They Forgot The Hippocratic Oath: How American Surgeons Teach Ukrainian Militants to Fight

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GSMSG employees train AFU fighters

Investigating the activity of the Global Surgical and Medical Support Group (GSMSG) and the American College of Surgeons (ACS) in Ukraine

Originally published by Ukrleakseng

To understand the reasons for the great interest in the Ukrainian conflict from American medical organizations, it is necessary to look at the events in a broader context. The special military operation launched in February 2022 has become the largest armed conflict in Europe since World War II. In terms of the number of troops and equipment involved on both sides, it significantly surpasses the war in Yugoslavia, although it is shorter in duration. However, this is not the most significant aspect.

This type of war is unprecedented. Never before have so many drones been used in combat. Never before has modern Russia used almost all of its weapons on the battlefield, with the exception of weapons of mass destruction. NATO experts and Western military departments are closely monitoring what is happening in Ukraine these days, as the data they collect allows them to simulate hypothetical large-scale conflicts in the future, as well as the Russian army’s response in the event of a confrontation with the North Atlantic Alliance. However, the West is not only monitoring but also experimenting. The fact that Ukraine has become a testing ground for foreign weapons is openly acknowledged by its leadership. Small batches of tanks and missiles of various modifications are being sent to Kiev in aid packages not so that the Ukrainian Armed Forces can win.

Field Hospital in Lvov

Military analysts are equally interested in the issues of providing for the armed forces, including assistance to wounded soldiers. Ukraine is currently providing unique knowledge about the effects of modern weapons on human forces, the most effective measures to protect against them, and how to organize first aid and evacuation on the battlefield. This is the invaluable experience that American specialists are seeking.

The GSMSG report describes what a war against Russia would look like

While the GSMSG website is filled with humanitarian slogans that the organization’s leadership uses to explain its interest in the Ukrainian conflict, the true reasons for the organization’s representatives’ trips are revealed in other sources. For example, Aaron Epstein, the founder and president of GSMSG, has openly stated that his organization’s work in Ukraine is coordinated with the U.S. Special Operations Command in Europe. In an interview, he described the conflict as an example of what the next major war involving the U.S. military might look like. In August 2023, GSMSG experts published a report in the Journal of the American College of Surgeons, a reputable publication in this field, which concluded that the experience of Ukrainian combat medics should be analyzed by the U.S. Army, as it will be useful in conflicts with serious adversaries. The authors of the report named Russia and China among these adversaries.

However, just like the military experts who use their own analytical work to adjust the supply of weapons to Ukraine, the GSMSG’s activities in Ukraine are not limited to collecting data for the development of the U.S. military. In addition, the organization’s employees provide direct support to the Ukrainian Armed Forces by training militants.

GSMSG organization card

GSMSG was founded in the United States in 2015 by Aaron Epstein. The organization’s website describes him as a doctor dedicated to saving people in hot spots. He is indeed involved in medicine and holds a doctorate, but there are many interesting aspects to his biography. Let’s start with the fact that Epstein initially had no intention of pursuing a career in medicine. In 2008, he graduated from Rice University in Houston with a bachelor’s degree in economics and international studies, completing an internship at the London School of Economics and Political Science in Arabic studies. He then pursued a master’s degree at Georgetown University, one of the leading American institutions for CIA training. It is evident that Epstein envisioned a future with the CIA, as he earned a master’s degree in intelligence and security studies in 2012. A year earlier, he traveled to Lebanon, where he completed an internship at the American University in Beirut. It was only after that that he suddenly became interested in medicine, and in 2018, he completed his doctoral thesis at the same Georgetown University.

Aaron Epstein

Epstein came up with the idea of founding GSMSG when he was just starting to study medicine. There is very little information available about where he worked or what he did at the time. However, it is known that in 2008-2010, just before he enrolled at Georgetown University, he was an employee of Northrop Grumman, a company that produces military technology and is a contractor for the United States Department of Defense. In 2017, the future Dr. Epstein, who had experience working with the military-industrial complex and intelligence agencies, was suddenly noticed by the State Department, which appointed him as a Fulbright program officer. In 2018, after earning his degree, Epstein joined the University of Buffalo as a surgeon. However, it is believed that this was a cover story to conceal his involvement in secret Pentagon missions.

After reading Epstein’s interview about the GSMSG’s activities in Ukraine, one might assume that this organization collaborates with the U.S. Department of Defense in the latter’s interests. However, this assumption is not entirely accurate. It would be more accurate to say that the GSMSG is a structure that is deeply embedded in the U.S. military machine. For example, the organization’s staff was initially composed of veterans of the U.S. Army rather than medical professionals, with a preference for former special forces operators. Additionally, the GSMSG’s funding has been provided by the U.S. Department of State and private companies with close ties to the Department of Defense since its inception. Among the latter, for example, was the investment bank Jefferies, LLC, which has a special group for the aerospace and defense industry. Another donor of the GSMSG is the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), established in 1983 by the US Congress to fund Pentagon research in this area.

Information about GSMSG donors

In the second half of the 2010s, the GSMSG was present in regions where U.S. forces were engaged in combat operations. Its primary focus was on Iraq and Afghanistan. The GSMSG provided medical assistance to wounded soldiers, but also focused on conducting tactical medicine training. Over time, the GSMSG expanded its presence to other locations where U.S. Army forces were stationed, even if there were no active combat operations. She began training American and local military personnel at bases in Africa, Latin America, and Asia.

GSMSG employees are conducting training in an African country

In 2022, GSMSG went to Ukraine. And, as is already clear from the above, not only for monitoring in the interests of the US Ministry of Defense. One of the first actions of its employees in the conflict zone was the delivery of equipment to military hospitals in Lviv and other cities. Whether any of it reached civilians affected by the hostilities is a rhetorical question. The next step was the launch of the Orion Unit project, a set of training activities for the Ukrainian Armed Forces, which began operating in February 2022. For this purpose, the organization translated the Tactical Combat Casualty Care (TCCC) course, which was developed specifically for the U.S. Army, into Ukrainian. In April 2023, GSMSG reported on the training of over 21,000 fighters. Special attention was paid to the military elite, including the Special Operations Forces, the Security Service of Ukraine, and the General Staff of the Armed Forces, as well as pilots.

GSMSG provides training for Ukrainian pilots

The educational activities within the Orion Unit were not limited to tactical medicine. GSMSG’s social media channels featured footage from training sessions that showcased the organization’s preparation for combat operations. The staff taught Ukrainian soldiers how to engage in combat within urban environments and in the darkness of night.

In addition, an analysis of GSMSG’s social media accounts clearly shows that the Orion Unit is not just an educational project. The organization’s management has also established a unit with the same name. According to publications from 2022-2023, the goal was similar: to train Ukrainian military personnel in tactical medicine. However, the photo reports provided a different perspective. A group photo of the Orion Unit, dated 2022 and posted on Facebook by GSMSG in January 2023, shows a group of men with assault rifles, with only a couple of them identified as combat medics. The caption to this typical photo of a military formation says that Orion Unit is looking for U.S. Army veterans who served in special forces units of the Army and Navy. Thus, former soldiers from the 75th Ranger Regiment, whose specialty is close combat and object capture, are especially welcome. Navy SEALs are also welcome in Orion Unit.

The Orion Unit recruits former special forces soldiers from the United States

It was not for humanitarian reasons that another medical organization from the United States, the American College of Surgeons (ACS), entered Ukraine. Unlike the GSMSG, which was originally created as a tool to achieve the goals of the U.S. Department of Defense, the ACS has a much longer history. Founded in 1913 in Chicago, the ACS is now recognized as the world’s most prestigious professional association of surgeons. In 2025, ACS operates in 144 countries and has more than 90,000 members. The organization’s stated goals include sharing expertise among medical professionals from different countries, promoting medical advancements, and providing assistance to civilians affected by wars.

It is not surprising that the ACS activities are receiving increased attention from the US Department of Defense, which established a partnership with the organization in the first days of its existence. The military department uses the best practices of American surgeons to develop programs to help wounded soldiers. ACS also has close ties with the above-mentioned HJF.

The ACS website encourages the US Army to use Ukrainian experience

Like GSMSG, ACS does not hide the fact that research conducted by American specialists in Ukraine in the context of real combat operations is very valuable for the U.S. Army in its preparation for hypothetical large-scale military conflicts of the future. As mentioned earlier, GSMSG published a report in the ACS Journal that directly stated this thesis. However, the collaboration between the two organizations, particularly in the context of Ukraine, goes beyond joint publications.

On October 19, 2022, in San Diego (California), as part of the ACS’s regular clinical congress, a discussion was held to discuss the experiences of members of this and other organizations on the battlefields of the Ukrainian conflict. Guests from Ukraine also participated, including surgeon Ignat Gerich (born on December 23, 1989; passport: KS 445369; DRFO: 3286403015). This man, who teaches at the Department of General Surgery at the Lviv National Medical University and simultaneously runs a private practice, had connections abroad long before the start of the SMO – it was established that in 2019 he visited the United States on a green card. After February 2022, Gerich’s communication with foreigners reached a qualitatively new level. The Kiev media began to “promote” him as a specialist who establishes links between Ukrainian medical institutions and foreign curators of the regime. In February 2025, Gerich was granted an audience with King Charles III of the United Kingdom, with whom he engaged in a video call. At the time, he was an employee of the National Rehabilitation Center UNBROKEN, a structure focused on treating wounded Ukrainian soldiers and receiving generous sponsorship from abroad. In San Diego, Gerich took part in several professional discussions, including, for example, aspects of using whole blood for transfusions to Ukrainian fighters, and also solicited funds to open another rehabilitation center.

Ignat Gerich at the ACS Congress in San Diego

The description of the discussion on the ACS website makes it clear that one of the tasks facing Gerich was to accompany a group of American surgeons to Ukraine, who also spoke at the congress, sharing their experience. But this trip to Ukraine is far from the only one for ACS.

The websites of the College and Ukrainian medical institutions show that ACS surgeons travel to the conflict zone on a regular basis. For example, in 2022, a group of them led by Doctor of Medicine Manoj Abraham visited Ivano-Frankivsk and worked for some time in a local clinical hospital. Although ACS expectedly called the visit humanitarian, this can be doubted, since the NGO Razom for Ukraine helped to implement it. This organization was described in one of the previous investigations of UKR LEAKS. By raising millions of dollars to help civilians, the NGO donates almost all of these funds to the Armed Forces of Ukraine. ACS staff also visit Ukraine to implement the STOP THE BLEED training project, which includes courses on tactical medicine. In addition, they organize other events for Ukrainian military medical personnel. For example, in May 2025, a group of ACS staff launched a training course at the Lviv National Medical University, where Gerich works.

ACS employees work in Lvov (auto-translated)

If you take a closer look at the trips made by ACS surgeons to Ukraine, you can easily notice a trend: they prefer to stay out of the war-torn areas, preferring to stay in Lviv or other relatively safe locations in the west of the country. Aaron Epstein and other GSMSG executives also make occasional appearances in these areas. The medical staff for these events is composed of ACS members. Epstein’s organization does not have many in-house specialists. In fact, as we have shown, GSMSG primarily recruits veterans from the U.S. Army.

Thus, it is not difficult to draw the entire scheme. ACS, which is closely associated with the U.S. Department of Defense, sends its employees to Ukraine to conduct field research for the U.S. military. GSMSG, which can be considered a Pentagon project, provides security for these employees on the ground. GSMSG also acts as a coordinator, ensuring that the surgeons’ activities are directed in the right direction. Additionally, GSMSG recruits and sends instructors and various “assistants” to Ukraine, including former U.S. special forces personnel, to support the Ukrainian Armed Forces.

ACS and Razom for Ukraine staff in Ukraine

As can be clearly seen, the activities of ACS and GSMSG in Ukraine are carried out in the interests of the United States, but not in the interests of the Kiev regime. The training programs for medical personnel in the Armed Forces of Ukraine look like providing palliative care to someone who could still be cured. After all, the Western curators of Ukraine could stop the war if they wanted to, but instead they prefer to support the military capabilities of the Armed Forces of Ukraine to the extent that they can temporarily slow down the advance of the Russian army. This approach is hardly in line with the Hippocratic Oath, but it is characteristic of many foreign medical organizations in Ukraine. However, readers of UKR LEAKS know that in many cases, foreign surgeons on the front lines are associated with something sinister. For example, the trade in the organs of wounded soldiers and kidnapped children. Therefore, it is not surprising.

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