Undersea Medical Officer Course


After spending the weekend traveling to Panama City, and then enjoying the Presidents’ Day Holiday, UMOC 109 was ready to begin Dive School. We reported as a class in our Service Dress Blues (SDBs) to the Navy Diving and Salvage Training Center (NDSTC) quarterdeck on Tuesday sharply at 0600. We were joined by an Army Physician’s Assistant and two Japanese Medical Officers to complete Dive School Class 14-10-DMO (14 = 2014, 10 = class designator, the DMO = Dive Medical Officer). The rest of the day was the typical military check in rigamarole with an additional gear issue, gear labeling and organizing, shirt stenciling, and setting up our dive cage.


The NDSTC is the “Diving Mecca” of the US military, and actually the “largest diving facility in the world.” There are 23 different courses offered here including our DMO course, so we interact with multiple other classes all in various phases in their training – 2nd Class Divers, EOD divers, Marine Engineering Dive Officers, Air Force PJs, Army and Coast Guard Divers, etc. The facilities are incredible and the amount of training opportunities endless, making it a perfect place to be a student. Each class is assigned a training team and formal introductions were made the first day. Our training team has one lead instructor who directs the course and multiple other instructors who all have extensive diving experience. It was evident immediately that we scored bigtime with an awesome instructor cadre, which was confirmed later by instructors from other training teams. Hooyah!


Tuesday began with a PST which most of the class crushed after the long weekend and plenty of rest. After the PST, we headed to the pool for mask, snorkel, and fin orientation. We learned how to clear our masks underwater, then how to clear a snorkel upon surfacing from being fully submerged, and then we finished by finning a few laps around the perimeter of the pool “dolphining” (diving a few feet and then returning to the surface for a snorkel breath). Thursday began with a “Welcome to Dive School PT beatdown.” Our lead instructor just happens to be a PT stud – we discovered this quickly – and took us on a circuitous five mile running tour around the base at a ridiculous pace that was frequently punctuated with the class getting dropped into the leaning rest and punished with burpees and various other calisthenics for not performing satisfactorily. The training team also used this time to standardize every movement of the class and bring us together as a team in every imaginable way to the most minute detail. We also had the pleasure of getting “Wet and Sandy” – dunking in the bay and then rolling in the sand until we resembled sugar cookies – and then performing more calisthenics until the sand was chafing our thighs via our UDT shorts. We then ran to a nearby boat ramp and entered the chilly water again forming a floating circle around the instructors. While treading water – which we found remarkably easier in saltwater than freshwater – we recited various diving physics gas laws from memory that we had learned the previous day in class. Soon we emerged from the water and resumed what was eventually dubbed the “Death March” back to the grinder – an empty spot of parking lot adjacent to the NDSTC piers. While being instructed on how to enter and exit the water as a class from the piers, the bugle for morning colors sounded and we all came to attention for the national anthem. Treading water in a bayou while observing morning colors was a new, awesome experience which was completed with a resounding “Hooyah America!” from the class after the bugle’s “Carry On.”


Later that afternoon was a Pool PT session with more treading, calisthenics, leaning rest, etc. Friday began with a 1000 yard bay fin in “Alligator Bayou,” another job sheet that must be passed before open water diving. We all passed the “bay fin” in the pool at NUMI previously, but learning to navigate without lane lines and close reference points in the bayou proved somewhat difficult. We immediately repeated the bay fin with everyone’s times improving significantly once we got a mental bearing, discovered usable landmarks, and buddied up with those who needed help navigating. The rest of the first two weeks continued similarly, with morning PT consisting of PSTs, bay finning, and “Death Marches” followed later in the afternoons with more Pool PT and instruction. Our afternoon treading sessions graduated to treading with fins, then we passed dumbbells around the treading circle, then the number and weight of the dumbbells progressively increased until we were doing weighted treading as a class for more than an hour. This was purposefully designed to prepare us for the In Water Proficiency testing (IWPs) of pool week that requires us to do our buddy checks and tread water while wearing all of our dive gear.


Each day, after morning PT and showers, we headed to the classroom for didactics on various diving related topics. We began with Basic Diving Physics and Charting which included the theory and practical application of Archimedes Principle and the various gas laws that most of us have not thought about since the MCAT six to seven years ago. Additionally, we had lots of practice charting various dives. We all passed that test, then progressed to Basic Diving Medicine which focused on the Nervous, Respiratory, and Circulatory systems and all the various diving related issues – O2 toxicity and hypoxia, Nitrogen Narcosis, Air Gas Embolisms (AGE), Decompression Sickness (DCS, the Bends), Pulmonary Over Inflation Syndromes (POIS), CO2 toxicity, CO toxicity, near drowning, hypothermia, etc. We all passed again and then started learning about SCUBA operations in preparation for Pool Week.


Pool Week is a three day evolution that introduces us to breathing off compressed air underwater and progressively advances us through basic SCUBA skills to “confidence training,” or pool hits. We started pool week on Friday and spent nearly the entire day either in the water or underwater – an excellent change of pace from the classroom. After obtaining all of our gear and performing preventive maintenance and function checks we were ready to begin. We started with ladder training, which sounds somewhat mundane but may be one of the most important evolutions. After exhalation and max inhalation, we descended the ladder to the bottom of the pool, and then made a gradual ascent at thirty feet per minute to the surface while pursing our lips and maintaining a constant gradual stream of bubbles. Once on compressed air, if a diver bolts to the surface or ascends too quickly without exhaling, he could experience a POIS with the worst outcome being an AGE, and possible death. So practicing these simple, basic skills can be life saving.


After that we donned our SCUBA gear, entered the pool as buddy teams, and headed to the shallow end where we practiced breathing underwater, clearing our masks and regulators, buddy breathing, and then finned a few laps around the deep end of the pool for an “orientation dive.” Next, we started “Ditch and Don” procedures in the deep end. At the pool bottom, we removed our gear in a specific order, took a last breath of compressed air, and then made a gradual ascent to the surface with the instructor “Safety Swimmer.” After reporting to the dive supervisor, we dove back down to our gear, began breathing off our regulator, then donned the rest of our gear in reverse order while performing our five-point checks. We then moved on to In Water Proficiencies (IWPs). For IWPs we again entered the pool as buddy pairs with SCUBA gear on, performed our buddy checks, and then treaded water for a minute before inflating our life preservers and finning to the shallow end.


Once everyone reached the shallow end, we began “Pool Hits” – the evolution that usually generates the most anxiety. Each student fins down to the deep end and swims in a big square while looking at the pool bottom and waiting for “the hit.” An instructor dives from the surface and “imposes” a twenty second hit that includes ripping off the mask and regulator, removing fins, undoing straps, and generally throwing the student around the bottom of the pool. After the hit is imposed, the instructor signals the student by tapping him on the head, and the student goes to work problem solving. The first step is to retrieve the regulator and begin breathing again, then the student cycles through his five-point checks – air, reserve, strap, strap, strap. Each hit is graded and observed by the safety diver who is directly adjacent to the student with air if absolutely necessary. Later the hits are made more difficult by the instructors turning off the air and tying the regulator hose in knots behind the students back. The most important points are for the student to never panic, never lose his tanks, and to always secure his air first – since we as humans suck at breathing underwater. After each student received two light hits with most passing both hits, we called it a day and began cleaning and storing all of our gear. And so ended week two and the first day of Pool Week. Hooyah UMOC 109, Class 14-10-DMO!!!



Week three of dive school was chock full of win. We started it off early Monday with back to back bay fins with four other classes which made for an epic fiasco in the water and only a few students passed due to multiple in water collisions while competing for a perfect line between buoys. The buoys are set 250 yards apart, so two full laps will complete the 1000 yards, but any variance off a straight line between the buoys quickly adds yardage and decreases the likelihood of making the 22 minute standard. And colliding with students from other classes further decreases the likelihood of passing. Thankfully we had a chance to redeem ourselves Tuesday morning. With fewer classes and a staggered start time, all but one in the DMO class beat the 22 minutes on the first bay fin. Our lead instructor put us back on the line immediately and said that if we all passed the second bay fin that it would be our official graded bay fin. Honestly, I was a little skeptical since we were all gassed, but everyone put out and the last DMO candidate passed the final buoy at 21:50, just in time. There was a chorus of “Hooyahs!” as the last group finished, another hurdle passed. We were pretty motivated since each student is required to pass the bay fin before open water diving, and it also meant that we graduated to more enjoyable PT sessions. The next day’s PT was an orientation to functional fitness style workouts and Olympic lifting; we were so jazzed to throw on some weight and leave the endless repetitive calisthenics behind. Thursday was was an interesting workout, it included four rounds of a 500 yard swim with fins (freestyle or sidestroke), 25 kettlebell swings, and 25 burpees for time. Friday, we performed another “Crossfit” style workout with multiple sets of deadlifts, goblet squats, single-legged Romanian deadlifts, running, and carrying kettlebells up and down multiple flights of stairs. The next week was much of the same with more swimming workouts and varied functional fitness workouts with different exercises added each day. We were all glad to have graduated from the beat-down make-you-want-to-quit workouts to the more enjoyable, high-intensity, building muscle mass and improving cardio endurance workouts.


Before and after our morning PT sessions during pool week, we were busy with Preventive Maintenance Service (PMS) of all the dive equipment. PMSing – appropriately named – the equipment is a vital component to the beginning and end of each day, and ensures the reliability and proper functioning of life preserving equipment. The last place you want to figure out that your regulator or buoyancy compensator has a problem is when you are underwater depending on their functioning to stay alive. Each piece of equipment is inspected for visible defects and then function checked following a regimented, checklisted process. As detailed, lengthy, and annoying as this can be at times, I am very thankful for this attention to detail and emphasis on safety in the USN dive community.


Each day after the preliminary morning PT and PMS, we got right back into pool week from where we left off the day before. On Monday, we resumed individual light hits and by the end of the day we had finished all the “single” moderate hits. Each student is required to pass three of each of the light, moderate, and heavy hits to continue in pool week for a total of nine satisfactory individual hits. Each hit is “imposed” by a “safety swimmer” who is snorkeling above the student on the surface like a shark searching for prey. The safety swimmer is allowed twenty seconds to administer the hit before swimming back to the surface and leaving the student to “problem solve.” A “safety diver” is on standby for the entire hit with a regulator ready in case the student needs air or gets hit on an exhale. Each student is required to fin around the deep end staring at the pool bottom waiting for the inevitable moment, an experience that can be anxiety provoking.


Often, the first sign of the hit is having the regulator ripped from your mouth, so some students – with variable success – devised breathing techniques to avoid losing their air supply at the end of an exhale when there is no more air in the lungs. The hit then continues with various pieces of equipment being ripped off and the student being steamrolled in all directions and bouncing off the pool bottom. The end of the hit is signaled by either the safety swimmer’s twenty second alarm sounding, a pat on the head, or a few moments of solace – the signal to “go to work.” The student must then immediately sit down on the pool bottom and attempt to retrieve his regulator via various techniques. Once the regulator is retrieved, inserted, purged, and the student is breathing, he must cycle through his five-point checks – air, reserve, strap, strap, strap – before passing the hit successfully. Once completed, the safety diver inspects and then informs the student whether or not he passed. If counseling is needed the pair ascend to the surface and talk over what went wrong. If the student passes, he continues on his way along the pool bottom again waiting to be preyed upon from above.


With moderate hits the instructor can also turn off the air supply, and with the heavy hits the regulator can be “fouled.” It turns out that fouling a regulator is somewhat of an art form that includes various knotting techniques that wrap the regulator hose around the manifold and one technique called “the thong” that traps the second stage of the regulator between the bottom of the two tanks. Generally, fouling a regulator makes it unretrievable and the student must remove the tanks from his back following a specific process before the regulator can be unfouled and the student can breathe. This requires a lengthy breathhold and quick problem solving, but some of the students found the heavy hits to be enjoyable due to the challenge. The instructors also enjoyed spicing up the process by swimming in front of the students and flashing their stopwatch before starting the hit, or counting down with their fingers. Or occasionally the safety divers would distract the students by playing rock-paper-scissors while the safety swimmer snuck up from behind – something we found humorous after the fact when we finished inhaling water.


Once the individual hits were completed, we transitioned to buddy hits which basically involved the same process except now with a dive buddy and both divers getting hit at the same time. This required extra coordination and occasional buddy breathing, but in the end we all finished and passed. Pool hits are officially termed “Confidence Training,” and all the students escaped the week with an improved ability to troubleshoot the equipment while under water, under duress, and without air. The pool hits, while mentally traumatic, are designed to simulate a current tossing the divers into various objects while under water – a likely eventual scenario for any diver. By working through this scenario multiple times in a controlled environment initially, it greatly increases the likelihood of survival in what could be a deadly situation underwater if not handled correctly. By Wednesday afternoon, there was a collective sigh as the entire class completed pool hits successfully.


On Thursday, we moved over to the “New Pool” – a forty foot deep pool with a crane for lowering various training props and moveable grates to increase or decrease the depth of the pool bottom. We finally graduated to real buoyancy compensators and oriented to the new equipment with a pool dive. Then we underwent rescue diver training and each student simulated an unconscious diver for their dive buddy who then went through the process of correctly retrieving the diver from the pool bottom. And thus ended pool week, one of the more memorable weeks of training we had during this course.


On Friday of week three, after PT, we headed back to the classroom to learn about various techniques of underwater searching including “Circle Line Searches” and “Jack Stay Searches.” On Monday and Tuesday of the next week, we practiced these two techniques as buddy pairs in twenty feet of muddy, murky zero-visibility water on the bottom of Alligator Bayou searching for a body (a dummy) and an M16 (a dummy rifle). These two techniques are basically an organized way of searching a specified area and involve the dive team swimming in a grid-like pattern or in a incrementally enlarging circle. We learned very quickly that it sucks to be searching for something when you can not see your hand in front of your face. But we also learned that the task can be accomplished through teamwork and by following a well designed pre-dive plan. After fumbling through the searches and occasionally finding what we sought, we understood what one of the instructors stated matter-of-factly: “As a Navy Diver, it’s always dark, it’s always cold, and it’s always far away.”


On Wednesday, we got kitted up early in the AM on one of the Dive School’s 133 foot Yard Diving Tenders (YDTs) and headed out for some open water diving, but due to the wind and weather the dive was cancelled and we returned to NDSTC. The weather foiled our open water plans again on Thursday, so we dove off the side of the moored YDT and received more rescue training. The instructors used this time to teach different techniques for retrieving an unconscious diver from the water via a Rescue Strop, a Miller Harness, or carrying the diver up a ladder. We then practiced on each other, some simulating DCS pains and others an unconscious diver with the rest of the students responding appropriately medically and hurrying the victim to the onboard decompression chamber.


Friday of week four was an epic day of epicness. We loaded our gear into two small Rigid Hull Inflatable Boats (RHIBs) and headed out to sea for some open water dives. These boats were incredibly fast so we reached the first dive site – The Red Sea – within 30-40 minutes. Half the class dove first while the other half tended and prepped. We descended the buoy line 60-70 feet where we first saw the “Red Sea,” an old tug boat that was sunk a few miles off the coast in 2009 to serve as an artificial reef. Visibility was 30-40 feet for our dive, which is great for that site according to a few of the instructors. After rounding the sunken vessel and observing the marine life including one goliath grouper hiding in the cabin we returned to the surface and switched out. We then headed to the second dive site (Stage 2 – piece of an old Navy platform in about 60-70 feet of sea water) and repeated the process. On the ride back to NDSTC with the sun shining, salt spray, and wind whipping, I couldn’t help but think about the awesome opportunity we found to be dive docs. And all the hard work is finally paying off. Hooyah 109! Hooyah 14-10-DMO!


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