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Well, what is left on the original list is how medical officers interact with line officers in the field or on Star fleet bases and ships, and SVC already answered that earlier in ths thread.

Does any one else have a suggestion or a comment on any part of what has already been discussed? If you do, now is the time to speak up!

If not, there is one thing I would like to ask.

How does or should Star Fleet Medical Corps be organized as an institution?

Should it function as a teaching hospital or facility? Where should it be located?

Personally, I would anticipate that it is the organization that tracks educational progress of all SFMed personnel, Doctors, nurses, therapists etc.

How should it be organized?

If I may make a suggestion, I would suggest that there would be a medical school at Star Fleet academy on Luna, (Earth’s Moon.)

My second thought is there should be a Medical facility or Major Hospital at or near Star Fleet Headquarters, something like Johns Hopkins in Washington D.C.(Not a replacement for the rehabilitation center on Vega IC, just the one Hospital in the Federation operated by Star Fleet Medical. All others would be at Star Bases, or set up and run by member worlds or associate words of the Federation.

And finally, a data collection/catalogue center, perhaps leased from the The Federation Express Corporation on the planet Zena, in the Terra star system , (See Prime Directive GURPS, Federation Express article.). The rationale being, that is the destination of all Federation Express Couriers and long haul freighters to and from Earth to the rest of the Federation, and all of the third party carriers serving those areas that it isn’t economically feasible for the Federation Express Corporation to service with its own personnel.

(Note to SVC: should the Federation Postal Union have a facility on Zena as well? The purpose being to monitor and maintain the Subspace communications, for the same reason StarFleet Medical maintains a data processing system there. So that human/sentient eyes sees the raw data as it is received looking for errors or anomalies. As we are learning in real life, Artificial Intelligence is a wonderful thing, but left unchecked, could lead to serious problems.)

In that last case, I would suggest a ground base facility on Zena , that specializes in the processing of information received from ships, colonies, Minor and Major Worlds concerning Star Fleet Medical Personel updates such as death, professional status of education and certifications, assignments, professionalism, etc.

This is not for assignments, Star Fleet Headquarters would handle that. Its a separate unit intended to police and maintain professionalism and integrity of the medical community in Star Fleet.

Comments? sugestions? Observations?

By Mike Grafton (Mike_Grafton) on Tuesday, March 17, 2026 - 11:12 am: Edit

A Mobile Army Surgical Hospital is a wartime asset, part of the fleet war plan, and you would have a dozen or so stored prefab sets in the whole Federation.

I would propose that there are units, both Starfleet and Guard that are ready for mobilization from every major & minor world. Heck, the US has many such. KY Guard mobilized to the Virgin Islands post hurricane. And then there were Covid mobilzations ( I don't think Trump gets enough credit for these). Google "national guard mobile medical units"

And then scale that up to HUNDREDS (?) of Billions of beings in the Federation...

By Jeff Wile (Jswile) on Tuesday, March 17, 2026 - 01:54 pm: Edit

Mike, I do understand where you are going with this, and from an intellectual perspective I could agree.

My concern, is game scale.

ADB has not defined the contents of all 234 F&E hexes on map, or the 18 off map hexes for the Federation. If they did, they would also need to populate the rest of the f&e map. 19 hexes, top to bottom and 60 or so columns left to right. Nearly 1,200 hexes.

You’re asking for population figures, and worldwide information that has never been calculated.

Even if it were only the Federation, and if there are only 4 populated worlds per f&e hex, its still over 1,000 worlds that would be required.

The best you could expect, would be a polite ‘no’.

And this is coming from someone on your side.

By Ryan Opel (Ryan) on Tuesday, March 17, 2026 - 08:30 pm: Edit

Star Fleet Medical School is colocated with Star Fleet Academy. Gurps-Fed pg 106

Medical School: While most doctors in Star Fleet come from civilian universities, Star Fleet has its own very prestigious medical school focusing on the broader range of skills needed for a starship doctor. Some cadets who graduate from the University with pre-med degrees go directly to the Star Fleet Medical School and the associated teaching hospital; others come to the Medical School after obtaining pre-med degrees from civilian schools. (Those must attend a brief orientation course to learn about the military.) Part of this school is at Star Fleet Academy in San Francisco, but there are branches on every starbase. Medical officers in Star Fleet often spend time at the starbase hospitals between ship assignments, gaining new skills and knowledge through the intense training available there. pg 107

Bureau of Medicine: This bureau operates the fleet hospitals. It is responsible for recruiting, training, and assigning doctors and for conducting medical research. This bureau is commanded by the Surgeon General, who holds the rank of a Colonel-General (O-10) or Fleet Admiral. pg 107

By Jeff Wile (Jswile) on Tuesday, March 17, 2026 - 10:49 pm: Edit

Thanks Ryan, I totally missed that.

By Ryan Opel (Ryan) on Tuesday, March 17, 2026 - 11:52 pm: Edit

It's easier to find when you have the digital versions of the products.

ctrl-F

By Mike Grafton (Mike_Grafton) on Wednesday, March 18, 2026 - 08:16 am: Edit

My point is that Mobile Medical units at the scale needed to treat planetary level emergencies isn't something Starfleet is going to have close unless your problem is near a "Major" planet. Just not going to used enough so these will be low density. Hence hospital ships.

You will need NG Medical units all over the place. Any planet with a population of more than tens of millions will have something. Not least to deal with your own local disasters. even if it is only a small unit.

You mobilize what is available as needed. So you get the closest (the 9999th Medical Platoon is 5 crew units with 2 doctors and maybe 3 carfdo boxes of stuff) first from NewSettlementIstan via the closest random freighter. Then the 40026 th Medical Company from EstablishedPlanentIstan with their skid. These get joined by companies & platoons from other systems as transport is available.

You scale up until you have enough to deal with casualties as they are brought in.

By Jeff Wile (Jswile) on Wednesday, March 18, 2026 - 10:06 am: Edit

Mike, the information required simply does not exist.

Oh I could make a”WAG”, based on population density of various F&E hexes(the capital hex and the half dozen printed Major and Minor worlds on the F&E map) having excellent chances of one or more NG units, with empty F&e map hexes radiating out from the capital hex having lower chances of having NG units present, and the off map hexes having little to no chance of NG units present.

But that is a very long way from quantifying hard numbers of actual National Guard units home base locations.

You could approach SVC to give you what you want, but as it won’t result in a module that could be sold, the priority on SVC’s time might not be very high.

By Jeff Wile (Jswile) on Wednesday, March 18, 2026 - 10:31 am: Edit

On second thought… we do actually have a back door, based on published information.

Existing Major and minor worlds already have assigned active PDB (Planetary Defense Battalions). Minor worlds start with two PDB combined into a single PDU (Planetary Defense Unit), with a maximum possible of up to six PDBs. The difference very likely is inactive NAtional Guard battalions.

We can calculate the size and locations of all the inactive NG battalions, and we don’t need any new rules to do it, its implied in the rule set.

We can even calculate the number of MASH units since SVC gave us that information a few days ago in this topic.

While were at it, perhaps we should at the same time calculate what other support NG units would be present.

What we do not have is a list of what those support units are…

I am talking about Combat engineers, transporter artillery, transportation (truck) units size and composition, tank battalions etc.

This could make a compelling Captains Log article.

The fly in the ointment, is not all units are human. Member worlds would have to include Vulcan, Andorian, Orion worlds etc.

Big job, but it’s doable.

The only part we’re missing are the number of Major and Minor worlds that are not published in F&E or other Captains Log issues.

By Jeff Wile (Jswile) on Thursday, March 19, 2026 - 08:24 am: Edit

Mike Grafton posted:

Quote:”… You will need NG Medical units all over the place. Any planet with a population of more than tens of millions will have something. Not least to deal with your own local disasters. even if it is only a small unit. ”

SVC stated earlier that a MASH would be a Brigade level thing, I think he meant that it would be a support unit present where and when a combat brigade is deployed.

Just to state the obvious I assume SVC does not want to have MASH units represented in F&e, after all, they are just targets, and in my opinion serve no purpose in f&E other than as a planetary ground unit equivalent to a hospital ship.

We could, (and players in home run campaigns could) deploy MASH style units using commanders option points for operations on planets, moons, even large asteroids.

Same justification would exist for players to have a MASH unit anytime a game setting has a Federation brigade is deployed in a Prime Directive RPG session.

My point is, the unit is small enough 16 crew units or less, not counting any patients present.

Heck, any number of scenarios could be devised for a gaming group using a MASH unit as a setting, including having one or more participants of said gaming group being hospitalized at the MASH or even having surgery to treat in game injuries.

But that said, I just am not convinced that we need any kind of listing of National Guard MASH units since we do nout have any sort of catalogue listing of NG combat units.

By Jeff Wile (Jswile) on Saturday, March 21, 2026 - 10:01 pm: Edit

I think we have enough data to pull together an outline, and (from that starting point) some sort of narrative.

Tomorrow is Sunday, and I will have some time to pull it together.

SVC:would it be helpful if I send the first draft to you? Or just post it for public comment?

By Jeff Wile (Jswile) on Monday, March 30, 2026 - 11:56 pm: Edit

I have reviewed information posted by SVC, Ryan Opel, Mike Grafton & others.

I consulted the u.s. army official history of WW2, and found similarities to the information posted by Steve, Ryan, Mike and several other people.

The following is an outline provided by a google search.

If any one sees any errors or mistakes, please let me know. I will do my best to correct any errors.

Quote:” The U.S. Army in World War II organized medical support through a tiered system of chain treatment, moving wounded from front-line aid men through specialized, mobile units back to general hospitals. Units were divided into combat zone support (medical battalions, evacuation hospitals) and communications zone support (general hospitals).
PubMed Central (PMC) (.gov)
PubMed Central (PMC) (.gov)
+1
Key Medical Organization and Structure:
Division Level: Each division had an active Medical Battalion that provided essential flexibility for transporting, collecting, and providing aid to casualties.
Regimental Level: Medical detachments were assigned directly to regiments, providing front-line medics (aidmen) and organizing battalion aid stations.
Evacuation and Clearing: Collecting companies and clearing companies (within the Medical Battalion) moved wounded from the front, while Evacuation Hospitals (400 or 750 beds) were positioned 30 miles behind the front to treat and prepare patients for transport.
Fixed and Mobile Hospitals: Field hospitals and specialized hospitals were mobile, often utilizing tents or repurposed buildings (schools, villas) near the front to provide rapid care.
Air Force Support: The Army Air Forces (AAF) had specialized aviation medical units, creating parallel medical services (such as dispensaries) for aircrew.
AMEDD Center of History & Heritage (.mil)
AMEDD Center of History & Heritage (.mil)
+5
Organization by Echelons:
First Echelon: Regimental medical detachments provided immediate company aid and ran aid stations.
Second Echelon: The Clearing and Collecting companies of the Divisional Medical Battalion.
Third Echelon: Field Army units (evacuation hospitals) handled more serious cases, with specialized units for specialized wounds.
AMEDD Center of History & Heritage (.mil)
AMEDD Center of History & Heritage (.mil)
+1
The overall structure prioritized rapid, motorized transport and constant triage to conserve fighting strength.”.

I should point out, that the hypothetical MASH unit we talked about totals about 160 personnel, not including patients (60 to 100 depending on the type of MASH in question.)

The u.s. army structure posted in this thread is definitely not a MASH unit having several different types of functions that are different in nature and scope to a Hypothetical MASH to be used in Star Fleet Battles.

By Ryan Opel (Ryan) on Saturday, April 04, 2026 - 04:23 pm: Edit

Jeff,

You might want to take a look at this:

1st Med Group WW2

Pg 61 has a chart on the chain of casualty evacuation.


There is also some information on the sizes of the hospital staff.

By Jeff Wile (Jswile) on Sunday, April 05, 2026 - 12:13 am: Edit

Ryan, I am unable to access the link you posted.

By A David Merritt (Adm) on Sunday, April 05, 2026 - 12:30 am: Edit

Jeff, it downloads a .pdf file.

By Jeff Wile (Jswile) on Sunday, April 05, 2026 - 06:32 am: Edit

ADM:

Thank you. I did not know that.

By Mike Grafton (Mike_Grafton) on Sunday, April 05, 2026 - 03:14 pm: Edit

I read the link provided. Thanks.

Much of the manpower described are:

Battalion aid stations. With many "litter bearers and ambulance personnel."

Higher echelons also had a lot of personnel toting casualties in trucks and ambulances. With transporters these personnel are moot.

As a former paramedic I can tell you that a LOT of time is spent in the ambulance (aka the "vibrating box") whoop whooping to the scene, woo wooing to the hospital and then driving back to quarters.

I posit that in the SFU the field corpsman/ medic is going to treat a patient for a couple minutes, triage them and then have them transported to higher.

At a Platoon sized medical section, they will deeper triage and transporter to higher level care as needed. Ouchy booboos, simple fractures, & stiches get fast care and then transported to a recovery echelon by Nurse Practitioners, PAs and the like. Serious cases go to a Surgical unit higher (aka MASH). Those that can get better do so locally. Those that can't get transported to the local BS/ BATS/ SB/ Major/ Minor planet. Or maybe there is even a "casualty collection unit" for post treatment recovery much like a high tech nursing home. IIRC even Minor planets have a metric butt ton of population. And should have a decent level of medical care there.

GURPS tells us how many live in a lot of those systems. Billions?

BS and BATS get cases fed into them from the obscure local colonies/ whatever that don't have the population to support a "full service" medical" system.

So Mike the miner with a case of 'heck no we can't figure it out" gets evacuated to higher. Maybe via a passing POL, maybe via a skiff, or even a freighter.

My point is that movement within transporter range is trivial. Between planets in the same system is akin to modern ambulance service, and between systems is going to require liners or hospital ships.

Given the high tech, I'd bet most patients are NOT evacuated out of the planetary system. Heck my mom broke her femur when she was in her 60s and was discharged from the hospital 2 days later. People DIE from femur fractures which is why EMTs have specific training and equipment just for femurs (aka D ring splints).

When i was run over by a Camry I was taken to the local trauma center hospital. Loss of consciousness and TIRE TRACKS ACROSS MY CHEST pretty much made that decision for us. (By the way, I remember nothing until I woke up lying in the street. In retrospect I was pretty heavily concussed.) I really didn't get how beat up I was until Dr Wolfe told me "you ain't going nowhere for at least a week..." I lost a LOT of time whilst in the hospital due to an intense Oxycontin haze. I did convince a company to hire me to be chief of safety for the Ammunition Storage point at camp Arifjan while still admitted to the SICU though.

By Ryan Opel (Ryan) on Sunday, April 05, 2026 - 07:27 pm: Edit

They hired you on the theory that nothing bad could happen to you again. So the ASP wes going to be fine.

By Mike Grafton (Mike_Grafton) on Monday, April 06, 2026 - 08:20 am: Edit

Nah. They just never thought to ask if I was in a SICU.