The U.S. Army Medical Command (MEDCOM) is a direct reporting unit of the U.S. Army that formerly provided command and control of the Army's fixed-facility medical, dental, and veterinary treatment facilities, providing preventive care, medical research and development and training institutions. On 1 October 2019, operational and administrative control of all military medical facilities transitioned to the Defense Health Agency. MEDCOM is commanded by the Surgeon General of the United States Army, Lt. Gen. R. Scott Dingle. The Surgeon General is also head of the U.S. Army Medical Department (the AMEDD). Peacetime garrison medicine until 2019 MEDCOM maintained day-to-day health care for soldiers, retired soldiers and the families of both. Despite the wide range of responsibilities involved in providing health care in traditional settings, as well as on the battlefield, it was claimed that quality of care compared very favorably with that of civilian health organizations, when measured by civilian standards, according to findings of the DoD's Civilian External Peer Review Program (CEPRP). Deployments Historically, when Army field hospitals deployed, most clinical professional and support personnel came from MEDCOM's fixed facilities. In addition to support of combat operations, deployments were for humanitarian assistance, peacekeeping, and other stability and support operations. Under the Professional Officer Filler System (PROFIS), up to 26 percent of MEDCOM physicians and 43 percent of MEDCOM nurses were sent to field units during a full deployment. Medical personnel are now MTOE Assigned Personnel, referred to as "MAPED" or "Reverse PROFIS." Under the new system, personnel are assigned to the MTOE (Modified Table of Organization and Equipment) unit with duty assigned elsewhere to support TDA facility operations. To substitute staff, Reserve units and Individual Mobilization Augmentees (non-unit reservists) are mobilized to work in medical treatment facilities. The department also provides trained medical specialists to the Army's combat medical units, which are assigned directly to combatant commanders. Many Army Reserve and Army National Guard units deploy in support of the Army Medical Department. The Army depends heavily on its Reserve component for medical support—about 63 percent of the Army's medical forces are in the Reserve component. The concept of the Expeditionary Resuscitative Surgical Team (ERST) has been around for several years. However, an official force requisition for ERST Teams was relayed to LTG Nadja West, former Army Surgeon General, in January 2016. ERST falls under the command and control of Medical command (MEDCOM) for the US Army. ERST Training