Hospital Cor-what?

People worldwide have seen the iconic photo of the hospital ship USNS Comfort entering New York Harbor on a mission to help relieve the overwhelmed medical departments of N.Y.C.

Photo by Brendan Mcdermid/Reuters

The staff of this massive floating hospital is made up primarily of a very rare breed of hybrid medical provider known as Hospital Corpsmen. During the extraordinary times of the COVID-19 pandemic, and the ensuing mobilization of the U.S. Navy's hospital ships USNS Mercy and USNS Comfort, I thought it would be worthwhile to share some background of the Hospital Corps and the role of the men and women who make up the Navy’s largest enlisted rating. It is a career that is typically a mystery to those outside of military healthcare, but advanced programs, such as Duke University’s PA Program, have used the model of the Hospital Corps to structure their own curriculum.

How is this Wilderness Medicine?

In “Wilderness EMS,” Seth Hawkins, MD, MFAWM, FACEP, FAEMS, offers two definitions of wilderness medicine, both of which seem as if they were written for Hospital Corpsman:

• Wilderness care and problem-solving in circumstances where the surrounding environment has more power over our well-being than does the infrastructure of our civilization.
• Medical care delivered in those areas where fixed or transient geographic challenges reduce availability of, or alter requirements for, medical or patient movement resources.

The field and expeditionary environment that units in the United States Navy and Marine Corps fit those definitions, and, with some exceptions, consist mostly of Physician Medical Officers and Navy Corpsman, or Corpsmen alone. The Corpsmen can be found worldwide in the field, deployed shipboard at sea, or by submarine, providing care for large and small military units during various operations and humanitarian relief efforts. Corpsman fly as crewmembers on search and rescue helicopters at sea and ashore, as well as casualty evacuation missions in combat zones. Corpsman work with every unit of the Navy and Marine Corps, in every hardship zone around the world, tirelessly caring for their sick and injured teammates and anyone else who crosses their path.

A Proud Heritage

The history of the Hospital Corps traces its roots back prior to World War I, where Hospital Corpsman performed medical care alongside Marines in battle. Although the title of Hospital Corpsman did not come about until it was officially recognized by congress in 1898, various forms of the job have existed since the inception of America’s Navy and have held a wide variety of titles, from surgeon’s steward to Loblolly boy. These consummate professionals have set the standards of care for treatment of casualties so high that they are the most decorated group among all our Nation’s military service personnel. In fact, Navy corpsmen have earned 22 Medals of Honor, 179 Navy Crosses, 959 Silver Stars, more than 1,600 Bronze Stars, and have had 20 ships named in honor of them.

A Hybrid Medical Asset

The training of Hospital Corpsman is vast and various but has its roots in two fundamental training programs based on whether the trainee will be assigned to a Navy (blue-side) or Marine Corps (green-side) unit. These two programs are Hospital Corpsman Basic, which all attend, and Field Medical Training Battalion (formerly Field Medical Service School) which all Corpsman must pass prior to any assignment with the Marines. A Corpsman provides all nonphysician healthcare in most field units including gaining IV access, performing phlebotomy, medication administration, wound care, as well as many other general duties and advanced procedures like toenail removals, I&Ds, and suturing. Some Corpsman are trained for Independent Duty, allowing them to provide care similar to the level of a physician assistant. All basic clinical skills are learned in Hospital Corpsman Basic training, and there are many opportunities for advanced training in various areas of allied health such as X-Ray, Lab, Pharmacy, and the more exciting and predominantly wilderness medicine relevant roles like Deep Sea Dive Med Techs, Search and Rescue/Casualty Evacuation Aircrewmen, Marine Corps Special Forces/Raiders, and further work alongside SEAL teams.

Hospital Corpsman Basic - Scope of Instruction

Per the Military Medical Education and Training Campus, “The Hospital Corpsman Basic (HCB) Program provides requisite knowledge, simulated, and clinical training in various aspects of emergency, nursing, and primary care. Students will receive training in subjects of Medical Terminology, Anatomy & Physiology, Basic Life Support (BLS), Emergency Medical Technician-Basic curricula, as well as various aspects of nursing and primary patient care. Outcome-based practices and safety techniques are emphasized throughout the program.”

Field Medical Training Battalion (Field Med) – Scope of Instruction

All Hospital Corpsman must attend Field Medical Training Battalion (Field Med) prior to any assignment with Marine Corps units. Their motto reads, “To train the Navy's finest to serve with the few and the proud.” Corpsman first learn the fundamentals of the Marine Corps mission, followed by the medical fundamentals of operating in expeditionary and remote settings, and finally, all aspects of Tactical Combat Casualty Care (TCCC/TC3). Some of these topics include field water purification & field waste disposal, land navigation, care of feet, treatment of heat, cold, and envenomation injuries, and management of nuclear, biological, and chemical warfare casualties. During this training, potential Fleet Marine Force assigned Corpsmen are challenged both mentally and physically as they complete evolutions in simulated combat environments, as well as pack-weighted endurance marches, and litter bearing obstacle courses.

Photo by Maria Kirk

The Legacy

Often throughout the most austere wilderness and tactical environments, Navy Corpsmen are the only medical providers available. This is how the title of “Doc” came about to characterize those Corpsman who serve side-by-side their Marine and Sailor brethren. To quote one of the most historically well-known Marines, General Lewis B. “Chesty” Puller, “You guys are the Marine’s doctors; There’s no better in the business than a Navy Corpsman.”

Photo by Maria Kirk