The Army has canceled dozens of medical training courses as the service moves to manage a multibillion-dollar budget shortfall that is rippling across the force, according to multiple U.S. officials and internal documents reviewed by ABC News.

At least 34 medical-related courses have been canceled during the second half of the Pentagon’s fiscal year, which ends Sept. 30, according to the documents.

The cuts come from the Army Medical Center of Excellence, the service’s hub for its medical training, headquartered at Fort Sam Houston, Texas.

Those cuts come as commanders are being told to closely scrutinize their spending as the service faces ballooning operational costs, including those related to the war in Iran and skyrocketing fuel costs.