF Medics:

Those individuals who have graduated from the Joint Special Operations Medical Training Center’s (JSOMTC) Special Operations Combat Medic Course (SOCM) at Fort Bragg, N.C. or the Air Force Pararescue (PJ) School at Kirtland AFB, N.M. within the last twenty years, and have prior or current certification as an ATP through USSOCOM Command Medic Certification Program (CMCP) within the last four years, may submit their record for review. Though not universally so, candidates with these credentials are generally grandfathered in as RAMP 4s, assuming they also have the requisite BLS, ACLS, PHTLS, PEPP, and other ancillary certifications that RAMPs must possess to be registered. Candidates from other countries who have trained in similar schools with allied countries may also be considered.

Prior SOF Medics (more than four years and/or no ATP certification):

Candidates who served as PJs, 18Ds, or in similar capacities within the SOF community, but do not fall within parameters listed above, or have never held ATP certification, are encouraged to apply and will be evaluated on a case-by-case basis. In all instances, candidates in this category will be required to establish their service record and competency levels prior to acceptance at any RAMP level.

Recent and Current Combat/Service Medics:

Those individuals who have graduated from military service schools in any branch of the armed forces and have also held EMT certification at any level within the last two years, may directly transfer into our RAMP certification program. As with the above example, candidates must pass a background investigation and a comprehensive written medical skills examination to establish their current medical knowledge level. Once the exam is graded, the candidate will be placed in the appropriate RAMP training phase.

Prior Combat/Service Medics:

Candidates who served as combat or service medics in any branch of the military within the last ten years may apply for direct appointment into our RAMP training program, but must undergo comprehensive testing to establish their current medical knowledge.

Non-Military EMTs & Paramedics:

Those candidates who are currently certified as EMTs (B, I or P) at the state or national level, and who successfully pass our recruitment process, may directly enter our RAMP recruit program to be evaluated for advanced placement to one of the RAMP training phases or steps. This process is challenging and is designed to establish the candidates physical and mental capacities, as well as their clinical knowledge. Once a recruit is accepted into the training program, they are assigned an FTO (Field Training Officer), tested, and placed in the appropriate phase or at a given step.

Associate RAMPs:

BOTG offers training programs designed to allow non-organizational medics the opportunity to become RAMP certified. EMTs (or equivalently trained medical personnel) from around the globe are allowed to enter our Associate RAMP training program, which mirrors the requirements of our RAMP Recruit Program, but does not have the same residency requirements. Successful candidates who matriculate into the A-RAMP program spend six to twelve months completing distance learning assignments, each of which concludes with a proctored exam. In addition, they must fulfill a significant internship at an approved clinic, hospital, or other similar organization.

For more details, use the contact form and a recruiter will get back in touch with you.

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