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Role and Duties
A Chief Medical Officer (CMO) is far more than a doctor. CMO’s have a wide variety of duties that involve them in away missions, emergency medicine, research, surgery, and the command structure.
On a starship or starbase a chief medical officer’s most obvious duties involve running the medical department, which normally consists of several doctors and nurses, and responsibility for catering to all the crew’s medical needs. On a daily basis this means providing general care to a community of several hundred; in deep space that can mean everything from treating minor infections and broken bones to dealing with possession by an alien parasite.
The CMO is responsible for operating a walk-in surgery, organising regular check-ups for the entire staff; they have the authority to order anyone to sickbay. In the earliest days of space exploration, the CMO was responsible for screening any crew who had left the ship for infections and, if necessary, ordering them to decontaminate. This role has virtually been eradicated as a result of the introduction of transporter biofilters.
Of course, a ship’s sickbay is as closely related to a hospital as it is to a doctor’s surgery. In fact, it has been remarked that a starship’s sickbay can provide everything found at a starbase, with the possible exception of long-term care. A CMO is effectively the equivalent of the chief of surgery. The staff will include a number of specialists, but the CMO is normally the leading surgeon. In today’s world of multi-species starships and starbases the CMO must be familiar with a wide range of species anatomy. CMO’s often encounter new conditions, and they typically demonstrate a remarkable ability to improvise. For example, in 2266, Dr. Leonard McCoy only had a matter of hours to develop a cure for a previously unencountered condition known as the Psi-2000 virus. These requirements tend to mean that CMO’s are generalists. Some of them do have particular areas of expertise, for example Dr. Katherine Pulaski who served aboard the Enterprise-D in 2365 is one of the Federation’s leading cardiac surgeons.
If a starship or starbase is engaged in combat, the main sickbay becomes an emergency room. The CMO coordinates all necessary medical treatment and acts as the liaison with the bridge, keeping the captain informed of the number and severity of any injuries. In the extremely rare event of a murder, the CMO serves as a pathologist, and may be called upon to perform an autopsy or examine forensic evidence. As head of department, the CMO has a variety of administrative duties that includes conducting performance reviews for the medics under their command, and making recommendations for promotions to the first officer.
In conjunction with the ship’s counsellor the CMO is also responsible for the mental wellbeing of the crew. Given the pressures of deep space exploration, this is a particularly important role. Under normal circumstances the CMO will make regular reports to the captain about the crew’s condition, and it is part of their duties to advise the commanding officer when the crew are overworked and would benefit from shore leave. In more extreme circumstances, the CMO has always had the authority to remove any officer, including the captain, from duty if they deem them unfit, though they are required to perform an examination to support their actions. In practice, Starfleet regulations mean that a CMO can only remove the commanding officer if they present an obvious danger to themselves or the crew. This authority is not related to the CMO’s rank. The position exists outside the normal command hierarchy, and CMO’s may have a relatively lowly rank, such as Dr. Julian Bashir who was a lieutenant when he took up his post on Deep Space Nine.
In planetary emergencies, CMO’s are often called upon to organise triage facilities and provide aid to the wounded. Large starships are equipped to provide significant help, and can accommodate hundreds of patients by converting the shuttlebays into emergency treatment centres. During such emergencies all personnel with medical training are placed directly under the CMO’s command.
During Starfleet’s greatest period of expansion, space exploration is extremely hazardous, and the CMO routinely joins landing parties in order to provide medical aid if anyone is injured or infected during the mission. Naturally they are thoroughly trained in field medicine and can treat most injuries with the aid of a standard issue medkit. Research is also an essential part of a starship’s mission; the CMO is effectively the head of the life sciences department and is responsible for studying the many new races a starship encounters. The opportunities this provides for research are incredible.
On starbases, CMO’s are more likely to be involved with long-term medical projects such as Dr. Bashir’s immunology project on Bajor. Starfleet CMO’s have conducted some extraordinary medical research projects that are easily on par with work conducted in major hospitals or universities. In 2371, Dr. Bashir was even nominated for the prestigious Carrington Award for his work on biomolecular replication. Starfleet medics regularly write-up reports on their research for publication throughout the Federation and attend medical symposia to discuss their findings.
In short the position of Chief Medical Officer is extremely demanding and is only filled by the most able and versatile medics of the day.