Why Medics Should Train Like Fighters—Not Doctors

by Johnathon Miranda

The day you choose to be a medic is the day you waive the luxury of being overweight, lazy, or undisciplined. Unfortunately, most don’t realize that until it’s too late—until their lack of conditioning costs them a patient, or worse, costs them respect for themselves. Because that’s the real weight you carry—not just the gear on your back, but the knowledge. The knowing that you weren’t strong enough, fast enough, or prepared enough when it mattered most. Knowing that someone’s life was in your hands, and you failed—not because the injury was unsurvivable, but because you weren’t capable. That kind of failure doesn’t leave bruises; it leaves ghosts. And ghosts don’t let you sleep.

“Under pressure, you don’t rise to the occasion; you sink to the level of your training. That’s why we train so hard.” – Anonymous

The Moment I Realized Being a Medic Isn’t About Me

A reality I had to grasp early in my EMS career hit me hard when I was fresh into EMT school. It was 03:00 in the morning, and I was studying—actually putting in real effort for the first time. But I was exhausted. Energy drinks weren’t working, blasting metal wasn’t keeping me up, and nothing could stop my head from nodding off before the exam I had in just a few hours. I was ready to call it quits.

But then something in me snapped. Call it God, my subconscious, mental fatigue—whatever you want. But a voice in my head cut through the exhaustion like a blade: “Your future patients don’t care how tired you are. They don’t care if you’re lazy. They don’t care if you’re nervous, scared, or fiending for a cigarette. All they care about is that when you show up, you deliver—and your best is enough to save them.” That was it. That was the standard. And ever since that night, I never let myself drop below it.

The Fatigue We Ignore

We don’t talk about it enough, but we should. The obesity epidemic isn’t just hitting the general population—it’s hitting firefighters, EMTs, paramedics, and combat medics harder than we’d like to admit. More than 75% of emergency responder recruits are overweight or obese (1). Among firefighter-paramedics? That number jumps to 84.6%—higher than the general U.S. population (2).

Let that sink in. We’re the ones running into burning buildings, lifting patients twice our size, and carrying wounded soldiers under fire—and yet, we’re more out of shape than the civilians we’re supposed to be saving. Why? Insane shifts, long hours, no sleep, and garbage food options. Stress eating. The job takes a toll, and a lot of medics cope with fast food, sugar, and caffeine. “We’re too busy.” The irony? We preach health to our patients but neglect our own. And let’s be real—it’s killing us. Obesity in emergency responders is directly linked to higher risks of heart disease, diabetes, and musculoskeletal injuries (3). That means we’re not just slower and weaker—we’re also breaking down faster than a Walmart lawn chair at a family BBQ.

You think the job is hard now? Try dragging a downed firefighter up a flight of stairs when both of you are out of shape. Try sprinting across a battlefield in full kit when you can barely run a mile. Try telling a 350-pound medic to climb through a crushed car to save a kid in the backseat. This isn’t about looking good. It’s about survival. If you wouldn’t trust an out-of-shape cop to chase down a suspect, why should a patient trust an out-of-shape medic to save their life? The job demands strength, endurance, and resilience. The question is—are you meeting that demand?

You Don’t Have to Be a Door Kicker—But You Can’t Be a Liability

I get it. Not every medic is running into gunfire. Not every EMT is dragging bodies under fire. Not every MEDEVAC crew chief is dodging RPGs while loading patients. But does that mean you get a pass? No. MEDEVAC crews spend hours strapped into a bird, shoulders stiff, muscles tight, bodies wrecked from years of bad posture and high-stress flights. Of course, the ground medics are crammed into an ambulance for 12, 24, sometimes 48 hours, running on caffeine and whatever gas station food they grabbed between calls. Firefighter paramedics? Their bodies take a beating before they even get to the patient.

You might not be the one kicking in doors, but that doesn’t mean you’re off the hook. When it’s time to move, to lift, to react—will your body keep up? Or will you be the guy slowing your crew down? The one who can’t climb into the bird fast enough? The one who needs a break when there’s no time for one? You don’t have to be a Navy SEAL. But you do have to be someone your team can rely on. And if you’re not? You’re a liability.

No One’s Asking You to Be a Bodybuilder—Just Stop Being Weak

Look, I’m not a personal trainer, and I don’t have some magic program to turn you into a beast overnight. But here’s the truth—you don’t need one. The basics are stupidly simple, and if you’re making excuses, that’s on you. Stop eating garbage. You know exactly what’s trash and what’s fuel. Quit pretending you don’t. Drink water. Not energy drinks, not sodas, not five cups of coffee a shift. Water. Your body runs on it. Do cardio. Run, ruck, row, jump rope—I don’t care. If you can’t move fast without gassing out, you’re a liability. Lift something heavy. If you don’t like weights, do calisthenics. If you can’t lift your own body weight, you’ve already failed. Be consistent. No, you won’t be shredded in a month, but if you actually train instead of just talking about it, you’ll be stronger when it counts. That’s it. No fancy plans. No BS. You don’t need a tactical strength coach to tell you being fat and weak makes your job harder. You don’t have to be a world-class athlete. You just have to be better than you were yesterday. Figure the rest out as you go.

The Fight Is Bigger Than You

At the end of the day, this job isn’t about you—it never was. It’s about the people counting on you to show up ready, capable, and strong. Your patient doesn’t care if you’re tired. They don’t care if you meant to work out but got too busy. All they care about is that when their life is on the line, you are the best possible version of yourself to give the best care possible. One day, you’ll be on a call that tests everything—your endurance, your strength, your mind, and your will. You won’t have time to “wish” you were in better shape. You won’t have time to make up for the training you skipped. In that moment, you either rise to the standard or you fail the people depending on you. And if you fail—not because of lack of skill, but because your body couldn’t keep up—that’s on you.

This job demands a fighter’s mindset, not a doctor’s complacency. A doctor gets to work in a controlled environment, with backup on hand, climate control, and time to think. You don’t. Your operating room is the back of a truck, the middle of a street, a collapsed building, or a battlefield. So train accordingly, not for your ego, not to look good. But so when the moment comes—you don’t have to wonder if you’re enough. The real question is: Would YOU trust YOU to save your life? If the answer isn’t an immediate “yes”—fix it.

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References

1. National Institute for Occupational Safety and Health. (2020). “Obesity and overweight among emergency responders.” Retrieved from NIOSH.
2. Kahn, C. A., et al. (2019). “The prevalence of obesity among firefighter-paramedics.” American Journal of Public Health, 109(5), 678-684.
3. Hoffman, R. S., et al. (2021). “Obesity and its impact on emergency medical services.” Journal of Emergency Medical Services, 46(3), 45-52.

Johnathon “Gamble” Miranda is a 68W Combat Medic Specialist, EMT, and Tactical EMS Specialist with expertise in prehospital trauma care, tactical emergency casualty care, and hemorrhage control. Recognized by U.S. Army Special Forces for his investigative journalism under Operational Sentinel, he writes to challenge outdated medical thinking and bridge the gap between civilian and battlefield medicine.