Skip to main content
HonestMOS
●InvestigationsCongress made VA disability claims free to file. An entire industry charges veterans anyway — and nobody can stop them.→
←Back to HS Health Services Technician — overview, pay, training, civilian translation, reviews
HSE1-E3

Health Services Technician

E-1 to E-3 (Junior Enlisted) · Coast Guard

E1–E3E-4E-5E-6E-7E8–E9
HEADS UP

You are a non-rate striking for a rating that carries a federal controlled-substance license and a scope of practice enforced by federal law — before you touch the first patient, the controlled substance locker, or the sick call log, you need to understand that a single documentation error is not a training event. It is the beginning of a paper trail a federal investigator reads. The NREMT-B card is the gate to A-school; do not wait to be reminded to earn it.

The Honest MOS Read
The HS non-rate experience is front-loaded in ways that differ from almost every other CG rating. You came out of TRACEN Cape May and reported to a cutter, a sector command, a small boat station, or a shore-based medical department as a Seaman Recruit, Seaman Apprentice, or Seaman — undesignated, striking for HS. What you find is a small medical department: one or two qualified HS petty officers, standing medical orders that define a scope of practice under COMDTINST M6000.1, and a controlled substance locker that is counted twice a day and witnessed every time. You are not in the way and you are not doing nothing — you are the administrative and logistical backbone of a medical operation that runs on accurate records, stocked equipment, and a treatment space that is clean, organized, and ready before the first patient of the day. The Coast Guard's medical rating structure is smaller and more geographically distributed than the Navy's. There is no large teaching hospital base you can train in passively. The HS working a small boat station or an FRC (Fast Response Cutter) may be the only qualified HS at the command; the sick call bay may see a dozen patients a week across a full range of primary care presentations. The non-rate who pays attention in that environment learns faster than the non-rate who waited to be taught. The qualified HS teaching you is also running sick call, managing the controlled substance log, maintaining the formulary, filing HIPAA-compliant records, writing EERs, and standing command duty officer in rotation. The ones who show up early, stock the bay before sick call, take vitals without being asked, and bring a PQS signature to the HS2 once a week — those are the non-rates who get the A-school endorsement letter without a second ask. The NREMT-Basic (NREMT-B) is the structural prerequisite for HS A-school at TRACEN Petaluma, CA. The pipeline to Petaluma starts with the exam card. TRACEN Petaluma's HS A-school is roughly 20 weeks covering EMT-Basic curriculum integrated with military health services — patient assessment, vital signs, emergency medicine, pharmacology basics, HIPAA compliance, controlled substance management, sick call documentation, and the scope-of-practice framework the COMDTINST M6000.1 Health Services Manual governs. You cannot sit in that classroom without NREMT-B in hand. The unit wants the card before the designation form drops. Units that have nominated a striker and then watched the NREMT exam date get pushed twice start looking at the next name on the list. Controlled substances are the line you do not cross unsupervised. COMDTINST M6000.1 and federal law — Schedule II-V controlled substances under 21 U.S.C. § 812 and the DEA framework — govern every vial, every count, every dispensation. The qualified HS is the accountable officer. You are not authorized to dispense, count unsupervised, or document without direct supervision and a standing order in hand. One discrepancy in the controlled substance log without an immediate, documented explanation does not stay at the unit level. It becomes a phone call to Sector, then to the District Medical Officer, then potentially to the DEA field office depending on the substance and the timeline. The investigating officer asks every person named on the log for their independent recollection. If you are on that log, you had better have done exactly what you documented doing, and you had better have been supervised by exactly the person you named as your witness. HIPAA is not an abstract requirement on a poster in the passageway. On a cutter, the crew lives in close quarters and the messdeck is a zero-latency news network. The patient who came to sick call this morning with a mental health concern does not want the deck division to know what was discussed. The crewmember with a positive STI screen does not want it mentioned at evening chow. The HS department does not generate messdeck content. If you hear information about a patient in the treatment room, it stays in the treatment room. The first MSO visit that uncovers a HIPAA violation traces the source, and the source is always the most junior person in the department who did not yet understand that the rule was real. The HS Rating PQS (Performance Qualification Standard) is the document that takes you from non-rate to A-school-ready, signature by signature. Pull the current PQS from the CG Institute immediately after check-in. Read the entire qual book in the first week so you know what signatures you need. Then start pursuing them — not waiting for the HS2 to call you in, but showing up to sick call prep with the book open and asking for the next line item after the work is done. The non-rate who has the PQS half-completed before the A-school designation comes through is the non-rate the OIC writes a strong endorsement letter for. The non-rate who has a handful of signatures and a stated intent to get more is the non-rate who waits another cycle.
Career Arc
  • 01TRACEN Cape May Recruit Training — 8 weeks. Report to first unit as undesignated non-rate (SR/SA/SN).
  • 02Strike for HS: begin HS Rating PQS, demonstrate administrative and clinical support skills under direct supervision.
  • 03NREMT-B exam — the A-school prerequisite. Earn the card within the first 6 months. Do not wait for the unit to schedule the class.
  • 04EER cycle 1 — professional performance, military bearing, and PQS progress rated by the OIC and the qualified HS. This EER travels to Petaluma.
  • 05OIC endorsement and A-school designation — TRACEN Petaluma HS A-school class date (~20 weeks).
  • 06Graduate A-school with NREMT-B current, rating badge on, advancement to HS3 (E-4) pending SWE eligibility.
  • 07First HS3 SWE cycle — advancement to Petty Officer Third Class.
Common Screwups
  • ×DUI, drug pop, or NJP during the non-rate period. The CG is a small service with institutional memory that spans decades. One alcohol incident as a non-rate generates a conduct code that follows the service record, surfaces at every advancement and selection board, and can terminate the A-school endorsement before the OIC writes it. The HS rating is a controlled-substance-holding position; a substance violation as a non-rate is often a career-ending event, not a developmental warning.
  • ×Any contact with the controlled substance locker without the qualified HS present and documenting the witness. The standing order is real and the consequences are federal. 'I just checked the count' without a witness documented in the log is the explanation an investigating officer hears right before they ask how long this had been happening.
  • ×Discussing patient information outside the treatment space. HIPAA applies on cutters with the same force as in a hospital. The crewmember who hears about their diagnosis at the chow table files a complaint, and the complaint names the most junior person in the department first.
  • ×Phoning the NREMT-B preparation. The exam is not easy, particularly the NREMT-B cognitive exam under the current computer-adaptive testing format. The non-rate who treats it as a formality and fails the first attempt has now added 2-3 months to the A-school timeline while the SWE cycle marches on without them.
  • ×Filing a sick call SOAP note from memory after the fact. The CG medical record is a federal document under COMDTINST M6000.1 and HIPAA. A note written an hour after the encounter from recollection is not contemporaneous documentation — it is a reconstructed record, and if the case resurfaces in a line-of-duty investigation, the timestamp and the content do not align.

A Day in the Life

  • 0530-0630Morning PT with the unit — cardiovascular training three times a week (run or swim), strength days twice a week per the OIC's PT plan. The HS2 is watching who shows up without being chased.
  • 0630-0700Shower, uniform inspection, chow. Rate the uniform standard — medical department non-rates are visible representatives of a department that patients trust.
  • 0700-0730Sick call bay prep: restock consumables, verify AED battery and pad expiration, check O2 supply gauge, run through controlled substance count with the qualified HS. Pre-underway checks on any day with a scheduled sortie.
  • 0730-0800Controlled substance morning count — witnessed and logged with the HS3 or HS2. If you are not authorized to open the locker, you watch and sign as witness only.
  • 0800-0900Sick call opens. Non-rate handles patient intake: chief complaint log, vital signs, seating patients in the waiting area. Present each patient to the qualified HS with vital signs recorded and legible.
  • 0900-1000Sick call continues. Assist the HS3 with minor procedures under direct supervision — wound irrigations, dressing changes, suture-site checks. Document everything in real time.
  • 1000-1100PQS work or rating study. Ask the qualified HS to sign off on any PQS tasks completed during morning sick call. Review NREMT-B study materials for the day's scheduled exam content.
  • 1100-1200Medical department administrative tasks — formulary inventory update, pharmaceutical stock reorder check, equipment calibration log review. The HS2 assigns this work; complete it without reminder.
  • 1200-1300Chow. Back at the medical department at the top of the hour.
  • 1300-1500Training evolution or duty section tasks. On training days: BLS refresher, mass-casualty drill, OPSEC brief, or unit training officer's scheduled instruction. On regular days: medical records filing, supply inventory, equipment maintenance logs.
  • 1500-1600Afternoon controlled substance count — witnessed, logged. Verify sick call bay is restocked and ready for the duty section overnight.
  • 1600-1800Off-watch time, subject to duty section rotation. NREMT-B study or PQS review in the barracks. Duty section non-rates stand quarterdeck or pier watch per the watchbill.
  • 1800-2200Evening: personal time, unit liberty call, or duty section watch. NREMT-B prep is personal time well spent at this rank — no one is going to schedule it for you.
  • Field noteUnderway on a cutter: sick call bay opens at 0730, vitals and intake for all walk-ins under direct HS supervision. Pre-underway kit check is mandatory before departure. Controlled substance counts continue on schedule regardless of sea state.

Weekly Cadence

The non-rate week at a small boat station or cutter medical department is structured around sick call, controlled substance accountability, and the qualification events that mark progress toward A-school. Monday through Friday follows a consistent rhythm: PT at 0530, sick call bay prep and morning counts by 0730, sick call from 0800 through roughly 1000, and then administrative and training time in the afternoon. The sick call volume varies — a cutter with 24 crew will have 2-6 patients a day on average, spiking during underway periods when injury risk is higher. The non-rate's role in each encounter is standardized: prep, intake, vitals, documentation, and support under direct supervision. The cadence does not vary because the documentation standards do not vary. Wednesday afternoons at most commands are dedicated to all-hands training — emergency drills, OPSEC briefs, or department-specific training. The medical department runs its own recurring training: monthly AED check and BLS currency, quarterly mass-casualty drill, and whatever the unit training officer schedules for the medical readiness program. The non-rate participates in all of it and runs the equipment check for the ones they are assigned to own. Weekend and duty section watch rotation changes the rhythm. Duty days mean quarterdeck or pier watch in addition to medical department coverage. The controlled substance counts continue on schedule regardless of the duty day — the morning and afternoon counts happen with the duty HS, and the non-rate witnesses them if assigned. Underway periods compress everything: sick call, counts, kit checks, and emergency readiness all happen in a narrower operational window. The non-rate who has built the habits in garrison finds the underway routine natural. The non-rate who has not built the habits in garrison finds the underway routine chaotic.

Key Skills — How to Drill Each

  1. 01
    Take a complete, accurate set of vital signs — blood pressure (manual cuff and electronic), pulse, respiratory rate, pulse oximetry, and temperature — on every sick call patient under direct supervision.
    Document vitals in the SOAP note immediately and legibly — not on a sticky note, not from memory, not after the patient leaves. The record is the only evidence of what you found and what the qualified HS decided based on it.
  2. 02
    Inventory the unit medical kit, the controlled substance locker, and the sick call pharmaceutical stock accurately to the COMDTINST M6000.1 standard — every item, every count, every expiration date, every time.
    Build an inventory discipline that does not vary by shift. Count every controlled substance vial, every tablet in the blister pack, every sealed unit — against the running log — with the qualified HS watching. If the count is off by one item, say so immediately before anything else happens. The instinct to recount silently and hope it resolves is the instinct that turns a transposition error into a federal investigation. When the count is right, document it, witness it, and move on. Never shortcut the expiration-date check — an expired epinephrine vial found during an audit under a HS's name is a failure of basic supply accountability, not a minor oversight.
  3. 03
    Assist with patient triage during a medical emergency — clear the treatment space, stage the medical kit, establish patient positioning, and stay coordinated with the qualified HS.
    Your job in a medical emergency is not to lead the response — it is to make the qualified HS's hands available for the patient. Know where every piece of emergency equipment lives before the emergency happens: the AED, the oxygen delivery system, the suction device, the BVM, the hemorrhage control bag, the IV supplies. Run a mental inventory check every morning when you stock the sick call bay. When the casualty alert goes out, you have the kit at the treatment bay before the HS2 arrives because you have already done this in your head fifty times.
  4. 04
    Perform basic wound care — irrigation, dressing changes, and suture-site checks — under direct supervision of the qualified HS per the unit's standing medical orders.
    Watch the qualified HS perform the procedure once with you narrating back what they are doing and why. Then ask to perform the next dressing change under their direct observation with a running commentary on your own decision-making — 'I am irrigating the wound bed with normal saline before applying the dressing because the wound had visible debris' — so the HS2 can correct the reasoning, not just the technique. Wound care mistakes that go uncorrected become infection cases and the infection becomes a line-of-duty finding. Slow and correct beats fast and unwitnessed.
  5. 05
    Operate the AED, the BVM, and the oxygen delivery system to the BLS standard — the NREMT-B curriculum sets the bar, and the HS2 will test you cold.
    Do not wait for a drill. Pull the AED out of the cabinet weekly, run through the pad placement, power-on sequence, and the verbal prompts. Check the battery indicator, the pad expiration date, and the adult-versus-pediatric pad configuration. Practice BVM seal technique on a training manikin every month — a poor mask seal in a real BLS event is a preventable failure. The HS2 who asks you to demonstrate AED placement at 2200 during a duty day is not giving a quiz. They are making sure the crew has a safety net before the next underway.
  6. 06
    Maintain HIPAA-compliant medical records — legible, accurate, time-stamped, and locked per the unit's medical records SOP.
    Read the unit's medical records SOP in the first week. HIPAA Privacy Rule (45 CFR Parts 160 and 164) requires that protected health information (PHI) not be disclosed without patient authorization except for treatment, payment, or operations purposes. On a cutter or small boat station, PHI stays in the locked medical department records file and is not discussed on the messdeck, over the quarterdeck radio, or in the berthing spaces. Pull a blank SOAP note template and practice filling in every field — Chief Complaint, Subjective, Objective, Assessment, Plan — from a hypothetical patient encounter until the format is automatic. The HS2 reviews your entries and the MSO reviews the HS2's.

Manuals & References — What Chapters Matter

  • COMDTINST M6000.1 (current series) — Coast Guard Health Services Manual
    The doctrinal source for every clinical and administrative action the HS rating owns. Read the scope-of-practice section and the standing medical orders section before you touch a patient. Chapter references vary by revision; verify the current revision against the CG Directives System. At the non-rate level, the sections governing sick call documentation, controlled substance accountability, HIPAA compliance, and medical equipment standards are the ones you will be tested on during the A-school application review.
  • NREMT National Registry EMT-Basic Candidate Handbook and current Cognitive Exam Blueprint — available at nremt.org
    The NREMT-B cognitive exam is computer-adaptive with a minimum of 70 and maximum of 120 questions across five content areas: airway/ventilation/oxygenation, cardiology/resuscitation, trauma, medical/obstetrics/gynecology, and EMS operations. The psychomotor exam requires demonstrated proficiency on patient assessment, airway management, and hemorrhage control stations. Pull the current exam blueprint from nremt.org — not a prep guide from three years ago — and build your study plan around the actual content weights.
  • COMDTINST M1000-series — Coast Guard Personnel Manual (current series)
    The umbrella personnel manual governing leave, liberty, advancement eligibility, conduct standards, and Servicewide Examination cycles. At your paygrade, the advancement criteria for E-2 (SA — 6 months TIS), E-3 (SN — 9 months TIS / 6 months TIG), and E-4 (HS3 via SWE) are in here. Verify current advancement criteria against the current M1000 series and the most recent PSC ALCOAST for the SWE cycle.
  • HIPAA Privacy Rule — 45 CFR Parts 160 and 164
    You are operating inside a covered entity from your first day in the sick call bay. 45 CFR Part 164.530 requires covered entities to train all members of the workforce on HIPAA policies. Read the definitions of PHI and the permitted disclosures in 45 CFR 164.512 before you document anything. The unit's HIPAA compliance officer (typically the senior qualified HS or the Medical Officer) should walk you through the unit-specific policies the first week. If they do not, ask.
  • HS Rating Performance Qualification Standard (PQS) — current version from the CG Institute
    The PQS is the A-school endorsement application disguised as a qual book. Every task in the PQS corresponds to a demonstrated clinical or administrative skill the qualified HS signs off after watching you perform it. Pull the current version from the CG Institute, map every line item to a training opportunity in the daily sick call routine, and bring the book to the qualified HS — not the other way around.
  • Joint Trauma System (JTS) Clinical Practice Guidelines — jts.health.mil
    The JTS CPGs are the evidence-based emergency protocols the CG medical program maps to for trauma and emergency management. At the non-rate level, reading the TCCC (Tactical Combat Casualty Care) basic CPG gives you the doctrinal framework for hemorrhage control, airway, and hypothermia prevention that the qualified HS references when running a mass-casualty drill. Start with the TCCC Guidelines CPG and the Hemorrhage Control CPG — they are publicly available at jts.health.mil.

Standards — How to Hit Each

  • NREMT-B certification earned before the HS A-school designation at TRACEN Petaluma.
    Register for the exam within 60 days of arriving at your first unit. The NREMT cognitive exam requires scheduling through the NREMT portal (nremt.org) and testing at a Pearson VUE testing center. The psychomotor exam is administered at state-certified sites. Most units near a moderate-size metropolitan area have both within an hour. The non-rate who has the NREMT-B card in hand 6 months before the anticipated A-school designation window is the non-rate who does not miss the class.
  • Coast Guard PFT passed every cycle per the current personnel manual; body composition compliant with COMDTINST M1020.8.
    The HS rating is a physically demanding afloat assignment. You respond to man-overboard casualties, fire emergencies, and traumatic injuries on the same cutter that has a sick call line in the morning. The CG PFT — cardiovascular component (run, swim, or bike depending on unit), sit-ups, and push-ups — is the baseline. Verify the current standards in the M1000 series and the current revision of COMDTINST M1020.8. Failing the PFT as a striker signals the OIC that the A-school endorsement letter carries risk.
  • HS PQS book signed to a visible progress level before the A-school designation — the OIC's endorsement depends on documented progress, not stated intent.
    Set a target of two PQS signatures per week during your first 90 days. That pace is achievable if you show up at sick call prep with the book and ask for the next task after the work is complete. The qualified HS does not have unlimited time to run you through the qual book — you have to manage the schedule, bring the book, and complete the task demonstrably before asking for the signature.
  • A clean controlled substance log entry on every count you witness — no unresolved discrepancies, no entries made without a witness.
    The controlled substance count witness process requires two people: the accountable petty officer and a witness. Your job as witness is to count independently, compare your count to the log, and sign only if the counts agree and the log is accurate. If they do not agree, you say so immediately — before anything else happens — and the qualified HS takes it from there. You do not resolve the discrepancy. You report it.
  • Sick call preparation complete before first patient — bay stocked, equipment checked, AED battery verified, controlled substance count witnessed.
    Build a daily sick call prep checklist the first week and execute it before the HS3 arrives. The prep checklist should cover: treatment bay cleanliness and organization, vital signs equipment calibrated and ready, AED battery indicator green and pad expiration current, controlled substance count witnessed and logged, formulary pharmaceutical stock checked against par levels. The HS2 who finds the prep already done walks into sick call with one less item on their list and one more piece of evidence that the non-rate is ready for Petaluma.

Technical Mistakes — Concrete Consequences

  • Touching, documenting, or dispensing any medication without direct supervision and a standing order in hand.
    Dispensing a controlled or scheduled medication without a standing order and a documented witness is a federal violation. The DEA registration that authorizes the unit to maintain controlled substances is held by a responsible officer. If a non-rate dispenses without authorization and a patient is harmed, the DEA investigation names every person who had access to the locker. The career consequence at the non-rate level is typically administrative separation and a federal criminal referral for the most serious cases.
  • Filing a sick call SOAP note from memory instead of real-time, or backdating a note to make a visit appear contemporaneously documented.
    The CG medical record is a legal document. If the patient later develops a line-of-duty condition and the record is the key evidence, a discrepancy between the documented timestamp and the actual time of the visit — detectable in the medical records management system — becomes record falsification, not a training deficiency. The JAG office reads backdated entries at face value and then asks the documenting person under oath whether the note was written at the stated time.
  • Letting the controlled substance count slip by one without immediate notification to the qualified HS.
    A single unresolved discrepancy in the controlled substance log triggers a mandatory report up the chain — to Sector, to the District Medical Officer, and potentially to the DEA. The investigation looks at every person who signed the log in the preceding 30 days. The non-rate who sat on a one-count discrepancy for two days hoping it would resolve is now explaining the delay to an investigating officer, which transforms a possible arithmetic error into an evidence pattern.
  • Discussing a patient's clinical presentation, diagnosis, or treatment with other crewmembers.
    HIPAA's minimum-necessary standard means PHI is shared only with personnel who need it to provide treatment. On a cutter, that means the qualified HS and, under their supervision, the Medical Officer. The crewmember who files a HIPAA complaint with the HHS Office for Civil Rights does not need to demonstrate harm; a disclosure without authorization is the violation. The unit HIPAA compliance review names the person who made the disclosure.
  • Going underway without verifying that the medical kit is fully stocked, the AED battery is current, and the emergency oxygen supply is charged.
    At sea, the closest emergency room is the qualified HS. If the HS is managing a primary casualty and a second emergency occurs, it falls to whoever is next most capable. If the AED has a depleted battery because no one checked it before getting underway, the unit CO learns this while the patient is on the deck. The non-rate who was responsible for the pre-underway medical kit check that morning does not get the benefit of 'I didn't know I was supposed to check it.'

Career Decisions at This Rank

  • NREMT-B: self-prep versus unit-funded class
    Some units near training centers or community colleges will have EMT-Basic programs that the unit can fund or credit time toward. Most will not. The default assumption should be self-preparation using the current NREMT-B exam blueprint, a reputable EMT-B prep textbook, and practice exams from legitimate testing preparation sources. Self-prep timelines typically run 60-90 days for someone without a healthcare background, shorter for someone with prior clinical exposure. The risk with waiting for a unit-funded class is that the class schedule does not align with the A-school designation window and you lose a cycle.
  • Striking for HS versus lateral to another rating early in the enlistment
    If the non-rate experience reveals that the clinical environment is not the right fit — that the controlled substance accountability, the HIPAA discipline, and the patient care responsibility feel like obligations rather than engagement — it is far better to explore a lateral move before investing 20 weeks in Petaluma. The CG has lateral designation mechanisms for non-rates who are a better fit for BM, MK, OS, or another rating. The cost of lateral movement early is low. The cost of washing out of A-school or being miserable in the HS rating for six years is high. Have the honest conversation with the HS2 before the A-school designation drops.
  • First duty station: small boat station versus cutter versus shore medical
    This choice, to the extent you have input on it through the detailing process, shapes how fast you develop clinical independence. Cutter assignments on an FRC or WMEC give you exposure to a wider range of patient presentations and an afloat operational rhythm that accelerates IDHST-eligible sea time. Small boat station assignments give you a high-operational-tempo environment and multi-mission exposure but may have thinner clinical caseloads if the station population is small. Shore medical assignments — sector health services sections, base clinics — offer more supervised clinical volume but slower sea-time accumulation. There is no single correct answer; the HS who wants to be an Independent Duty provider as fast as possible should prioritize afloat assignments early.

How the Seat Varies by Unit Type

  • Fast Response Cutter (FRC / Sentinel-class, 154 ft)
    An FRC has a crew of approximately 24 and typically one HS on board — usually an HS2 or HS3. As a non-rate on an FRC, you are the sole medical department support under that one HS. The clinical workload is concentrated and the HS you work for has no redundant coverage, which means your administrative reliability matters immediately. FRC patrols run approximately 84 days in published CG operations, with transits in the Caribbean Basin, Eastern Pacific, and coastal fisheries areas. Underway sick call, man-overboard medical readiness, and the full controlled substance program run during every patrol regardless of sea state.
  • Small Boat Station
    A small boat station (running 29-foot RB-S, 45-foot RB-M, and/or the 47-foot MLB) may have one HS assigned or may rely on a sector health services section for periodic clinical coverage. If the station has an organic HS, the non-rate is the administrative backbone of a one-person medical operation. The multi-mission SAR/LE/PWCS operational rhythm means the HS is sometimes underway on a case when a crewmember walks into sick call — and the non-rate is the first contact. Know what you can do (intake, vitals, call the HS) and what you cannot (treat without supervision).
  • Sector Health Services Section
    Sector-level health services sections provide primary care to a geographically distributed population of sector command personnel. The clinical volume is higher than a single station, the patient presentations are more varied, and there are typically multiple HS petty officers working under a civilian or contract Medical Officer. For the non-rate, this is the highest-supervised clinical learning environment — there are more qualified HS to learn from, more procedures to observe, and more PQS opportunities per week. The tradeoff is that the sea time accumulation for IDHST eligibility is slower.
  • Aids to Navigation (ATON) Team or Buoy Tender
    ATON teams and buoy tenders (e.g., Inland Construction Tenders, Coastal Buoy Tenders) have CG medical coverage requirements but smaller organic medical departments. The operational rhythm is different from patrol cutters — ATON work is domestic and geographically focused on the river system, the Gulf Coast, or specific inland waterways. If you are assigned to a buoy tender as a non-rate striking for HS, your clinical exposure will be limited to the crew's sick call volume and whatever the unit can arrange with the nearest sector health services section for supervision.

What Good Looks Like at This Rank

The good HS striker is the non-rate the HS2 does not have to find in the morning. The sick call bay is prepped before the first patient arrives, the controlled substance count is witnessed and logged, and the NREMT-B study schedule is on the calendar — not theoretical, but scheduled against a specific exam date at a specific testing center. This person brings the PQS book to the qualified HS after morning sick call, not the other way around, and they have two signatures ready to earn, not one. What the HS2 notices is the documentation discipline. The SOAP notes are legible, timestamped correctly, and accurate — not because someone is watching, but because the non-rate understands what the record is for. Vital signs are auscultated, not estimated. The wound care log entry describes what was done, not what was intended. The HIPAA compliance is internalized, not performed — the messdeck does not know anything about this morning's sick call patients, and it never will. The OIC who writes the A-school endorsement letter for this striker describes a non-rate who showed up early, learned the equipment, never touched a controlled substance without supervision, and made the qualified HS's workload lighter, not heavier. That is the only endorsement that gets the Petaluma class date without a committee review.

Preview — The Next Rank

HS3 (Petty Officer Third Class, E-4) is the first paygrade where the HS rating functions as an autonomous entry-level provider rather than a supervised striker. You come back from Petaluma with NREMT-B current, a rating badge sewn on, and standing orders under COMDTINST M6000.1 that authorize you to assess patients, document encounters, manage the formulary, and dispense medications within a defined scope — all without the HS2 standing over your shoulder for every transaction. The transition from striker to HS3 is a scope-of-practice transition, not just a paygrade change. As a non-rate you were a witness and a support resource. As HS3 you are the provider of record for the sick call encounters you run. Your SOAP note is the clinical documentation. Your controlled substance count is the accountable record. If you send a crewmember back to duty and they return two hours later worse, the disposition note you wrote is the first thing the Medical Officer reads. The next level also begins the advancement clock toward HS2. The HS2 SWE bibliography is longer than the HS3 bibliography, and NREMT-Advanced (NREMT-A) is the certification differential that separates HS2 candidates who are competitive from those who are eligible. Start the NREMT-A study plan within six months of returning from Petaluma — the AEMT national exam adds IV access, advanced airway management, and expanded pharmacology to the NREMT-B scope, and those clinical expansions are the capabilities the HS2 assignment at a cutter without a Medical Officer depends on.
FAQ

HS E1-E3 — Frequently Asked Questions

Q01What does a E1-E3 HS (Health Services Technician) actually do?
You came out of TRACEN Cape May after eight weeks and reported to a cutter, a sector command, or a small boat station as a non-rated Coast Guardsman striking for HS.
Q02What's the most important thing to know as a E1-E3 HS?
You are a non-rate striking for a rating that carries a federal controlled-substance license and a scope of practice enforced by federal law — before you touch the first patient, the controlled substance locker, or the sick call log, you need to understand that a single documentation error is not a training event.
Q03What does a typical day look like for a E1-E3 HS?
Time-blocked day at the E1-E3 HS rank tier: 0530-0630 Morning PT with the unit — cardiovascular training three times a week (run or swim), strength days twice a week per the OIC's PT plan. The HS2 is watching who shows up without being chased, 0630-0700 Shower, uniform inspection, chow. Rate the uniform standard — medical department non-rates are visible representatives of a department that patients trust, 0700-0730 Sick call bay prep: restock consumables, verify AED battery and pad expiration, check O2 supply gauge, run through controlled substance count with the qualified HS.…
Q04What mistakes get E1-E3 HS soldiers fired or relieved?
DUI, drug pop, or NJP during the non-rate period. The CG is a small service with institutional memory that spans decades. One alcohol incident as a non-rate generates a conduct code that follows the service record, surfaces at every advancement and selection board, and can terminate the A-school endorsement before the OIC writes it. The HS rating is a controlled-substance-holding position; a substance violation as a non-rate is often a career-ending event, not a developmental warning;…
Q05What career decisions matter most at the E1-E3 HS rank tier?
NREMT-B: self-prep versus unit-funded class — Some units near training centers or community colleges will have EMT-Basic programs that the unit can fund or credit time toward. Most will not. The default assumption should be self-preparation using the current NREMT-B exam blueprint, a reputable EMT-B prep textbook, and practice exams from legitimate testing preparation sources. Self-prep timelines typically run 60-90 days for someone without a healthcare background, shorter for someone with prior clinical exposure.…
Q06What's next after E1-E3 for a HS (Health Services Technician) in the Coast Guard?
HS3 (Petty Officer Third Class, E-4) is the first paygrade where the HS rating functions as an autonomous entry-level provider rather than a supervised striker.
Q07What manuals and regulations does a E1-E3 HS need to know cold?
COMDTINST M6000.1 (current series) — Coast Guard Health Services Manual. The doctrinal source for every clinical and administrative action the rating owns. Verify the current revision against the CG Directives System before citing by number.; NREMT National Registry EMT-Basic (NREMT-B) candidate handbook — the national standard your A-school prerequisite certification is tested against. Pull the current exam blueprint from nremt.org.;…

Based on 18 tips from 0 contributors

Published by the Honest MOS Editorial DeskVerified against DoD/.gov sourcesUpdated May 2026Editorial standards