While the Kurosaki Clinic handles minor cases, the General Hospital is equipped to handle much more serious cases and larger incidents, catering to residents from both inside and outside of Karakura Town. The current director of the hospital is Ryūken Ishida. Ryūken has an office in the hospital, with a large window, curtains, a desk and bookcases stocked full to capacity with large books.

Ryūken has constructed a secret training area in the hospital. It is unknown when it was built, or where exactly it is inside the hospital, but grass can be seen just outside its windows, suggesting that it is at ground level. The training area has multiple levels, and these windows are on the upper levels, meaning that much of the room must be underground, forming the basement of the hospital. There are no furnishings or objects visible in the chamber.

The only known physical access to the room is via a large door which appears to be on the lowest level of the chamber. The door does not appear to have handles, or any obvious means to open it from either side. Outside this door, there is a staircase leading upwards, presumably providing access to the main part of the hospital. Kisuke Urahara uses an unspecified ability to break into the training area, appearing to cut a hole through space. Isshin Kurosaki also gained entry to this hidden area, though he does not explain how he did so when questioned on it by Ryūken.

The chamber is constructed from soul-synthesized-silver and soul-synthesized-glass. While it is evidently strong, it is unable to fully withstand numerous strikes from arrows without sustaining damage. When Ryūken fights Uryū Ishida in this chamber, there are multiple pock-marks and holes in the walls and floor from Quincy Spirit Arrows and Gintō. The chamber also does not completely block out Reiatsu, as Uryū is able to sense that the Shinigami are fighting Arrancar outside during his training in this room.

It is in this hidden room that Ryūken fights Uryū to the point of exhaustion, shooting him in the chest with a Spirit Arrow in order to restore the abilities he lost due to the Quincy: Letzt Stil. It is unconfirmed if Ryūken himself used this hidden chamber to train or practice, or if it was constructed solely to aid Uryū in regaining his powers.

There is also a hidden storehouse inside the hospital, possibly within the training area itself. Uryū took five Seele Schneider from this place to aid in the invasion of Hueco Mundo.