Doctor, Doctor

Illustration from “Introducing: The Diagnosticator Medikit!” Ling-Standard Products promotional holobrochure (1043). Courtsey of LSP Sector Archives, Dexter (MAGY 2416).

“In the course of my medical career I have, on occasion, been asked to name the single most important tool for a good Navy doctor. Is it a high tech mediscanner or laser scalpel? Maybe the diagnostic databases or gene editing techniques? Perhaps years of intensive training and experience? The answer, of course, is far more elementary, and has been the same very answer for the last thirty-six-hundred years or so: antibiotics. The best tools for your harried ship’s doctor are high dosage, wide-spectrum antibiotics. And lots and lots of them.” —Dr. Urban Zabulon Konstantinov.

In Traveller, skill levels reflect both experience and expertise. And a few skills, such as Medic, map directly to professions with specific hierarchies of licensure or titles. So how do skill levels relate to these associated professions? Both Classic Traveller and MegaTraveller have an interesting note on the Medical skill:

Medical-1 qualifies an individual as a medic on a starship crew. Medical-3 qualifies an individual as a doctor and assumes a license to practice medicine, including writing prescriptions, handling most ailments, and dealing with other doctors on a professional level. Dexterity 8+ qualifies a doctor to be a surgeon. (MT Player’s Manual 36).

While this approach wouldn’t work with all skills, Advocate 3, for example, might qualify an individual to practice law and represent clients before planetary and Imperial courts.

CT has a companion rule for starship crew: the “Highest skilled [Medic] is ship’s doctor and draws 10% more pay” (Traveller Book 59, 60). But note that this is purely a shipboard honorific and not a license to practice medicine off the ship.

Although Mongoose Traveller did not carry the CT and MT language over verbatim, the Core Rulebook specifically uses Medic as an example of what skill levels might mean within the setting:

A Traveller with Medic 1 may be a paramedic or nurse, while another Traveller with Medic 2 might be a doctor. If a Traveller had Medic 3, they would likely be a very well-regarded doctor with many years of practice under their belt. A Traveller with Medic 4 or 5 would be at least world-renowned, and may well be known across several star systems for his expertise (Core Rules 56).

Further, the MgT2 Central Supply Catalog notes that an autodoc “is capable of diagnosing and treating … medical conditions as efficiently as a qualified doctor (treat as Medic 3)” (81).

Automatically giving MgT characters with Medic 3 a Doctor’s license feels a little gamist, but I really like the simplicity of this approach: a specific level in certain skills generally corresponds to an in-setting accreditation.

Adopting such a rule would create an interesting situation for my own campaign. Consider the Starjammer’s resident medical officer, Howard. With Medic 3, Howard not only qualifies as a Doctor but with DEX 10, a surgeon to boot. This notion has never come up in play and the player has never introduced Howard as anything but a humble ship’s medic. But his career history might explain why he isn’t called Dr. Howard . . . and sets up some interesting game hooks.

The Making of a Doctor

In CT and MT, there are three potential paths to getting Medical-3 and the coveted title of doctor.

1. Happenstance

This is pretty much the only viable path using just the LBBs or The Traveller Book, and it’s not all that easy. Medical is not available on the Personal Development or Service Skills tables for any career: it only appears on the general Advanced Education tables for the Merchant and Scouts careers. While Medical does appear on every career’s second set of Advanced Education tables, those can only be used by characters with EDU 8+.

In Mongoose Traveller, Medic 3 might be a little easier to pick up by happenstance. Medic is a background skill and can be gained through a University education. It’s on the Advanced Education tables for the Agent, Citizen, Rogue (?), and Scout careers and on the Personal Development table for the Army.

2. Career

The CT Citizens of the Imperium supplement and the MT Player’s Handbook both feature Doctor careers. Either version is hard to qualify for, requiring a 9+ entrance roll with bonuses for high INT and EDU. In MegaTraveller, the character must also come from a homeworld with a tech level of 1+, which is a modest bar.

In Mongoose Traveller, the equivalent career is Scholar with the Physician assignment. Further, both the Army and Marines careers have Support assignments for combat medics, which also gives access to the Medic skill.

3. Medical School

In CT, medical school is an option only available in High Guard as part of the pre-enlistment system. This basic mechanic is also used in MegaTraveller. In either edition, getting in is tough but the basic procedure and benefits are similar: any honors graduate of college or a service academy may apply for medical school, which requires a 9+ admission roll. A graduate of medical school can gain an automatic commission at rank O3 in the Army, Navy, Merchant, or Scout services.

Mongoose Traveller has no medical school option, though maybe it should, since without it there’s no easy way to create the archetypal “Navy Doctor.” And what’s a navy starship without its own Dr. Leonard McCoy? Putting together some simple MgT rules for medical school based on MegaTraveller is pretty straightforward.

Medical School for Mongoose Traveller

In Magyar, accredited medical schools are located on any world with a Class A or B starport and Population 7+. Elite medical schools are associated with the Imperial University of Seloo, the Solomani University of Pacific, and Walpurgis University on Kline.

Any Traveller who graduates with honors from University or a Service Academy may apply for admission to Medical School.

Admission: EDU 7+.

Skills: Gain Admin and Medic.

Graduation: EDU 8+. If 11+ is rolled, graduate with honors.

Graduation Benefits

• Gain Medic and Science. Honors graduates receive Electronics and Medic.
• Increase EDU by an additional +1.
• Graduation allows the Traveller to apply for a direct commission (which is granted automatically) before the first term of an Army or Navy career. Marines have no medical officers; they are treated by Navy doctors. The Traveller enters the career at officer rank (O2).

Graduates of medical school are doctors, licensed to practice medicine, regardless of their total levels in Medic.

A Doctor’s License without Medical School

Both CT and MT assume that Travellers can become licensed doctors without graduating from medical school. In contrast, both T20 and GURPS Traveller require a medical degree. The T20 Traveller’s Guidebook states that “To be legally considered a doctor (MD), one must have a Doctorate in Medicine from the University and a Medical skill rank of 5 or greater” (124). And GT: Far Trader has “An M.D. degree requires attending an accredited medical school, regardless of skill” (85).

Even the MT Player’s Manual notes that “Formal training produces documentation that a skill has been learned. This fact is usually unimportant but can make a difference. A character with medical skill learned during combat might not qualify as a ‘genuine’ doctor” (42).

With this in mind I considered using the EDU score as a mechanical proxy for formal medical training. In Traveller⁵, the “Education” table on page 60 of Characters and Combat suggests that a graduate of medical school has an EDU score of 10 (or higher, presumably).

I toyed with amending the CT/MT rule for MgT to read something like “A Traveller with EDU 10+ and Medic 3+ is qualified to practice medicine as a medical doctor.” But in looking at the 40 sample doctors in CT Citizens of the Imperium (1979), I count 29 doctors with a EDU of 9 or less—not quite 75%, but a clear majority.

In the 21st century, the only reliable way to become a medical doctor is to graduate from medical school and complete a residency program, which represents years of intensive, hands-on learning. The thinking is that a resident needs to be exposed to the widest variety of clinical experiences under high stress conditions in order to prepare for becoming a doctor.

This regimen might not be so important in the far, far future. Computer databases, AIs, genetic testing, and advanced scanners should all greatly aid doctors in diagnosing and treating ailments. Reality simulations and maybe (gulp) clones will afford future residents vastly more opportunities to test their skills on a much wider range of patients. Today, a doctor in training might spend years in residency and never see a single patient with tonsillitis. But one week in a reality simulation program could allow a resident to examine hundreds of virtual tonsillitis cases.

So with all of this in mind, I think I will stick with simplicity: in my MgT games, any Traveller with Medic 3 can be qualified to practice as a medical doctor. They just need to secure appropriate certification, which is generally issued by accredited medical schools. A school issues medical degrees to graduates of its four-year programs, but could also issue certifications based on proof of equivalent coursework and appropriate test results.

Paging Dr. Howard?

So let’s bring this back around to the Starjammer’s medical technician, Howard, and his Medic 3 rating. Howard joined the Unified Army of Fugue and after basic combat training was assigned to combat medic training, where he showed great aptitude for the speciality. From there he went on to serve four terms with the Army, steadily increasing his medical skills through a series of deployments. Imperial worlds wracked by fierce urban fighting gave Howard all-too-many opportunities to practice his speciality. During his service Howard continued to study medicine on his own with the dream of becoming an Army doctor.

By the time he reached his fourth term, Howard was a skilled and experienced trauma nurse in line for both a commission and a doctor’s license. But while deployed on Iatur (Magyar 2628 C510A9E-B), a high-population border world, Howard discovered that Major Erk Raines, the chief emergency doctor for his Army hospital, was diverting HerkVees (SuSAG Herakles-V combat drugs) from the regimental supply to the local black market.

Howard cooperated with the military police, who rolled up the scheme and arrested all involved. But Major Raines did not go down without exacting revenge on Howard, trashing the medic’s exemplary service record and effectively blocking any future advancement in the Army.

Howard received an honorable discharge, but his dreams of becoming an Army doctor had been destroyed. Bitter, he joined the merchant interface line Celestine Transfers and served as a ship’s medic for four years before his shipmate Wayne hooked him up with the crew of the Starjammer.

Given his experience as an Army medic, Howard could easily get his ship’s surgeon certification. He would just have choke back any lingering resentment, complete his paperwork, pay a (probably hefty) fee to a medical school, and pass the appropriate certification exam.

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