Medical Personnel on Starfleet Vessels

[Shamrock Holmes]

In reality, nurses are almost unheard of on frontline naval vessels and doctors are fairly rare (limited to the largest vessels like amphibous vessels and carriers recently, and cruisers, battlecruisers and battleships historically), with Independent Duty Hospital Corpsman (essentially highly-skilled military paramedics/care assistants) doing most of the medical work.

In Starfleet, at least one doctor is typically posted to much smaller vessels (probably small multi-role vessels of Saber-class or better, and combat vessels of the Defiant-class or larger as they come online (probably equivalent to no more than a frigate)), with two or more on long-range explorers) and nurses are at least as common. Looking at evolving developments in civilian medicine, I would assume that that nurses act more in line with primary care physicans (or British GPs) and treat most of the routine medical conditions that sensors can identify automatically (with the assistance of the technicians), whereas Medical Officers act more as diagnositians and researchers (for conditions that the system can't identify the condition or treatment) and also as surgeons when physical damage needs treated.

Does that make any sense?

Shamrock Holmes

 

[Sgt_G]

First question is: do you have the Gene Roddenberry style all-officer crew or do you have the modern military style officer/enlisted crew (15% - 85%, give or take)?? If it's all officers, it's pretty simply to say "every ship has a doctor". You then decide how large the crew has to be to warrant adding a nurse, and then to add another nurse, and then another doctor, etc., etc., until you have a full medical staff. One could say "This ship's crew is too small to warrant a doctor and only needs a nurse assigned."

On the enlisted side, you could have Corpsmen, equating to hospital orderlies, and Combat Medics, equating to paramedics / EMT of today. And one could say "This ship is too small for a doctor, so we'll assign a high-ranking (Petty Officer First / Chief Petty Officer) Corpsman or Medic."

 

[Shamrock Holmes]

Well, I've never really been overly keen on the idea of an "all officers" (at least in the US Armed Forces sense of everyone been unversity graduates), so that's the simple option out.

Then we have the question of "how small is too small"?:

ESF vessels like NX-01 appear to have 1 Doctor and 1 Corpsman (from her insignia either an e-3, e-4 or e-6, given her role, e-6 seems most likely) for a crew of ~80. This seems a little high, but could also be explained by Phlox also being intended as their Chief (Life) Sciences Advisor in addition to the medical officer. Also, IIRC Cutler wasn't originally The Medic but was assigned as a research assistant focusing on entymology.

Later, NCC-1701 had up to three doctors (McCoy (doctor/surgeon), M'Benga (doctor/surgeon) and Sanchez (pathologist, possible surgeon) and also Chapel - identified as a nurse, but also qualified as Life Sciences researcher - so IMO probably at least 'general practioner' level as a medical officer. No specifically referenced corpsman, but there were several background characters that could have been such.

NCC-1701-D specifically per dialogue usually has a staff of at least nine (three doctors (Crusher, Selar & Hill as of s4's Remember Me), two duty nurses and at least four other "members of (my) medical staff") but later dialogue indicates that a minimum of four medical personnel should be on-duty at again given time, which suggests a minimum of 12-15 personnel (for a nurse and two technicians per doctor) and I seem to recall seeing a reference to a medical staff of 5 doctors, eight nurses and twelve medical technicians (tho I can't remember where) which gives a total of 25 personnel and would allow for the above ratio of 1:1:2 but with limited time off for the doctors).

TNG: Disaster also seems to imply that basic field medic training is at least optional for Security Officers (and I would expect some MA/SG's). However, this is contradicted later by VOY which suggests that Voyager has only 1 doctor, 1 nurse and no technicans/field medics or even any cross-trained back-ups until Kes (sensible) and Paris (ridiculous) are co-opted.

Deep Space Nine generally seems to be somewhat short on Starfleet medical personnel other than Bashir, but Bajoran doctors and nurses are occassionally seen and IIRC at least a couple of corpsman are implied on occassion to be attached to the Defiant.

 

[Bry_Sinclair]

I remember reading somewhere (no clue when or where) about the TOS Enterprise having a medical staff of 30. For a crew of 430 that is about 6% of the overall complement, which is usually a calculation I use when creating my own crew complement.

I would see the medical staff having a number of enlisted medtechs, corpsmen, and orderlies, though would have a higher proportion of officers compared to other departments as all Doctors and Nurses would be Academy graduates (at least that's how it is in my head).

 

[Shamrock Holmes]

I remember reading somewhere (no clue when or where) about the TOS Enterprise having a medical staff of 30. For a crew of 430 that is about 6% of the overall complement, which is usually a calculation I use when creating my own crew complement.

I would see the medical staff having a number of enlisted medtechs, corpsmen, and orderlies, though would have a higher proportion of officers compared to other departments as all Doctors and Nurses would be Academy graduates (at least that's how it is in my head).

Given the on-screen evidence, I'd say if there's as much as thirty "medical" personnel then it probably includes xeno/exobiologists, Archeology & Antropology, psychologists, pharmacologists and other life sciences roles that can suppliment the medical team as needed rather than doctors or nurses.

However, I agree that the enlisted to officer ratio is probably higher than in engineering or flight operations.

 

[Bry_Sinclair]

Given the on-screen evidence, I'd say if there's as much as thirty "medical" personnel then it probably includes xeno/exobiologists, Archeology & Antropology, psychologists, pharmacologists and other life sciences roles that can suppliment the medical team as needed rather than doctors or nurses.

I believe that did include pharmacy, dental, research, and mental health staff. A&A specialists I would class under the ship's social science division not life sciences, though that's my take on them.

 

[Shamrock Holmes]

I believe that did include pharmacy, dental, research, and mental health staff. A&A specialists I would class under the ship's social science division not life sciences, though that's my take on them.

I've never been entirely sure whether Social Sciences is a separate department within Starfleet?

Certainly they are separate in the RW (and probably at facilities like Memory Alpha or the Daystrom Institute) I believe that canon has never identified more than two science departments in Starfleet and I'd be more inclined to group social sciences with medical/life sciences than I would to group it with physical sciences (stellar cartography, chemistry, geology, astrophysics etc).

Would you agree?

 

[Bry_Sinclair]

I apply a five division science department:
Life - Biology, Botany, Ecology, etc
Physical - Chemistry, Computer Science, Physics, etc
Planetary - Geology, Hydrology, Mineralogy, etc
Social - Anthropology, History, Sociology, etc
Stellar - Astrophysics, Cosmology, Stellar Cartography, etc

On a standard cruiser or explorer some divisions would be smaller than others, whilst some officers may specialise in multiple disciplines and fill a couple of different roles in the department. On research ships with specific missions one division may be in dominance, whilst the others just have one or two specialist onboard (such as stellar classification, planetary survey, archaeological expedition, and so forth).

But of course, this is just how it works in my head canon.

 

[Shamrock Holmes]

I apply a five division science department:
Life - Biology, Botany, Ecology, etc
Physical - Chemistry, Computer Science, Physics, etc
Planetary - Geology, Hydrology, Mineralogy, etc
Social - Anthropology, History, Sociology, etc
Stellar - Astrophysics, Cosmology, Stellar Cartography, etc

On a standard cruiser or explorer some divisions would be smaller than others, whilst some officers may specialise in multiple disciplines and fill a couple of different roles in the department. On research ships with specific missions one division may be in dominance, whilst the others just have one or two specialist onboard (such as stellar classification, planetary survey, archaeological expedition, and so forth).

But of course, this is just how it works in my head canon.

Makes a certain amount of sense, I'd estimate that the bulk of personnel would be either the Stellar Sciences (nominally the "Science Division") or Life Sciences (to a degree interchangeable with "Medical Division") with a mix of officer supervisors/advisers, civilians and enlisted personnel in the other sub-Departments).

 

[psCargile]

I would image also that for common infections and the like, you wouldn't have to see a doctor, just a medical computer for a diagnosis and replicated medicines, a do-it-yourself healthcare for minor issues.

 

[Shamrock Holmes]

I would image also that for common infections and the like, you wouldn't have to see a doctor, just a medical computer for a diagnosis and replicated medicines, a do-it-yourself healthcare for minor issues.

I think Reg Barclay shows why a true "diy" approach would be sub-optimal, but I agree that more sophisicated diagnostic tools esp linked to replicators would allow less qualified practioners, nominally "nurses" or even technicians for minor trauma or illnesses, to do the work without involving doctors.

 

[psCargile]

You got to make the computers smarter than the people.

 

[Sgt_G]

You got to make the computers smarter than the people.

I thought they were .....

 

[Laura Cynthia Chambers]

It depends on what the ship is supposed to do. If it's a scout ship or a transport, then the medical staff complement would be determined on basis of what the crew needs.

If it's a ship that frequently offers aid/answers distress calls (despite not being a hospital ship), more people would be assigned. Everybody else would know basic first aid, of course, though what constitutes "basic" would be different from the 21st century civilian definition.

When they're not needed in such large numbers all at once, the medical staff would devote their time to research and bettering themselves in other disciplines, maybe a bit of cross-departmental training to make the crew better overall.

 

[Sgt_G]

Oh, yes, very true. In the deck plans I drafted of the Federation Police Cutter, it has a crew of only a hundred, including one doctor, one nurse, and two corpsmen. The sickbay has ten recovery beds, one isolation bed, and four surgical / trauma beds. No ship with a crew of a hundred needs all that for itself. But this is a police boat. It's a first responder. For its mission, it needs all that.

 

[Nerys Myk]

Later, NCC-1701 had up to three doctors (McCoy (doctor/surgeon), M'Benga (doctor/surgeon) and Sanchez (pathologist, possible surgeon)

There was also Dr. Helen Noel (Psychiatry)

First question is: do you have the Gene Roddenberry style all-officer crew

I don't think that ever got from the page to the stage. Enlisted were there from the first pilot on.

 

[Laura Cynthia Chambers]

But this is a police boat. It's a first responder. For its mission, it needs all that.

So police and ambulance? Neat.

 

[Bry_Sinclair]

Onboard the Border Service Cutter Silverfin there was one Doctor (who also had qualified as a Counsellor) and nine Corpsmen. Nurse Tessi Jenka was assigned to oversee the department, when Doctor Mbeki took a sabbatical for a few months, and wound up remaining with the cutter, where she began her training and studies to become a doctor.

 

[Tenacity]

You got to make the computers smarter than the people.

I thought they were .....

Faster yes, more accurate memory yes, smarter no. Currently computers have the "intelligence" of a cockroach.

 

[Sgt_G]

So police and ambulance? Neat

Yeah, I guess you could say that. You may have seen me mention this before: it's from the game Star Fleet Battles. The background data says the police force is a separate agency from Star Fleet (they can't use the trademarked name "Starfleet"), much like the relationship between the Coast Guard and Navy. The difference is that the Federation Police has twice as many ships in service as Star Fleet right before the Great Galactic War. They have so many because they have patrol zones covering the entire Federation space such that there is always a police boat within two or three days, often 12-18 hours, from any given point. The Constitution-class heavy cruiser gets all the credit, but nine times out of ten the unsung hero of the day is the lowly police boat.