On 14 Jun 23, the Department of the Air Force Surgeon General (DAF/SG) presented the need for an Air Force Medical Command (AFMED) concept at the Air Force’s Corona South which was led by the Secretary of the Air Force, Air Force Chief of Staff, Chief Master Sergeant of the Air Force and comprised of approximately 90 general officers representing various areas of responsibility and functional areas of operation. The DAF/SG highlighted the challenge of the Air Force Medical Service not being optimally aligned to best support Line of the Air Force and Space Force partners in the future and the various levels of risk occurring across the 76 DAF installations as a result of Military Health System (MHS) reform. The Secretary of the Air Force approved the AF/SG to continue moving forward on AFMED’s design and, subsequently on 16 Jul 23, the CSAF signed an AFMED Program Action Directive (PAD) initiation memo appointing the AF/SG as the lead for PAD development and provided 2-letter Headquarters Air Force support. The AF/SG staff partnered with the AF A5/7 to conduct a strategic planning conference 14-18 Aug 23 with MAJCOM SGs, MAJCOM CMEFs and other Line and medical partners to build courses of action (COAs) using the 7-step Joint Planning Process found in Joint Publication 5.0, “Joint Planning”. The planning conference resulted in four COAs being developed for a future AFMED organizational design. AFMED as a Field Operating Agency (FOA) was established at Initial Operational Capability (IOC) on or about 1 Oct 23. Subsequently, the COAs on AFMED organizational design were briefed to the MAJCOM CCs, CSAF and Secretary of the Air Force for approval and to inform the creation of the AFMED PAD and formal implementation plans. The purpose of AFMED is to support the Department of the Air Force’s Great Power Competition. It optimizes readiness (AFFORGEN, medically ready force, ready medics, deployment line support, incident response, training/exercises, etc.) while balancing the statutory requirement to provide care to our beneficiaries by elevating the command authority of Airmen medics and Line funded medical Civilians to an Air Force Medical Service 2-star Intermediate Commander who is dual-hatted as a DHA Network Director. This presentation will convey the current status of AFMED implementation and provide the way-ahead as it moves toward Full Operational Capability (FOC).