Archive through February 26, 2026
Star Fleet Universe Discussion Board: Prime Directive RPG: Background: Star Fleet Medical Corps:
Archive through February 26, 2026
Request a Star Fleet Medical Corps topic.
At present, only Star Fleet Operates Hospital Ships based on military hulls (old style light cruiser.)
Many empires do in fact operate hospital ships based on various civilian freighters (large or small), as does Star Fleet, but there may be (probably are) several different characteristics of SFMC (Star Fleet Medical Corps) units that likely different from the regular Star Fleet services.
Not making a proposal here, but listing some examples…
Hospital ships are not commanded by combat officers, but by Star Fleet Medical personnel who have previously served on regular star fleet warships and gained experiences including command positions (helm, navigation, weapons fire control, engineering, communications…) as well as stood watches as officer of the deck, officer of the day (administrative roles), trained as a pilot for various shuttles (cargo as well as administrative shuttles), perhaps even security (corpsmen do serve in boarding parties).
That said, Federation Star Fleet Hospital ships can appear in scenarios and did get shot at (and even with the small number of phasers on board) do occasional little shoot back.
Specifically, the request for a topic is to discuss details related to Star Fleet Battles in particular, such as:
1. How are the civilian style freighters hulled hospital ships handled?
Are they commanded and operated as regular freighters (the command module plus drive section commanded and staffed by merchant marine personnel?) or is the hospital pod/skids the only part staffed and run by Star Fleet Medical personnel, with the captain of the command and drive sections, treating it like cargo?
2. Can the Science ground base modules also be used as a hospital facility, also staffed by Star Fleet Medical Corps personnel?
3. For ground combat on a planet, is there also a possibility that some of the maneuver elements in a Planetary Defense Battalion (PDU) include Star Fleet Medical Corps units similar to real world MASH (mobile Army Surgical Hospital), Battalion Aid Stations, convalescent hospitals, used to allow wounded personnel time to recover without filling hospital beds in MASH or Battalion Aid Stations?
4. Transitional hospitals, used to house wounded personnel too seriously wounded personnel unable to be healed by MASH units soon enough to be returned to combat assignments. Said wounded soldiers have to be billeted somewhere while waiting transport.
5. How would Star Fleet Medical Corps personnel be handled when seconded to FEM operations? (Federation Emergency Management) such as happens when disaster occurs on populated worlds in Federation territory.
For example: pandemic treatment centers, large numbers of medical personnel might be required to treat the sick. Are they “on their own” and need to provide their own food, shelter, clothing, perhaps even oxygen for those planets with polluted or tainted atmospheres?
Second example, tsunami recovery, treating wounded survivors? Basic trauma recovery. Just going to issue the victims a blanket, a MRE (meal ready to eat) and tell them to “Find a spot to sleep, until we give you another MRE?
Finally, what happens when the only/senior officer is a Star Fleet Medical Corps? Several movies have portrayed such a situation (movies Sahara, Humphrey bogart, 1943, for one example, or the movie “Battle Circus” also starring Bogart.)
Just wanted to suggest that it might assist fiction writers to have the information, not to mention, the value of adding to the background data base.
Jeff?
Seemed like a good idea at the time, but in the light of day, not so much.
I should know better than to post when tired.
Sorry.
Okay, just to try and set a few parameters.
As a general rule, Medical Officers are a Staff function. They are not technically in the chain of command.
That said, they can, and have relieved officers and lower rank (enlisted) personnel on medical grounds. This includes small craft pilots (shuttles, fighters, bombers, interceptors and PFs) who, in the considered professional opinion of the Medical Officer, are not “fit to fly.”
Same logic applies to heavy equipment operators, (star fleet Corps of engineer personnel mostly), and various positions on star ships, star bases and other important military installations. (This includes weapons officers, navigators, helsmen, engineers and security personnel.
Please note:
I have not served in the military, and my understanding of this subject may be flawed.
Just think for fiction and history writers, it needed to be said somewhere.
Corrections, modifications suggestions or comments?
JSW, this sounds like it might have the makings for an RPG campaign.
One informal rule for RPGs is, "If you don't know, or don't like, feel free to wing-it."
A spin-off of the original source material for the SFU (i.e.: an episode of TNG) featured a situation where the ship's CMO had to take command.
She pulled off a brilliant maneuver (i.e.: did something Hollywood that can't be recreated using SFB or SFC) and saved the day.
There's also a novel (TNG, but featuring the Planet Killer) in which the Captain of a Hospital Ship prefers to be addressed as "Doctor," because, in his words, "I was granted the rank of Captain, but had to work to earn the title of 'Doctor.'"
The TV series M*A*S*H featured the character of Colonel Potter; a career officer, but who had been an enlisted man before going to medical school.
Again, it is Hollyweird, but Hollyweird, like RPG campaigns, is Storytelling. The objective of storytelling is to have fun. Does it have to be super realistic? No, not really. In fact, for many people "Super Realistic" can become a turn-off.
Hope that helps
Medical doctors in the military have their own chain of command. Junior doctors obey the orders of senior officers.
Any officer obeys the orders of a senior officer on items clearly within the "jurisdiction" of the situation. A medical captain visiting the front lines (perhaps to supervise the special evacuation of a seriously wounded soldier) might tell a sergeant or lieutenant something generic like "don't shoot those prisoners" or "you really do need to keep clean because of possible wound infections" but would never tell them "move that machinegun over there." Now, it's theoretically possible that a doctor with prior enlisted infantry service might see something out of what and comment on it, but equally likely that what looks out of whack is just the new way the infantry does things with the new anti-drone launchers.
Star Trek has always been strange because it is run by actors. You never see a US Navy cruiser captain leading a secret mission to recover a nun hiding from the Japanese on Guadalcanal; Kirk did stuff like that because the star of the show has to be the star of every episode. Thus the idea that a doctor might qualify as a naval command officer to command a hospital ship is trekkie but I seriously doubt it happens in the real world. I am sure that the medical staff on USS Comfort is run by a very very senior doctor, but I doubt he has taken time from his medical career to learn enough about the engine room to command the ship.
Ok, that works for purposes of writing Star Fleet Battles fiction, and can be handled in the abstract, for historical events.
I personally would imagine a Star Fleet Medical officer in any command situation being an exception, rather than the rule.
Sort of like Col. Sherman Potter in the MASH sitcom.
A career calvary officer, with combat service “ under his belt”, who perhaps passed over for command (recognized that horse calvary had no future in the modern U.S. Army of the 1920’s and thirties) took the opportunity to study medicine, gaining his MD in peace time.
Served during World War 2 in the pacific (Earning his purple heart when his still exploded,( see the sitcom episode…) and eventually posted to command of the 4077th MASH during the Korean War.
The only “Real World” example I can think of, off hand, dates back to the War of 1812. The frigate U.S.S. Essex (32 guns) cruised in the Pacific raiding Englands whalers, capturing merchant ships and generally strewing havoc and chaos in his wake.
At one point, the captain (Porter, I believe) was running out of officers to command all of the prizes they captured, gave command a marine officer. (Not something that has happened a lot over the last couple of hundred years…)
Such a scenario in Star Fleet Battles almost has to be linked to a chaotic situation.
Perhaps an isolated unit during the Klingon invasion of the Federation summer, year 171 or a support force cut off during the retreat from Romulus after the Destruction of the U.S.S. MacArthur…a shuttle convoy desperately trying to reach the safety of Federation or Gorn Space…. The only survivor of the Senior officers being a retread Star Fleet Medical officer with years of experience in starships he gained as a junior officer before he transferred to SFM?
Oh, well. That’s probably a good story that will never get told.
Colonel Potter was a doctor commanding a medical unit. That's quite normal.
I'd say for a Aux Hospital Ship the overall command of the ship is the Star Fleet Medical Officer. He also commands the hospital portion of the command. The ship functions are then either a Military Space Command civilian and/or Star Fleet crew.
Outside of medical units, Medical officers are not in the chain of command, but like chaplains, do have a general military authority.
That seems reasonable.
I guess, if were going to follow up on this, the next step might be to establish a short list or establishment of medical units that might appear in fiction or history of Star Fleet Medical Corps.
The smallest, battalion aid stations are organic to either Planetary Ground Bases, or Ground Maneuver units.
At a guess, (and if any one actually knows how this part works, I hope you will inform the rest of us! 
)
For a conventional PDU (planetary defense unit) there would be a battalion surgeon & head of what medical personnel are in the battalion. The surgeon would be one of the head quarters crew unit, and (for a star fleet marine battalion) one star fleet naval corpsmen for each squad. , 4 squads per platoon, and 4 platoon per company.
That works out to be 16 Navy Corpsmen in an average battalion, plus any reinforcements (commanders option points spent on additional personnel.
Obviously, the battalion aid station wouldn’t have all of those individuals at the same time, most likely, in combat, a designated place would be established for the aid station, and emergency medical care provided as needed. Then wounded would be transported to another medical unit behind the front lines.
Not a separate command, integrated in the battalion itself, and the battalion surgeon would be subordinate to the battalion commander.
At another guess, the aid station would most often be near by or adjacent to the battalion headquarters.
Non Marine battalions likely would also have a battalion surgeon (a lieutenant in most cases, but possibly could have a captains rank if the battalion was deployed as part of a regiment or even a brigade…say anywhere from two battalions up to four.
All of whom would still be assigned to their own battalion.
Anyone have suggestions, comments or additional information to add to this?
Practically, if the senior officer (Captain) commands the ship and also commands the medical staff, how does that person split their time? If there are major medical problems or surgeries or whatever, won't that require time in the hospital portions of the ship, consulting, supervising, etc? Who's on the bridge?
Or then does the XO, who's non-medical, functionally run the ship most of the time when medical duties call?
--Mike
Hey Mike.
Just a guess, but you are bringing up two different things that may seem contradictory but in a practical sense, are not.
Hospital ships, in the Federation Star Fleet come in at least two different types, one, the most common, are converted Freighter designs, Small or Large, they both are basically converted cargo pods with a command module and a drive section.
While the medical personnel can function while the ships are maneuvering, generally, they proceed to a designated destination, and provide the necessary services. Again this could be treating wounded combatants, or participating in a FEM (Federation Emergency Management Activity (natural disaster, catastrophic accidents , pandemic etc…). The normal command functions at that point is basically an anchor watch.
Oh, sure, if it happens to be a planetary invasion, or a Large Scale Raid, or even a Fleet Action, there might be ship combat, but unless there are already wounded on board before the ship combat begins, the senior officer would be on the bridge.
Once the ship combat is completed, the ship, in most cases would be in orbit of the planet being invaded(or raided) awatch can be set, and the medical team get to work treating the wounded.
The senior office can be expected to know where he is most needed, either sitting in his command chair on the bridge, or healing the sick.
The converted warship hospital ship variants (old Light Cruiser type hulls) would function in a similar manner, and could be operated as part of a squadron, but in most cases, could be expected to be in a support echelon. Perhaps in a logistical role where they would be used to receive injured personnel (naval, marine or other soldiers) when the ships that had fought in combat would have been able to get to where the logistical support group is deployed from where ever the ships had been deployed to where the combat occurred.
Again, in most cases, the hospital ship would be either stationary or in orbit.
I suppose, an able XO could run the ship ,most of the time, but there is a chance that they (the XO) could be a other (more junior) medical officer.
Generally, there is little difference in function between a hospital ship, and a detached cargo pod that has been converted into a hospital module.
Both get moved to where needed, and tend to be stationary while they function as a stationary hospital.
I hope that helps.
Would there be a difference between mission command (the senior medic) over ship command (the captain, probably junior to the senior doctor but responsible for running and "flying" the ship)? The mission commander receives an order to go to planet planet X for the medical emergency, and deliver assistance. The ship's captain gets the order to fly to plant X and do what the mission commander tells him/her. Might make for some nice story tension points if the missions commander wants something that the mission commander can't (or won't) deliver.
Just thinking about other units that would be part of a Star Fleet Battles /Star Fleet Medical Corps unit…Looking at the commanders Options rules, we could take a shot at assembling a SFU version of a Star Fleet M.A.S.H. Unit.
Just for reference/ comparison, I made a Google inquiry about MASH unit organization in the United States Army.
The results of which:
Quote:” In the United States Army, a Mobile Army Surgical Hospital (MASH) was a specialized medical unit designed to provide immediate, life-saving surgery near the front lines. While they were phased out in 2006 in favor of Combat Support Hospitals (CSH), their historical organization was highly structured to balance medical capability with rapid mobility.
National Institutes of Health (NIH) | (.gov)
National Institutes of Health (NIH) | (.gov)
+3
Typical Organization (Korean War Era)
Standard MASH units were much larger than the "4077th" depicted on television. A typical 60-bed unit was organized with approximately 120 to 130 total personnel:
Wikipedia
Wikipedia
+3
Medical Officers (Doctors): Usually 10 to 15 officers. This group typically included:
3 Surgeons and 3 non-surgeon assistants.
2 Anesthesiologists.
1 Radiologist and 2 Internists.
3 General duty medical officers.
Nursing Officers: Approximately 12 to 20 nurses. All nurses in a MASH were commissioned officers.
Other Officers: 2 Medical Service Corps (MSC) officers for administration/logistics and 1 Warrant Officer.
Enlisted Personnel: Roughly 90 to 120 soldiers. These included:
Medical Technicians: Surgical technicians, radiology specialists, and pharmacy specialists.
Corpsmen/Aidmen: Medics responsible for triage and basic patient care.
Support Staff: Cooks, drivers, mechanics, and clerks to maintain the hospital's mobility and infrastructure.
Wikipedia
Wikipedia
+7
Evolution and Scale
Bed Capacity: Originally designed for 60 beds, many units expanded to 200 beds during the Korean War to handle high casualty volumes.
Mobility: To remain "mobile," a MASH required approximately 50 large trucks to move all personnel and equipment, a process that could take 24 hours to set up or break down.
Command: The unit was typically commanded by a Colonel or Lieutenant Colonel from the Medical Corps..”
As far as the hospital ships go, I've read a little something about the Liberty and Victory ships during WWII. The commanding officer, the "Ship's Master," was Merchant Marine, but there was a separate Navy contingent aboard manning the guns. Technically, the senior officer of the Navy crew answered to the Ship's Master, but it was a separate administrative group of people.
What if medical ships ran the same way? The Captain leads one crew, the Chief Medical Officer runs another. Technically, the officers of the same ranks in both services warrant the same respect and junior officers, petty officers, and enlisted ratings who DON'T respect that and try to gin up interservice rivalries are more likely than not to face dressing down by senior people in their OWN service, perhaps even reaching the point where they'll be transferred with a black mark on their record...
>> What if medical ships ran the same way?
That sounds reasonable to me. And bear in mind that its not just about "Who gets to give the order to fire the phasers?" but also who takes care of the everyday decision making, supervisory and administrative matters in the respective groups.
And, as I think someone mentioned above, from a ficton perspective it might be something interesting to explore. Say, if the Captain and CMO didn't respect one another, or they had a genuine difference of opinion on a critical matter? Or if there was a difference in experience? Can they find a way to work together?
--Mike
Looking at history.
In WW2 the hospital ships were actual navy ships with navy crews manning the ships. In some cases the medical staff was an army hospital unit.
In my infantry battalion in the early 90's our battalion aid station was commanded by a Medical Service Corps officer, it has a warrant or commissioned officer Physicians Assistant and then enlisted medics. There was a battalion surgeon on the books but I don't think one was ever assigned. If we needed one I assume some officer from the division medical battalion would be assigned.
At a MASH/Combat Hospital to Commander would run things but when under a medical surge would leave the running of the hospital to the Medical Service Corps XO and staff.
There are certain aspects of this concept which might be worth delving into at some point, though they would not become a direct factor in the Federation proper until much later in the timeline.
Firstly, there is the question of how the Federal Republic of Aurora adapted the institutional knowledge they likely inherited from the Star Fleet Medical Corps for their own purposes - not least once they became aware of the threat posed by Sigvirion infection, and the need to maintain a series of anti-Sig inoculations in order to try and counter it.
Given that the Sigs, more than any other known viral organism, cross the boundaries between "medical", "military", and "political" spheres of concern, there might need to be a more formal degree of integration between the Auroran Navy and its attached medical service - not least since, as noted in the FRA update file in Captain's Log #53, the Navy's Home Fleet finds itself doubling as a kind of "military police", due to the more limited numbers of ships it has compared to Star Fleet or the Federation Police back in the Alpha Octant.
Than, there is the matter of the GSX NCC-1821 USS Sakharov, which first arrived in the Omega Octant in Y214. As noted in the Sakharov article in Captain's Log #51, First Contact between the ship and their initial Chlorophon hosts promptly led to their being provided a series of anti-Sig vaccines (for individuals aboard ship from those species who were known to exist in the Federal Republic) and an insistence on new inoculations to be worked up (for those aboard ship who were from "new" Federation member species, which had joined after the Aurorans had been transplanted in Y130).
All of these inoculations, together with historical records outlining the many cases of trouble which had ensued when those safeguards fell short, would have been brought back to Earth upon the return of the Sakharov in Y219. Which would no doubt trigger Star Fleet Medical itself, along with the equivalent organizations in other Alpha Octant empires, to set about studying the Sig threat in greater detail from that point onwards - not least with the prospect of sustained contact between Alpha, Omega, and the Lesser Magellanic Cloud now apparent.
So, even if the Sigs never manage to historically spread their infection to the other side of the Alpha/Omega Void, none of the medical corps in either Galactic octant - nor those out in the LMC, for that matter - would have the in-universe luxury of taking this for granted...
There was a 1950’s movie titled “away all boats”. Good movie, and according to the PR campaign, the book was adopted as required reading at the U.S. Naval academy for marine and naval cadets education in amphibious warfare.
The reason I bring it up, is the ship characterized in the movie, the U.S.S. Belinda, APA (Amphibious Personnel Assault) ship was expected to receive casualties from the beach head and after the battle, carry the wounded back to base.
The movie implied that the medical facilities were appropriate, snd included a surgery and sufficient surgeons and corpsmen to complete the mission.
As I recall, there were at least three medical doctors assigned who had speaking roles in the movie.
I do not know, but wouldn't be surprised to find that the medical staff on a ww2 APA (for the medical professionals) was similar to a ww2/Korean War MASH unit, and that they had a similar capacity to function as a hospital ship after the amphibious assault was completed.
All modern US amphibs can be rigged as fully equipped hospitals to support amphibious assualts or huminitarian missions. Their role is to triage and stabilize patients, moving along those that need more care to dedicated hospiral ships or stateside fixed hospitals. Similiar to what a MASH unit did, get the wounded from the frontline battalion aid stations, treat them, if they can return to duty in a short period care for them if not move them up the medical chain.
The dedicated hospital ship is the next step in the medical chain of treatment.
So the overall structure seems to be:
| Tier1 | squad level | star fleet marines/one navy Corpsman | size class 5 hulls | no MD | corpsman + pharmacist mate? |
| |
| Tier 2 | platoon level | no additional medical specialists beyond each squad’s corpsman | size class 4 hulls | one MD | (lieutenant) nurse& Corpsmen. |
| |
| Tier 3 | company level | no additional medical specialists | size class 3 hulls | two MD | (senior Lt.) 2 nurses & Corpmen. |
| |
| Tier 4 | Battalion level | one MD/surgeon & nurse practitioner Corpsmen | size class 2 hulls | 3+ MD | 3+ nurses and Corpsmen. |
| |
| Tier 5 | Regiment level (same as 2 Battalions) | Size class 1 and hospital Ship… |
I may have this wrong, so please, any correction, suggestions or comments are welcome.
Speaking for the US Army combat units, and probably the marines:
At the squad level you had non-medical combat lifesavers. Soldiers trained in advanced medical care not quite at the EMT level.
Platoon's had a medic assigned to them.
Companies had no additional organic medical capability.
Battalions would have a surgeon and a physician's assistant, along with a dozen medics, and a some ambulances staffed with 2 additional medics each.
Brigades/Regiments would have similiar to the battalion but they'd come from the assests of division medical battalion.
My father in law was a U.S. Navy Corpsman, he picked up a PurpleHeart & some black sand while serving in a Marine combat unit at Iwo Jima during World War 2.
I have to admit that I was unaware of marines who were cross trained to be non-medical life savers.
Not sure they were back then. Now in the army many infantry squads have at least one if not all members trained as combat lifesavers. I would assume the marines are as well.
I deployed to Iraq in 2004 and went through the same medical first aid tasks I'd done for years as a soldier. When I deployed as contractor in 2009 the level of medical training was far more advanced then what I'd previously recieved even from when I went through EMT training in early 90's.
Well, I can’t imagine having soldiers (or marines) trained to save lives is a bad idea.
The only joke I ever told my father in law, that caused him to laugh out loud, was the “the Marines have a few GOOD men. NAVY CORPSMEN!”