To expand on Rconch's response to #1: if you use SH3 Commander there is in option in it under Gameplay Settings called "Model effects" and if you check it you can choose from either Malfunctions or Malfunctions+Sabotage. Which means it will add to the game the possibility that your uboat may experience the effects of one or both depending on your choice. If you check this option, it's advisable to do thorough testing of all systems as soon as possible after you leave port on a patrol to make sure everything works properly before you are far from home and/or in a combat situation.
It may be possible to mod in those effects without the use of Commander, but someone will else will have to speak to that. Commander is so great, though, that you are missing out on a LOT if you don't try it.
Regarding the medic, in order for him to work any medical magic on another crewman, they both need to be placed in either the stern or bow quarters together.
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