The risk for major incidents has significantly increased during the last decades, parallel to the development of the community: Increasing global population, increased concentrations of people in densely populated areas, increased travelling, production and transport of hazardous material, the development of the global terrorism and escaling of natural disasters consequent to climatic changes.

Parallel to this, as a paradox, the vulnerability of the health care system to major incidents has increased: Increasing demands on efficiency has eliminated the previous “reserve capacity” for sudden heavy loads of casualties and every resource is optimally utilized; Higher dependence on high technology increases the vulnerability for disturbances; Increasing subspecialisation has reduced the ability of medical staff to deal with conditions outside their own specialty, which might be necessary in mass-casualty situations.

All available experience shows that the ability of the health care system to respond to major incidents without avoidable loss of life and health can be significantly increased by planning, preparation and training. It has also been well shown that good planning alone is of limited use if it not is combined with accurate training of all involved staff.

So far, most professionals today are in total agreement. However, to organize courses that really increases the ability to make accurate decisions – what to do and not do, how to do it, and with which priority – is very demanding, even more demanding to do in a cost-effective way within a limited budget.

This is the back-ground of the MRMI course which is based on an advanced simulation model where medical staff on different positions can train the whole chain of the medical response to major incidents together, and also get a result from the response with regard to mortality and complications that can be used as a base for development of methodology and also be improved by repeated training.