View source for Starbase 118 Ops Medical Simming Guide

Playing a Medical Officer on Ops offers a versatile role that easily branches out into Science and Counselling. This guide is meant to give an overview over simming a Medical Officer on Starbase 118 Ops in particular. 

Starbase 118 is a Trojan class II Spacedock with an overall population of 181,500 people. Of these, 119,000 are part of Starfleet, and this breaks down into around 18,400 officers and 100,600 enlisted. 
Due to its size, Ops has approximately 3500 medical officers and 20.000 enlisted (this includes Counselling), who are divided into forty specialised clinics in sixteen sickbays. Each clinic has around 90 Officers and 500 Enlisted.

<h3>{{LCARS-bar-left|Entering Starfleet Medical|275|COLOR=teal}}</h3> 

There are two ways for a character to enter into a medical career with Starfleet. A character can complete an eight year program at Starfleet Academy and, upon graduation, begin their journey as an Ensign. 
Alternatively, for those who are looking for a quick entry into Starfleet, a half-year on-the-job training offers the opportunity of enlistment, which is an attractive option for characters who already hold a medical degree and are not looking for career progression past Chief Warrant Officer 1st Class. 

===Competencies=== 

Generally speaking, during the first four years of their education, every medical officer who studied at Starfleet Academy has taken courses in Biochemistry, Microbiology, Immunology and Physiology, as well as Engineering courses for Medical Systems and Equipment, and life support systems.
The last four years are focussed on several clinical rotations. Most commonly, one rotation is taken during the first half of the semester and the second one is taken during the second half of the semester. That means a new medical officer has experience in areas such as  Internal Medicine, General Practice and Surgery, Obstetrics/Gynecology, Psychiatry & Mental Health, and it is only in the last part of their education that they specialise and add elective rotations. 
The nursing education looks very similar, but after completion of their Bachelor of Science in Nursing (four years), nursing graduates enter the fleet as commissioned officers - to continue their education with a specialisation in such fields as critical care, mental health, and rehabilitation is optional.

<h3>{{LCARS-bar-left|Medical Positions on Ops|275|COLOR=teal}}</h3> 

Especially a place such as Ops has countless opportunities when it comes to playing a medical officer, but it is important to develop an understanding of what your day-to-day job would look like. The key is to play realistically, and find a role you are happy with.


'''Chief Medical Officer'''
The Chief Medical Officer on Ops oversees all sickbays and clinics, and therefore serves in a largely administrative capacity. The CMO has full medical authority over any patient officially admitted to care in their facilities, including superior officers. Playing this role often involves large-scale projects, administrative duties and requires close cooperation with CO and FO. 
The Chief Medical Officer on Ops is Lt Commander [[Shar'Wyn Foster]].

'''Asst. Chief Medical Officer'''
An Asst. Chief Medical Officer can function as a CMO's 'Second in Command' when it comes to anything sickbay related. They are likely to take over in the CMO's absence, or - on a large station - have an assigned amount of sickbay to oversee. Currently, this position is filled by Lieutenant JG [[Madison Marsh]].

'''Clinic-/Department Heads''' 
Medical with a proven track-record of excellent work can be selected to head a clinic, which means they have dedicated time for difficult cases and serve as a mentor for aspiring doctors. Those Officers usually are Lieutenants or higher, but under certain circumstances the position can be offered to a lower ranking officer. 

'''Medical Officer'''
Medical Officers undertake the majority of the work aboard the ship/facility, examining the crew, and administering medical care. Depending on experience, they may participate in projects and  perform  more advanced examinations and treatments, but are also overseeing groups of enlisted Doctors and mentoring Ensigns. 

'''Chief Nurse / Nurse'''
Nurses provide vital patient care within a medical department aboard Ops and spend a considerable amount of time with their patients, serving as their advocates. Working collaboratively with medical officers and other members of the healthcare team, nurses work every day to help their patients maintain their health or recover from ailments.

'''Chief Counsellor/Counsellor'''
Counselling is part of Medical. Counsellors act as general overseers of the crew's mental well-being. They give advice and guidance for personal problems that crewmembers may have. If necessary, they can provide psychiatric and psychological treatment and care.


<h3>{{LCARS-bar-left|Things to do|275|COLOR=teal}}</h3> 

===Standard Medical Examinations===

One of the duties a medial Officer will very well face are routine medical examinations. Before they can be cleared for duty, Officers receive a standard medical examination from a member of the Medical staff. Such an exam makes sense when the crew member...
* is first posted to Ops
* returns from an IC Leave of Absence 
* returns from an away mission
* reports to sickbay with medical complaints

There is no rule as to who can give a medical exam, but of course, some make more sense than others. The Chief Medical Officer or the Head of Surgery would be less likely to have the bandwidth for such an exam than an Ensign or a Nurse Practitioner. 

'''Medical Records'''
It makes sense to review the patient’s medical history before beginning the examination. IC, the Medical histories can be accessed from the ship's medical database. OOC, it makes sense to speak to the player and see if they want the Doctor to discover anything specific. 

'''Physical Evaluation'''
Here are some ideas for a physical evaluation. A lot of them can be done with the medical tricorder. 

* Cardiovascular: Heart rate and blood pressure, blood gas levels and viscosity should be analysed to ensure adequate distribution to internal organs.
* Pulmonary: Respiratory rate should be within the recommended average level for that species. Oxygen intake should be measured and tracked.
* Gastroenterological: Stomach acid levels should be within the recommended average levels for that species. The digestive tract should be free of obstructions or swelling. Nutritional absorption levels should be tracked and recorded.
* Neurological: All neurological readings(e.g.engrammaticstability,cerebralactivity, neurotransmitter levels) should be within the recommended average levels for that species. Deviations should be followed up on. 
* Hormonal: All hormones present should be within the recommended average levels for that species. Deviations should be followed up on. 
* Ocular Evaluation: A retinal scan should be taken and filed with the patient’s medical history. Scans should be run on all areas of the eyes and optic nerves.
* Auditory Evaluation: Scans should be run on all areas of the auditory organs and adjacent nerves.

'''Psychological Evaluation'''
A psychological evaluation is something a medical officer can do, especially in situations where no Counsellor is available. However, especially in a place like Ops where there is plenty of counselling staff available, the preference is to send a character to meet with one of them. 

===Treatment Plans=== 

The year we are currently playing in is 2399, and as you can imagine, a lot has changed between 2022 and then. Life expectancy increased dramatically, and diseases that pose a threat in 2022 are basically exterminated in 2399.

When looking at a medical situation, a good approach is to keep to the following formula in mind:
* What is the injury?
* How is it treated in 2022, what are problems/side effects?
* With these side effects addressed, how do I imagine it treated 400 years into the future
* How do I still make it cool?

A more specific example:

After being involved in a house fire, the patient, a six years old Cardassian-Bajoran hybrid presents with pulmonary lesions that cause her to throw coughing fits, and reduce her lung volume which makes her unable to participate in physical exercise.

*  Treated in 2022: Small, noncancerous lung nodules don't usually require treatment. You may need treatments, such as antibiotics or antifungal medications, if you have an infection. If the nodule grows, causes problems or is cancerous, you may need surgery.
*  Problems/ Side Effects: Surgery is generally difficult, even more so for children. There is also the likeliness of breathlessness, persistent pain, and reduced lung volume.
*  2399: Surgery in the 24th century has advanced to become as non-invasive as possible, utilising Exoscalpels and Sonic Separators to make incisions. Alpha Wave and Somnetic Inducers work as the standard anaesthetic by lowering the patients' state of consciousness while not producing adverse side-effects. Some surgery can circumvent opening the body altogether. Anabolic protoplasers use force-fields and regenerative accelerators to quickly repair small wounds. For cases that require great precision, Nano surgeons, which are microscopic electronic “pores” can be injected into the patient's bloodstream and controlled from the physician through a computer.
*  Make it cool: We don’t just want to wave the magic wand and cure the patient. After discussing their wishes with the character's player, we decide that the patient has to attend physiotherapy and the lung needs to be monitored while she grows up.

[[Category:Medical Duty Post]]
[[Category:Simming Guides]]