This session will comprise a 30-minute presentation followed by a 30-minute panel discussion focusing on how addressing this shortfall will build resilience, enhance team dynamics, bolster retention, and decrease risk of moral injury. Pre-deployment Just in Time training and casualty care training programs are based on data including injury patterns and evacuation capabilities from OEF and OIF. We are reassured by the high survival rates that were achieved due to ready access to supplies and air superiority. The future fight will likely occur in large-scale combat operation and distributed maritime operating environments with a great power adversary. Casualty evacuation and injury circumstances will potentially more closely mirror WWII, but with newer and more advanced signals intelligence and missile capabilities. Combat engagements will result in a large number of casualties that will quickly overwhelm resources. There is a high probability that casualties with injuries that would survive CONUS, or even during OEF/OIF, have a greater chance of expiring due resource consumption and casualty retrieval and evacuation circumstances. This problem set has many implications for military medical providers. One of the most significant is the requirement to provide end-of-life care to casualties that have survived much longer than many patients that are immediately categorized as expectant. Though palliative and end-of-life care protocols and pathways exist in the civilian healthcare system, these programs are focused on patients with non-survivable injuries or illnesses. We have the opportunity to raise awareness across all levels of the chain of command and develop strategic initiatives to enhance knowledge, skills, and attitudes to face this challenge.