Due to much higher achievable blocking voltage and faster switching speed, power devices based on wide band-gap (WBG) silicon carbide (SiC) material are ideal for medium voltage (MV) power electronics applications. For example, a 15 kV SiC MOSFET allows a simple and efficient two-level converter configuration for a 7.2 kV solid state transformer (SST) for smart grid applications. Compared with multilevel input series and output parallel (ISOP) solution, this approach offers higher efficiency and reliability, reduced system weight and cost by operating at medium to high switching frequency. However, the main concern is how to precisely implement this device in different MV applications, achieving highest switching frequency while maintaining good thermal performance. This paper reviews the characteristics of 15 kV SiC MOSFET and offers a comprehensive guideline of implementing this device in practical MV power conversion scenarios such as AC-DC, DC-DC and AC-AC in terms of topology selection, loss optimization and thermal management.