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In my attempt to better understand the SR4A skill system, I'm going to lay down a sheet. Using BP, however many BP it uses, it uses.

The objective is to build a doctor. An MD.

The idea isn't to build a street doc or a PC, just a normal doc you might see at a hospital or in private practice. Possibly a street doc or PC *before* drifting into the shadows.

Edit: Originally, this started out trying to be helpful...As well as a bit of showing off, since I'm doing this without my books. Turns out I'm the sucker who needs the rescue - it generated a lot more questions than answers.

I'm going to say this is a Mundane Human for simplicity's sake.

For attributes, I'm thinking everything would be a 2 or 3 except for Logic, which would be a 3 or 4. For our purposes, let's say all 3s except for Logic at 4, and normal edge.

Skills: Here is where I run into problems. Show-stopping ones that turn this from a walk-through of the chargen system (without my books, too!) to a lot of questions.

Where's the dividing line between the First Aid skill and the Medicine skill? Both are active skills, after all.

How does one discern a really skilled paramedic from a skilled surgeon? How should I (in other words, given the stated objectives, how would you) divide the line between the two? How do you discern a nurse from a physician, even?
I would think first aid skill would be use for ER type medical type stuff where they need help now kind of thing. Medicine would be your more common family doc stuff. I can not remember if they have a Cybertechnology skill in 4th, if they do I would add that. Other skills that would be useful for docs would be chemistry and biology with anatomy specialization.

A paramedic would have first aid rating of 3 or 4, doctor would have first aid of 4 or 5 and medicine of 4 or 5, a delta grade clinic the skill ratings would be 6 maybe 7.

Ah, no Medicine also encompasses long-time care and treatment and as such is very valuable. (Also: yes Cybertechnology is in there, even in the same group as Medicine and first aid: Biotechnology)

Also a normal doc should have a variety of knowledge skills (Drugs & Compounds, medical theories, medical procedures, cyber & bioware, nanite-types, magical healing and whatever you can think of), maybe even a bit chemistry. Also he could complement with one unorthodox method of healing or people skills.

Depending on how long he is practicing (and how rich his parents were) it is very likely that he has an internal comlink with data about procedures and which can supply informations (maybe runs an agent with some knowsoft and such). Also a cerebral booster for a highly paid man and Sleep Regulator. (I guess a Sleep Regulator is pretty much a standart-thing to get as a present from your rich parents when you matriculate at the university. No matter if it is medical or technical or such). Other Headware depending on income and position.

In the future it also seems that there are a lot "doctors" in cheap implant-franchises which are not really that good and mostly just cram the shit in there and let the nanites do their thing... and if something bad happens they call a professional. Those i reckon will be normal (2-3)+3(+2 implanting) dudes with a meek pay.
Orcus Blackweather
I think he needs bureacracy (medical) 3, computer 2, datasearch (medical database) 2, (optional) Latin 2, language Medical Jargon 4, knowledge Golf at rating 2 or 3, Athletics (golf) 2 (may substitute for raquet ball), High Finance 2, mixology (martini's) 2, Knowledge fraternities 3

5 point Flaw: Hippocratic oath

Former Frat Members (group contact) Connection 9 Loyalty 3
University Alumni (group contact) Connection 9 Loyalty 1
Man, I'd love to comment but I have to go to the OR... I'll post some thoughts later tonight.

But for the record not all doctors come from wealthy families and join a frat. I come from a lower middle-class blue collar family and I spent my time in college playing SR. smile.gif
In a world where skillwires exist, why would you need doctors to be special at all ??
All they need is a high power skillwires system and a handful of chipware.

Tho, with smart systems and artificial intelligence machines, why would they not be doing the operations and medical treatment ??
Shadowrun is not designed to create characters with this level of specialization. It's good enough just to create a character with high Medicine and First Aid; give the character a brief background history and call him a doctor.

For what it's worth, I think that most (unaugmented human) doctors would have Logic 6, not 3 or 4.
Nah... not to insult the docters (umm... Method?) but not all of them have to be "world-class intellects". I would some start with 3, most of them with 4, some with 5 and just a few with 6 or 7. YES their education demands a very high performance... but not every docter has an IQ of 165+. Hell i think a dentist can do his job for the most time with an IQ of 65+, hehehe.

The thing with the skillwires and drones... lead me to another problem: Since the drones became so incredible cheap in the 4th edition i found nearly no job which they can't be doing cheaper and better than Namegivers... i mean metahumans. And i have really problems not having pretty much 80% of the population jobless. Yeah, you need some supervisors, maybe some programmers, scientists and some people for the extreme-high-risk jobs (which need insanely high skills and such). But any other you just need to purchase a 3.500 drone (or a bit more sometimes) and just maintenance and energy and you replace a whole worker... i guess in under a year it all has payed off. That is extremely weird.

While yes, drones in SR4 are the most cost effective and efficient doctors out there. I should think that most people want an actual metahuman to converse with and discuss options with. Part of medicine is customer driven after all, and I would think that any service that would involve so many customers would require a fair number of people involved.

Of course drones CAN handle everything, but people still most likely prefer people to robots. Yeah, the drone that delivers my groceries is always on time and speedy, but that gal who does it for a bit more is awful cute!
Orcus Blackweather
QUOTE (Method @ Feb 2 2010, 12:39 PM) *
Man, I'd love to comment but I have to go to the OR... I'll post some thoughts later tonight.

But for the record not all doctors come from wealthy families and join a frat. I come from a lower middle-class blue collar family and I spent my time in college playing SR. smile.gif

Not in 2070. Lower middle class people cannot read, will never get to college (or perhaps only with some sort of corporate sponsorship), and will only gain a medical license with the help of influential friends. Today you have a small number of doctors who achieved medschool with diligence and hard work alone, through scholarships and such, in 2070 they will be few and far between. Most doctors today finish internships with a huge crushing debt to pay off from student loans, these will only be accessible to people from a more affluent background in the dystopian future.
Interesting thread. A lot of what I would say has already been mentioned by others, but I'll throw out some thoughts anyway.


On whether docs would be obsolete:I think there are a number of reasons why doctors would still be around. First, as CollateralDynamo mentioned, people like having people for their doctor. Sure you can program an autodoc to deliver a baby, but what mother wants to drop her baby into the catch-tray of the Obstetricator 2000? We are social creatures and when we are sick or hurt or whatever we need people taking care of us. Plus, a big part of a doctor's job is offering support, reassurance, counseling... essentially placebo- giving the patient a mental framework through which to understand and cope with their illness. My bet would be that head-to-head trials of metahuman doctors vs autodocs would show the metahuman docs having more complications due to error, but the autodocs having worse outcomes overall and worse patient satisfaction.

Second, doctors would be needed for research. Sure you can build a robot that perfectly performs a given procedure, but somebody has to conceptualize that procedure first, and develop it and design all the specialized tools, etc. Not to mention that someone has to recognize the need for such a procedure in the first place (which comes from an understanding of the human condition and human suffering). Granted, with the emergence of AI's between 2060 and 2072, there are now digital entities that might be able to replicate some of those functions (Deus comes to mind... more on him later), but AI's are still rare, those with interest in human medicine would be even fewer. The vast majority of medical research would still be performed by metahumans.

Third, doctors fill a variety of legal and bureaucratic roles. They often function as hospital administrators, community leaders, and are sometimes active in local and regional politics. Unless your machines are recognized as legal entities, metahuman doctors would still be preferred in these roles. Of course, in SR you also have to consider the role of doctors within the corporate structure, as pretty much all medical infrastructure in most countries would be corporate.

Fourth, people might not trust machines to do a lot of things. IRL things like the Tuskegee Experiment and Joseph Mengele's Experiments have had a profound effect on how certain ethnic groups view modern medicine, and those things don't just go away overnight. In SR people would be acutely aware of the events that took place in the Renraku Archology, and that could greatly influence how they view the role of machines and AIs in medicine. If your nurse came in and said, "Our resident AI, Dr.01101110 01101111, has an experimental treatment that he'd like to try but we need your consent..." it would probably give you pause.

On who would become a doctor: I think Orcus is probably right. It would be an elitist thing in many parts of the SR world. You aren't likely to see traditionally trained docs coming out of the SINless population (although there was a great thread around here about non-traditionally trained street docs). However, I think most corporate funded schools would identify potential candidates early on through standardized testing, and "encourage" youngsters to join the corp's medical divisions.

On attributes: I'm sure you've heard the saying "Medicine is a science and an art". I think most skills would link to logic in most situations, but I'd argue that the GM could call for intuition in certain situations as well. And I agree with Summerstorm- not all doctors would have 6s in logic. Most would be 4 (just above average) with solid study skills and a good work ethic. Many would certainly be smarter (logic 5+) and some would be true geniuses (7s) but occasionally you'd have someone who clearly got in because of their connections (3).

On active skills: Axl hit the nail on the head. The skills presented in SR don't accurately represent what a doctor does, but then, its not a RP game about being a doctor (which would be pretty boring IMHO). You'd really need a few more skills. I'd add Nursing to represent actual patient care (of which doctors do very little)- things like starting IVs, administering the drugs, applying dressings, etc. I'd also add Surgery, which is clearly an active skill and should rightly be linked to agility. First Aid is a good approximation of trauma/life support resuscitation (which is based on standardized algorithms, not critical thinking). But Medicine (as its presented in RAW) is overly general. Medicine would encompass things like data collection (physical exam) and basic procedures, so it's still an active skill in some sense, but a lot of what medicine docs do is cerebral- diagnosis, treatment selection etc- and would probably be closer to a knowledge skill. As far as skill ratings, there is a clear hierarchy in medical education that nicely fits the SR skill system.

-- medical student: 2
-- intern: 3
-- senior resident: 4
-- fellow: 4 (with specialization)
-- attending (general): 5 or 6
-- attending (subspecialist): 5 or 6 (with specialization)
-- leader in their field/Nobel prize winner: 7 (this would be famous people like Halstaed, Osler, Murray, etc).

On knowledge skills: most of the basic science stuff you learn in the first 2 years of med school would fit here: anatomy, physiology, pharmacology, microbiology, pathology, immunology, biochemistry, etc. Most docs would also be multilingual, and the good ones would have some street knowledge (especially urban ER docs).

On ware: Senseware would be huge- mag vision, enhance touch, chem sniffers, image link (for laproscopy)- you could really go to town. Sleep regulator is also a great idea (wish I had one right now). Biomonitors (for the pt not the doc). A cyber arm with drug reservoirs and injector. Cyberhands enhanced for surgery (handrazors --> scalpel blades). Honestly, you could do a lot of cool stuff, and being a doctor really gives a PC legitimate reasons to have a lot of non-combat, non-military ware.


Thats probably more detail than you wanted for your character building "exercise", but if you want to be most accurate you could incorporate some of this and really watch the BP/Karma take off.

Anyway, you should post what you come up with. smile.gif
I actually have a former DocWagon Doc character concept I put together back in 3rd edition and have since updated. Most of the key points that I used have already been touched upon, but here is some more ware and one more point on the drone issue.

Cerebral Booster: No real reason needed.
Math SPU: Although not necessary, this could help with calculating out appropriate drug dosages. Especially on the fly in a trauma type capacity.
All the sense and scanner ware you can think of.
At least 1 hand cyber (blades were mentioned earlier, but think about the uses of Snake Fingers in surgery).
Finally, given the change to SR4 over previous editions, a Control Rig! You asked why have doctors when drones can do everything? Well, if you want to get the most from your drones you need someone with the appropriate skills controlling them from a captain's chair model. We already have surgical robots designed by MDs to improve what an MD can do (I know a MD/Engineer at Stanford); this trend would only continue in 2070. This also means that a doctor built like this would have a bit of an increased Reaction, but as the concept was for a Trauma Surgeon I hope we can agree that would be appropriate anyway.

Method is absolutely right, Intuition would be almost as important as Logic for a good doctor. However, its harder to train so there would be more docs with INT of 3 than Logic of 3 in my opinion.

EDIT: Oh yeah, don't forget Willpower. Give most MDs a Willpower of +1 over the norm. It takes a lot of dedication just to get to that MD. Not to mention some of the stuff they have to deal with on a regular basis.
The Jopp
May I Present:

The Drone Doc

The Drone Doc has a small arsenal of medical drones ready to swoop down upon victims.

He is a disillusioned trauma expert who spent several years in disaster areas and warzones
He has several drones under his command for carrying and taking care of patients.

GTS Tower
Drone Workshop (Mini Drone Maintenance Bay)

HK Emergency Medical Drones X10
Installed Minidrone Weaponry (Injection Needle Trauma Patch)
Special Machinery (Surgery Kit)
Special machinery (Tranquilizer)
Special machinery (Medkit 6)
Millimeter Wave Radar 4 Sensor (X-Ray)

C-D Dalmatian (X2)
Valkyrie Module
Passenger Protection
Doah! I forgot a major reason why you would want a metahuman doctor: Edge!
Wow, lots of responses. Thanks to Method for the horde of data.

Sadly, without my books, I can't build a character myself. but.

What I'm finding here is definitely useful.

The one point where I disagree with Method is on the corporateness of medicine, even in 207x.

I see most *hospitals* as being corporate, yes. About 60-70% of the publicly-accessible hospitals in the UCAS would seem to me to be corporately-owned. (So we're excluding the military hospitals, the private clinics, etc.)

However, 30% of hospitals would be publicly-owned or owned by large non-profits like religious groups. Some will even be comparable in quality to the private hospitals.

And we've never even talked about non-hospital practices. It'll depend on specialty, but I see private practice still being very popular for doctors, and being almost de rigeur in certain specialties (like psychiatry and psychology, for example). I still see the vast majority of doctors, even in 207x, as being in private practice at least part of the time.
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