Rounds and Actions

Prepare your hospital, improve its engine, and choose when to pass.

Round structure

A game normally lasts seven rounds. Resolve each round in order: Preparation, Actions, Patient Treatment, Cleanup.

Preparation

In player order, draw the Medical cards and Patients indicated by the current round. The designer clarified that Medical cards come first, then Patients. When drawing Medical cards at round start, draw extra cards equal to your Quality of Care position, then discard that many from your hand. Draw Patients from the bottom of the deck with their treatment sides hidden. Take resources from each production track, then ready your used action cards.

Production

Your production markers generate Diagnostics, Healing, Research, Staff, and Credits each round. When an effect raises a production track, gain that many of the resource immediately as well. Reaching the marked thresholds on resource and Credit production can claim a Congress Doctor or advance an Insurance Company, as shown on the board.

Action turns

In player order, take one action or pass. Continue around the table until everyone has passed. Available actions:

• Play a Medical card: Pay its listed cost, place it in your hospital tableau and resolve its immediate reward. Ongoing effects remain active; action effects can be activated once per round.
• Activate an action card: Turn an available action card sideways and resolve its action reward. It readies during the next Preparation.
• Pass: You take no more actions this round.

During your turn, you may also discard a Medical card from your hand or spend one Research to gain 3 Credits. This can be done any number of times and does not use your action.

Trading resources

The player aid summarizes permitted substitutions: Staff can replace Diagnostics or Healing during treatment; Congress Doctors can be used as Staff or Research. Research can be traded for 3 Credits, as can a Medical card from hand. These are different exchanges; use them only for the purposes stated in the rules.

Ambulance track

Each step reached on the Ambulance track grants its reward. If one movement crosses several spaces, resolve every passed reward. The track loops from its final space back to the start. A Helicopter reward lets you discard one of your Patients, make every player draw a Patient, or do both.

Cleanup

Add Time to every undiagnosed Patient and to each diagnosed but untreated Patient except Priority 4. Check deaths, then score half your Prestige rounded down. If the game continues, pass the first-player marker clockwise and advance the round. See Patient deaths and scoring.