On November 8, 2024, the Canadian Armed Forces (CAF) concluded a critical Submarine Medicine Course in Victoria, BC, following a simulated submarine emergency. The training, designed to enhance the medical readiness of clinicians, focused on handling medical crises in the unique and challenging environment of submarines. The course included realistic scenarios, such as trauma care, decompression sickness treatment, and psychological support for crew members, addressing both physical and mental health needs. Medical personnel from Canada, United Kingdom, United States, Australia, Netherlands, Singapore, and Portugal worked together in high-pressure drills to practice emergency responses. The exercise was conducted on a Royal Canadian Navy (RCN) Arctic Offshore Patrol Vessel (AOPV), which had multiple hyperbaric chambers and medical shelters position on its flight deck to serve a platform to conduct a submarine rescue. A key element of this year's training was the focus on mental health, recognizing the psychological toll of extended underwater deployments. The course also emphasized the importance of teamwork and communication among multinational allies during a crisis. This course also marked the final one organized by Lieutenant Commander (LCdr) Kirby, who has led submarine medicine training for several years. LCdr Kirby’s leadership has been instrumental in shaping the program, ensuring that medical teams are well-prepared for the unique challenges of submarine operations. The successful completion of the Submarine Medicine Course and SUBSAR Ex underscored the importance of international cooperation and shared expertise in submarine medicine, enhancing the global readiness of naval forces in responding to maritime medical emergencies.

The large triennial live exercise Dynamic Monarch 2024 was conducted in the vicinity of Arendal, Norway 8th to 19th September. The exercise is conducted by COMSUBNATO and its aim was to train and demonstrate that NATO and partners can cooperate successful in life saving operations for and from a distressed submarine including all relevant medical aspects.

Units and personnel from 10 nations (CAN, DEU, FRA, GBR, NLD, NOR, POL, SWE, TUR, USA) participated this year as well as observers from the force contributing nations and other nations (ESP, GRS, SNG). The participating force consisted of 2 submarines, 7 surface vessels, MPAs, and Rescue Helicopter as well as an large international medical team (125 pax +), a para rescue team and logistic support forces. 3 major rescue systems were embarked different MOSHIPs, namely the complete NSRS, SWE- and TUR- systems as well as diving teams.

36 in water serials and 4 mass evacuation serials were successfully conducted. The serials covered all aspects of a rescue operations, including pod posting, SRV-Submarine mating with personnel transfer, and live single escape from a bottomed submarine.

The exercise was a great success and all exercise objectives were met due to the hard and professional work of the approximately 750 personnel that participated.

Coverage from international and internal media positive and extensive throughout the exercise.

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The 2024 meeting of the Submarine Escape and Rescue Working Group (SMERWG) took place in Amsterdam 17-20 Jun 24, with over 120 delegates attending. As always, this conference provided a great opportunity to discuss SMER related topics with our partner nations enabling us all to enhance the knowledge across the global SMER network as well as creating and extending friendships. Many thanks to our hosts for an outstanding event.

The 2024 Royal Australian Navy (RAN) Coordinator of Rescue Forces (CRF) course was held on Garden Island in Western Australia and will conclude 02 August. Students represented Indonesia, Philippines, Thailand, Singapore, Malaysia, and Vietnam, along with RAN students. The CRF course was opened by CDRE Tom Phillips, Commodore of the RAN Submarine Force, and CAPT Richard Lindsey, CSC, Director of the Submarine School. The course highlighted the growing submarine focus in the Australasian region and the growing Escape and Rescue Capabilities of many nations in the area. Fellow submariners all united that safety of human life in a crisis should transcend national borders. Timing of the 2025 course is yet to be determined, but will is open to any nation.

The 5th NATO Coordinator Rescue Forces in Taranto will conclude on the 12th July 2024, at the Submarine Flotilla Command.

With students from Chile, Columbia, Poland, the UK and the Netherlands and specialisations in diving, submarines and training the course offered a rich platform for discussion and development.
We were honoured by the start of the course being officially given by the Commander of Submarines of NATO (COMSUBNATO), Rear Admiral Thomas Wall, and by the Commander of Submarines of the Navy (MARICOSOM), Rear Admiral Vito Lacerenza. 
The course continues to grow with feedback from the students being an important aspect of the development process. We are also pleased to announce the second of the Submarine Controller SMER event management course that is now available to international students.

SUBMED 23 has ended after being fantastically hosted and run by the RCN.

Two weeks consisting of lectures and embarkation onboard the HMCS HARRY DEWOLF

It is the generosity of people taking time out of their very busy schedules that is most remarkable. Invaluable practical training was achieved and a brilliant road test of new features on ismerlo.org for DISSUB medical teams.

The 2023 meeting of the Submarine Escape and Rescue Working Group (SMERWG) took place at the Marina Militare Istitutio Di Studia Militari Maritimi, in Venice, Italy, 27 through 30 June 2023. A total of 130 delegates from 20 nations attended. A number of SMER related topics were covered in depth and it was a great opportunity to share and enhance knowledge across the global SMER network as well as maintaining and extending friendships. We are truly grateful to the Italian Navy who did an outstanding job in hosting the event in the historic and marvelous city of Venice.

And so ends the Fourth NATO Coordinator Rescue Forces in Taranto, at the Submarine Flotilla Command.
We were honoured by the start of the course being officially given by the Commander of Submarines of NATO (COMSUBNATO), Rear Admiral Thomas Wall, and by the Commander of Submarines of the Navy (MARICOSOM), Rear Admiral Vito Lacerenza. 
This important two weeks in the SMER global calendar has again given a multinational, multi disciplined group of students the chance to gain knowledge of global SMER, taught by an international group of specialists, and experience practical live training scenarios to further their skills.
The course continues to grow and important work has been done by the students in establishing new ideas in how the CRF does their work during a DISSUB event, including live interactions with a major rescue asset, NSRS.
Looking to the future the course will continue to grow and improve - preliminary work has already been completed during this course in conjunction with the Italian Navy and we hope to link submarine controllers onto the course next year to achieve mutual training objectives.

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