Royal Hospital
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FroGames — Moments You'll Remember
In ten minutes, you'll be deciding whether to save lives or build a new wing. In an hour, you'll have realized that the real game is efficiency. And in the end, when the CEO counts the points, you'll understand that healthcare is first and foremost a business.
WHAT IT'S ABOUT
The Race to Become the New Director of Royal Hospital
Designed by Carlos Michán Amado and illustrated by Philipp Ach, Fran Fdez, and Daniel Rosa Durán, Royal Hospital puts you in charge of an elite healthcare facility. Royal Hospital is the best hospital in the world, a place where the most complex patients come for cutting-edge treatment. The long-serving director is about to retire, and the board is looking for a successor. You are one of the candidates.
At the table, you must build and manage a functional hospital: hire doctors and specialists, invest in research and technology, and treat patients with increasingly complex conditions. Every choice impacts your final score. The open draft allows you to plan future moves but also to read your opponents' strategies. In the end, the winner is the one who has best balanced operational efficiency, clinical excellence, and economic growth.
What they say abroad
A healthcare management game that confronts you with concrete choices, not just numbers to optimize.
— FroGames
Every patient cured is a step towards victory. But every wrong investment is a lost round.
— FroGames
Royal Hospital
FrogScore · editorial rating FroGames · based on rules, international reviews and play sessionsKey components
What you find in the box
Specialist Cards
Doctors, surgeons, researchers. Each has specific skills and maintenance costs. Hire the best or manage your budget: you can't do both.
Hospital Board
Your personal facility. Each department must be built and equipped. The more you invest, the more complex patients you can treat. But fixed costs increase.
Patient Cards
Different pathologies require different specialists. Some patients are worth many points but tie up resources for turns. Others are quick but less profitable.
Technologies and Research
Long-term investments that unlock more powerful actions, permanent bonuses, or new sources of income. Crucial for winning, but costly.
Recommended sleeves 305 cards in 2 sizes ▼
If you play often, we recommend protecting your cards with transparent sleeves to make them last longer.
| Size | Quantity |
|---|---|
| 63 × 88 mm | 196 |
| 44 × 67 mm | 109 |
| Total cards | 305 |
In a few hours, you'll have realized that managing a hospital is like building an engine: every piece counts, but only if you have the budget to run it.
A game in five moments
What happens at the table
Not the rules. The experience.
Initial setup: scarce resources
Everyone starts with a minimal hospital and few resources. The first cards drafted define the direction: specialize in a department or diversify? Some immediately aim for easy patients to make money, others invest in long-term technologies.
The first functioning department
Around the third or fourth round, the first hospitals begin treating complex patients. Those who invested in the right specialists collect points and income. Those who misjudged the timing find themselves with empty departments and fixed costs that devour resources.
Competition for key cards
The open draft reveals everything. Do you see that card you need? Others see it too. The psychological battle begins: anticipation, bluffing, sacrifices. Someone burns resources to deny you a crucial technology.
The engine is running smoothly
Mid-game: those who built well start racking up points. But the game isn't over: some final cards are worth a lot. A wrong choice now can cost you the victory. Someone bets everything on a legendary patient worth 15 points. If they complete it, everything changes.
Final tally
End of game: points are counted from treated patients, technologies, departments, secret objectives. The margin is narrow. Those who optimized every move win. Those who wasted a turn to block an opponent might discover it cost them the victory.
How to play
The flow of each round
Each round follows a cyclical structure: draft, actions, management. Time passes, resources are consumed, decisions accumulate.
Available cards are visible to everyone. In turn, each player chooses a card and adds it to their hand or plays it immediately. The draft continues until everyone has drawn.
Play cards from your hand: hire specialists, build departments, initiate treatments, invest in research. Each action costs resources. The larger your hospital, the more fixed costs you pay.
Patients undergoing treatment progress: if you have the right specialists, you complete the treatment and collect points and money. Otherwise, the patient remains blocked and occupies valuable space.
Collect income from treated patients and active technologies. Pay the hospital's fixed costs. Prepare for the next round. The player with the most points at the end wins the director appointment.
Why it's different from others
Six mechanics that make a difference
Open draft, no secrets
The cards are visible to everyone. You don't draw blindly: you see what your opponents want, anticipate their moves, block strategies. Bluffing and reading the table become part of the game. Those who can read others have an advantage.
Thematic engine building
Building a functioning hospital is literally an engine: every department, every specialist, every technology fits together. The first moves seem slow, then the engine accelerates and points cascade in. But it requires painful initial investments.
Increasing fixed costs
The more you grow, the more you pay. Each department has maintenance costs. Each specialist has a salary. If you don't generate enough income, your hospital eats up resources. Uncontrolled growth is a trap.
Patients as puzzles
Each patient requires specific specialists and different timeframes. Simple patients give points immediately. Complex ones are worth much more but block departments for multiple turns. Choosing who to treat is an economic decision, not just a strategic one.
Long-term technologies
Technologies cost a lot and don't give immediate points. But they unlock more powerful actions, reduce costs, generate passive income. Those who invest early in research pay the price in the first rounds, but dominate the endgame.
Multiple overlapping objectives
Points from treated patients, built departments, acquired technologies, personal secret objectives. There isn't just one path to victory. You can specialize or diversify. But every strategy has a price: resources, time, opportunities.
How it ends
How to win and how to lose
The game ends after a fixed number of rounds. Victory points accumulated during the game are counted.
Victory
- Points from treated patients: more complex ones are worth more
- Points from built departments and acquired technologies
- Bonuses from completed personal secret objectives
Obstacles and failures
- Uncovered fixed costs: insufficient income burns resources
- Blocked patients: departments occupied by incomplete treatments
- Wrong investments: useless technologies or mismatched specialists
Royal Hospital is a management game that rewards planning, but punishes greed. Every choice has a cost, every lost turn doesn't come back.
Frequently asked questions
FAQ about Royal Hospital
Is the healthcare theme just aesthetic or does it influence gameplay?
The theme is well integrated: each patient has specific needs (cardiology, oncology, neurology), and you need to have the right specialists to treat them. It's not an abstract eurogame with a theme slapped on: the mechanics truly reflect hospital management. However, it remains an economic management game, not a medical simulation.
How deep is the open draft system?
The open draft changes everything. You don't draw blindly: you see the available cards, read opponent strategies, block key moves. It adds a layer of psychological interaction that is missing in standard drafts. But it slightly slows down the game, as everyone has to consider what others are taking.
Is it suitable for casual players or does it require experience?
Medium weight: the rules are learned in 20-30 minutes, the first game is playable without problems. But to win, you need to understand the timing: when to invest in technologies, when to focus on fast patients, when to expand departments. After 2-3 games, the game truly opens up.
Does it scale well from 2 to 4 players?
With 2 players it's more tactical and controlled: you can easily read your opponent, plan better. With 3-4 players, the draft becomes more chaotic and competitive, cards circulate faster. Both experiences work, but the sweet spot is probably 3 players: enough interaction without too much downtime.
Is it available in Italian?
No, this edition is in English. The text on the cards is present (names of pathologies, specialists, technologies), but it's not critical: after one game, the icons are clear. Basic English knowledge is needed for the initial phase, then the game flows smoothly.
Royal Hospital is an economic management board game for 2-4 players, lasting 90-180 minutes, recommended age 12+. Designed by Carlos Michán Amado and published by Lost Games, it puts players in charge of elite hospitals competing to become the new director of Royal Hospital. The heart of the game is the open draft: all cards are visible, and every choice influences opponent strategies. Engine building mechanics, resource management, and economic optimization intertwine with the healthcare theme: hire specialists, build departments, treat complex patients, invest in research. Perfect for those looking for a thematic eurogame with indirect interaction and strategic depth. Available on FroGames.it.
Royal Hospital
Frequently Asked Questions
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