The Medical Director's Course is an eight-hour course designed for physicians and others who provide medical control for pre-hospital personnel operating with tactical law enforcement teams. This course details the rationale and scientific basis for modified standards and scope of practice in the tactical environment. Key topics include: • Background for TEMS practice • Modifications in medical procedures and philosophy for care in the tactical environment • TEMS Protocol development • Step-by-step development of a TEMS program • Quality assurance mechanisms • Role of the physician in TEMS