Medical Doctor and Medbay Ideas

[NanookoftheNorth]

I hate being a medical doctor. I don't want to hate it, but there are some fundamental problems with the meta of medbay, and the role itself.

Let's start from the beginning. A doctor, at the beginning of the round, has little to do. All they have is to prepare the cryo chambers and that's about it. What else can they do when people aren't getting their faces smashed in?
Well the answer to that question is more preparation. Engineering has the SM to set up, have something more for medbay to set up to help get through patients faster, or clone people faster. I'd say making the cryotubes more complex for different scenarios would be interesting, however I don't want to nerf anything in that regard. I'd say making surgery more relevant and being prepared in that regard would be cool too. Basically, how can we reward players for being prepared? Right now I'd say the best thing a doctor can do to be prepared is to ask for chemistry to make them tricordizine, and genetics to make some monkeys into bodies for brain transplants.

The next thing is more of a common scenario:
Security officer drags a dying body into medbay.
Throws the body into a sleeper
They attempt to give the proper chemicals

In this scenario, why does the doctor need to be there? The security officer is handling the scenario just fine. He knows how the machine works, he knows what the patient needs before arriving since he witnessed him get his face smashed in. I think that the doctor should have some sort of skill or access to certain better equipment that would make them relevant in this scenario. I'd say a skill that lets the doctor perform heals from crit without chemicals or items. This might be OP, so feel free to take that with a grain of salt.

Speaking about heals from crit, how about those debfibrillators right? Defibrillators are often ignored for the dead jumping straight into the cloner. This piece of equipment is something that doctors actually have access to, but no one thinks to use, and go for the cloner. The cloner (great mechanic by the way) is a punishment for death by having a long wait time to be cloned, and often needing to wait in line. The cloner is in my mind a last resort to bring someone back. I don't know the timer, but I'd expect a player to be unable to play for probably 10 minutes as they are dragged, cloned, cryo'd, and finally thrown out naked potentially retarded without any of their stuff. The defibrillator literally goes around that to instantly able to be saved again. The wait timers for the defib is what mostly gets me. It takes a little bit to just get the defib out. Can we turn off that timer? Buff the defib.

After taking a little bit of time, to review:
Give doctors something to do at the beginning of the round to prepare for patients
Give doctors something (a skill for example) to make them worth being there to help patients.
Buff the defibrillators, because they're vastly underutilized.
Shoutout to the cloner, since everyone loves the cloner.

Thanks for reading, feel free to add to or adjust ideas. I wanna be a space doctor again and have fun with it.
Also, if I am an idiot, and am missing out on certain parts of gameplay for doctors, feel free to call me an idiot.

[Dr_bee]

I would rather the keep the defib timer as it is but raise the damage threshold that the defib can be used at.

Let it bring someone back to life with their lungs cut out, it would mean prepared doctors with the right meds and replacement organs would be able to bring people back without cloning.

Also, let artifical hearts make the defib window huge. Right now there is very little reason to go under the knife and get the fake organs.

There is a stupidly low skill ceiling to /tg/s medical system that I wish could be raised with new mechanics or tricks.

[TribeOfBeavers]

I've played a lot of medbay, and it definitely needs some changes. As it is you can effectively run medbay with only a couple people, or solo if you're the CMO.

The issue that doctors have nothing to do except prepare for patients at round start isn't really fixable, as the entire job is reliant on other people being injured in order to have something to do. Giving other departments items that medbay would find useful would give doctors things to run around and collect/barter for at round start and during downtime. Cargo could order special upgrades for equipment, early game botany plants could have unique ingredients for stronger healing chems, etc.

Unfortunately doctors having fun after things are prepared comes at the cost of other crew members having nothing to do while they're being healed. As many /tg/ players are very focused on combat, they're usually opposed to anything that increases healing time.

Making doctors more relevant is reliant on nerfing cryo and sleepers. Both are easily usable by the general crew, fast, free, and require no sustained attention. Any random assistant can use them in under 5 seconds and fix 99% of injuries. Making healing require constant attention from someone would do a lot to making doctors more useful without increasing healing times.

[SpaceInaba]

defibs need wall hangers so people remember they exist and that's about it IMO

[Dr_bee]

I've played a lot of medbay, and it definitely needs some changes. As it is you can effectively run medbay with only a couple people, or solo if you're the CMO.

The issue that doctors have nothing to do except prepare for patients at round start isn't really fixable, as the entire job is reliant on other people being injured in order to have something to do. Giving other departments items that medbay would find useful would give doctors things to run around and collect/barter for at round start and during downtime. Cargo could order special upgrades for equipment, early game botany plants could have unique ingredients for stronger healing chems, etc.

Unfortunately doctors having fun after things are prepared comes at the cost of other crew members having nothing to do while they're being healed. As many /tg/ players are very focused on combat, they're usually opposed to anything that increases healing time.

Making doctors more relevant is reliant on nerfing cryo and sleepers. Both are easily usable by the general crew, fast, free, and require no sustained attention. Any random assistant can use them in under 5 seconds and fix 99% of injuries. Making healing require constant attention from someone would do a lot to making doctors more useful without increasing healing times.

Can always make medbay the source of combat based upgrades. It sorta already is considering the virology and genetics department, spreading that love to Doctors via surgery would be nice. Techwebs sorta helped this somewhat by giving them easier access to cybernetic implants and organs, but I would like to see them do augmentations and such as well.

Can also make goonstation style med implants that send a PDA message to the entire department if a person is in crit. It would make roundstart about spreading those implants around to those who need it, especially if you make them initially a limited resource.

[Selea]

Tg can't abbord long term medical work, since rounds are relatively short. So if you gonna make medicine harder, it shouldn't be something, that will need much effort. But it should need much knowlege.
-----preparing------It's about wht medics should do at round start
1.1.virology and sterilization.Make mess on floor contagious.As well as operating on non sterile table/with non sterile tools.So someone must sterilize medbay and keep it tidy. Also virologist will be very relevant with preparation cures from diseases.
1.2.Look at 2.1. Someone must prepare shitloads of different meds and combinations of them.
----hardness------
2.1.make much different medicines , which can heal brute/burn/tox/something else.But with side effects,contraindications and possibility to react into something unpleasant right inside the patient if used mindlessly.
2.2.make cloning device to be more complex. To make it require reagents, preciese setting of T and P inside growing cell.
2.3.Make lert button device and give it at loadout. Small thing, which can be attached on tie slot and add 2 buttons on HUD.Call meds and call security. Not so much medics now cared about sensor tracking. So if pressing of such button will cause alarm, it will motivate them.
2.4. Yes, sleeper is OP now. So maybe there is point to nerf it and make some different machines instead.One can dialize to detox. one can heal burn.etc.
2.5. Make organ dmg more noticeable.So security can do first aid. but not mess with organs.
2.6.Possibly make autosurgeon machine, which can do opetation. But it must have right settings.
-----frankenstein fuel----That's about wht should do bored medic
3.1.Buff monkeys.Make them cloneable.Make their biology similar to human. Make reverse MMI to stick posibrain into human or monkey.Possibly make IC brain to control brainless body with circuits.
3.2.buff limb grower with possibility to grow organs with interesting properties.Maybe even design new organs. Buff genetics as well. Make genes to represent not abstract abilities and disabilities, but organs.
3.3.As well buff xeno,slimes and bunch of other mobs. To make them have organs, blood, biochem.Possibly make it possible to integrate slime cores in human body.
3.4.Make it possible to stick inside body ore organs.possibly even 2 brains.
3.5.Make some items obtainable with growing it inside human or monkey body. Like xenomorphs, but something usable.
3.6.Look at 3.1. Possibly should be more ways to mess with brain/body connection. maybe make it bossible to make 10 bodies, including monkey, xeno,slime, borg and circuitry bot.And remore controle them, being brain in jar...or stick just monkey brain in this jar.

[CPTANT]

Said it before, merge doctors and chemists.

Doctors are a dumb waiting job that doesn't even have anything to do while people do show up.
Chemist is a job that is stuck in a booth all round without a purpose for applying most of the stuff they make.

Combine the two: One fun job that gets to make chemicals and heal people with them, more traitor opportunity for the entire medbay as well.

And merging the two in no way prevents making meaningful changes to the medical system if more "depth" is required (yeah good luck with that anyway).

[NanookoftheNorth]

A lot of the ideas being spoken about are great.

I think the simplicity of /tg/'s medical system is great. I think that the ability for anyone to be able to do it is good and shouldn't be taken away. I think that a doctor, who's job it is to help people, should have some additional benefits to make them favorable to their fellow crew. I also am trying to say what can we do to make it easier to prepare for the wounded? What are some creative ways to solve that problem? For example, one way I handle too many people in the clone que would be by genetically modifying monkeys into humans, removing their brains, and putting in the player's brain inside. Other creative solutions usually involve chemistry or virology.

Specifically on the note of combining roles, it would make chemistry a cluster, and no doctors would probably do their job. I think it would also mess with antag balance. More people with access to chemistry means less time for antags to play creatively, and more likely for them to get caught. Imagine if everyone had access to robotics from science. Really individual roles ends up benefiting everyone.

edit: I think after pondering on it for a little, maybe medbay should be set up like science with multiple parts to it that any doctor can go to, however, still have chemistry, genetics, and virology separate. Really, have more stuff to do.

[Selea]

I think, that doctors on TG shouldn't only make patients feel beter.They should make patients be better.
Also it will stop nerf circus^Why you should nerf x-ray lasers, when after good medic It just not enought to kill?

[WarbossLincoln]

I would be fine with sleepers going away entirely. Make it so that random people can't run in and fully heal basically anyone without at least having to get supplies, most of which are gated behind med access. Unless it's an emergency I won't put someone in a sleeper as a non-medical crewman just cause it's kind of shitty to deprive someone else of the role they signed up for.

[Dr_bee]

I would be fine with sleepers going away entirely. Make it so that random people can't run in and fully heal basically anyone without at least having to get supplies, most of which are gated behind med access. Unless it's an emergency I won't put someone in a sleeper as a non-medical crewman just cause it's kind of shitty to deprive someone else of the role they signed up for.

I dont think they should be removed but they should be nerfed, give them chem generation like the mech sleeper, it makes it so healing is possible if the chemists blow up both the chem dispensers making meth, but it SUCKS compared to using medical patches from chemistry.

[Armhulen]

remove medbay storage, and sleepers.

medbay fixed

[cedarbridge]

https://pastebin.com/fDnJHuhc

Reposting this.

[Hathkar]

https://pastebin.com/fDnJHuhc

Reposting this.

I quite like that design document. Maybe a coder should look through it?

[cedarbridge]

https://pastebin.com/fDnJHuhc

Reposting this.

I quite like that design document. Maybe a coder should look through it?

It was part written by one.

[Selea]

Also I want to remind one more time.It's future.Big and strange machines,like autosurgeon system,or automatic patient treatment is acceptable.As well as complex set up of these machines.

[Denton]

https://pastebin.com/fDnJHuhc

Reposting this.

That is pretty great, but I feel like some chemicals or chemistry would also need readjustment.
Right now, a competent chemist can whip up enough synthflesh/tricord + charcoal/pentetic + atropine/epinephrine for a whole round in about 10 minutes. Then again, balancing those must be a nightmare.

[cedarbridge]

https://pastebin.com/fDnJHuhc

Reposting this.

That is pretty great, but I feel like some chemicals or chemistry would also need readjustment.
Right now, a competent chemist can whip up enough synthflesh/tricord + charcoal/pentetic + atropine/epinephrine for a whole round in about 10 minutes. Then again, balancing those must be a nightmare.

The system proposed in the design doc takes injury outside of the mere "x brute y burn" realm and more into a framework of types of injury and degree of injury. Synthflesh etc are great and it would always be wise for paramedics to carry them and the fridge to stay stocked, but chems aren't going to resolve complex traumas.

[Mark9013100]

Merge MD and Chemist, limit the station maps to one sleeper and lessen the amount of medical kits in med storage.

[NanookoftheNorth]

https://pastebin.com/fDnJHuhc

Reposting this.

I feel like this has a lot of interesting ideas.

I think the cyrotube can be a fixall as it is, but it should take longer to heal except for clones.
I think the sleeper should be for stabilizing patients in crit (so someone can stay in a sleeper for a while if both cyros are in use). It would buy the user time to treat them.
I think that surgery or items should be the solution to fix wounds.

I think the tiered system is a great idea to encourage treatment, but I also think that as it said, it would mean some people would prefer death and cloning compared to treatment. I think that tiered treatment might actually give us time and reason to ask about injuries and put it in a person's file.

[cedarbridge]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

limit the station maps to one sleeper

This wouldn't make medbay more important or doctors more interesting to play. It would create either gridlock or people just not bothering to go to medbay at all. If there's only one heal machine that isn't cryo then its irrational to waste time in a hurry when you expect the single machine is already going to have a line in most emergency cases.

lessen the amount of medical kits in med storage

This is fine in theory but it also has severe limitations. If chem is doing your job you'll be fine. If chem isn't doing its job then post-roundstart gear up MDs have nothing to use to heal people. We can lynch chemistry, but then we're still stuck without a second prep phase of materials and people are dying. This leads to the above scenario where people just skip medbay because there's nothing for them there and they're just as medically helped staying out in maint.

[CPTANT]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

I didn't "not fly", there were split opinions. In fact YOU were one of the people most vocally against.

[cedarbridge]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

I didn't "not fly", there were split opinions. In fact YOU were one of the people most vocally against.

Two separate threads where you've been told "no this is dumb" and then it not happening because its dumb is the definition of "not flying." The fact that I was in the threads that I referenced is relevant how?

[CPTANT]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

I didn't "not fly", there were split opinions. In fact YOU were one of the people most vocally against.

Two separate threads where you've been told "no this is dumb" and then it not happening because its dumb is the definition of "not flying." The fact that I was in the threads that I referenced is relevant how?

You are taking a topic that had both proponents and opponents and presenting it like there was some super consensus for the side you were one of the lead advocates for.

[cedarbridge]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

I didn't "not fly", there were split opinions. In fact YOU were one of the people most vocally against.

Two separate threads where you've been told "no this is dumb" and then it not happening because its dumb is the definition of "not flying." The fact that I was in the threads that I referenced is relevant how?

You are taking a topic that had both proponents and opponents and presenting it like there was some super consensus for the side you were one of the lead advocates for.

No, I'm pointing out that attempting to relitigate something that has never gained traction and is stupid on its own merits is a waste of time. Unless you really think we need a third thread on a subject that failed to go anywhere the other times it was suggested.

[CPTANT]

Merge MD and Chemist

We've had that thread twice in recent memory and it didn't fly for reasons that should be obvious.

I didn't "not fly", there were split opinions. In fact YOU were one of the people most vocally against.

Two separate threads where you've been told "no this is dumb" and then it not happening because its dumb is the definition of "not flying." The fact that I was in the threads that I referenced is relevant how?

You are taking a topic that had both proponents and opponents and presenting it like there was some super consensus for the side you were one of the lead advocates for.

No, I'm pointing out that attempting to relitigate something that has never gained traction and is stupid on its own merits is a waste of time. Unless you really think we need a third thread on a subject that failed to go anywhere the other times it was suggested.

No I think we need to put up a PR and testmerge it and then evaluate it with a player poll and maintainer input to put the issue to rest either way.

[NanookoftheNorth]

No I think we need to put up a PR and testmerge it and then evaluate it with a player poll and maintainer input to put the issue to rest either way.

CPTANT, I appreciate your ideas, but that particular approach I did not want on the table for this thread. I remember seeing that thread, and I think it addresses different problems than what I want addressed. I think it indirectly handles the issues I mentioned.

[Mark9013100]

At this rate anything to increase the importance of MDs would be an improvement.

[cedarbridge]

At this rate anything to increase the importance of MDs would be an improvement.

This requires at least one of several things to change. A few of them are addressed in the overhaul doc but they all merit some discussion.

1) MDs need to offer something unique that players cannot get elsewhere. Right now, the only thing that is unique about medbay services is cures for viruses and revival via cloning. Everything else in medbay is either accessible via other locations or other means or just not really required. If everything a MD can do can also be done by a greyshirt dragging his buddy into a box and mashing all of the buttons, the role is basically fluff. Compare this to engineers. Obviously anyone on the station can fix a wall. What everyone on the station cannot do is fix external wall breaches or repair severely damaged areas. Engineers can because they have access to hardsuits and RCDs. MDs will need something that makes players say "I need to find the guy that can do this." and to be that guy. The surgical aspects of that are part of this issue's solution. Ghetto surgery exists, but rarely is it done, rarely is it a good idea (due to fail rate) and rarely does anyone actually collect the tools required to perform the whole process and grind through the fail rate to completion. MDs have the tools (or would be given the tools in the overhaul) required to diagnose and treat the issues particular to the patient and would have less of the issues related with ghettoizing your buddy with a glass shard. This makes medical something that anyone can do, but MDs are specially equipped to do it better, faster and with less code-enforced screw ups.

2) Remove instant or near instant healing effects. I'm looking at bruise packs and ointments here. MDs are basically useless when anyone can carry a bruise pack and fully recover from anything short of direct to crit damage.

3) Sec and Head enforcement of medbay access. This is a player issue that doesn't really require code assistance. Players generally force their way into medbay for one of a dozen reasons and its rare that sec cares or that the CMO gets involved. Part of the issue is ease of access. Any idiot can operate a sleeper/cryo tube and that means healing up your buddy is as easy as ordering the door open via AI and slamming your buddy into the machine. Alternatively, you get the guy that just smashes his way into storage and carts off half the med kits from the trove in storage. Sec is generally too busy chasing valids to care about medbay theft so this will keep happening until players decide they want it to change, basically. I know other servers have added a receptionist bell to the desk to alert MDs to new patients at the doors, but I don't think that will really do enough here to stop literally everyone from treating medbay like a public space rather than a medical doctor's workplace.

[Anonmare]

For real the only solution is to add permanent damage that can't be healed without outside help but nobody will go for it because the squeaky wheels will screech and reeeee that there's something they can't do. Some of you may not remember but removing self-serve cryo was literally pulling like teeth for a while

[vcordie]

all doctors start with an automatic firearm but every time they discharge it a random player dies

[kevinz000]

roundstart skills are bad unless you're trying to make this medium-high rp where people don't know how to do a job unless they're starting in that job don't do this. anything else might be nice.

[cedarbridge]

roundstart skills are bad unless you're trying to make this medium-high rp where people don't know how to do a job unless they're starting in that job don't do this. anything else might be nice.

Unless something got added to the doc I'm not aware of, who mentioned roundstart skills?

[Shaps-cloud]

tbqh i really don't mind people breaking in and serving themselves, or other people just healing each other with the sleepers. If someone doesn't want to get treated by me, or is already being treated by someone else, it's no skin off my nose, that just gives me more time to hang around and watch around medbay or talk to people. Doctors become important when the bodies are piling up and people are busy running bodies into medbay and taking off right after to go grab other bodies/patch up holes/shoot at bad guys, and a good doctor who can focus on which actions and pursuits would be the most useful and helpful can make a big difference.

Balancing medbay's mechanics around what happens when nothing is happening is silly, because it always falls apart in practice when bodies start piling up (which is also the most fun time to play medbay)

[Sweets]

Obligatory port bay med shitpost.

In all seriousness though, remove all the medkits in mebay storage and spread their contents to increase the amount of available meds in the ID required vending machines. ALSO REPLACE THOSE GOD DAMN WINDOWS WITH WALLS FOR MEDBAY STORAGE.

[Selea]

If we're gonna balance medbay,we shouldn't do it like with science.

[Lazengann]

Cedar pretending the idea was shot down as dumb when people can still read the thread makes you look dumb

[NanookoftheNorth]

roundstart skills are bad unless you're trying to make this medium-high rp where people don't know how to do a job unless they're starting in that job don't do this. anything else might be nice.

Unless something got added to the doc I'm not aware of, who mentioned roundstart skills?

I mentioned it in the original post.

It was an idea. I mentioned the problems I saw, and I thought it would be better to suggest a solution, even at an abstract level, so then it's less about complaining, more about coming up with ideas.

[Dr_bee]

For real the only solution is to add permanent damage that can't be healed without outside help but nobody will go for it because the squeaky wheels will screech and reeeee that there's something they can't do. Some of you may not remember but removing self-serve cryo was literally pulling like teeth for a while

sometimes you need to pull teeth. The pendulum of game balance has swung towards solo play for too long in my opinion. Things like permanent injury would help slow down the pace of the game a bit, and force some departmental interaction.

Plus it might make augmentation or cybernetic organs a bit more appealing if they are harder to damage.

[cedarbridge]

roundstart skills are bad unless you're trying to make this medium-high rp where people don't know how to do a job unless they're starting in that job don't do this. anything else might be nice.

Unless something got added to the doc I'm not aware of, who mentioned roundstart skills?

I mentioned it in the original post.

It was an idea. I mentioned the problems I saw, and I thought it would be better to suggest a solution, even at an abstract level, so then it's less about complaining, more about coming up with ideas.

I sorta addressed that concept in one of my posts. Specialized skills here are generally treaded as abstract through gear checks. Anyone can do anything but only if they have the tool that allows them to do so. That means that a job that has exclusive access to a tool that does a thing has exclusive access to the "skill" to do that thing. Its a workaround but it does dodge the "hey you don't know how to use that what are you doing" highRP stuff people worry about.

[Shaps-cloud]

Like I said before, balancing medbay around the times when not much is happening is silly since medbay definitely gets plenty of stuff to do when people start dying or getting wounded en masse. Dismemberment is already a pretty good layer of "you need to go to medbay for these wounds", gating healing trivial wounds behind time consuming medical procedures that require a fully functioning medbay is silly

[kevinz000]

If a cmo main tells you this they probably have a point

[cedarbridge]

If a cmo main tells you this they probably have a point

Hi Kev. I play almost exclusively cmo. What does this have to do with anything?

[cedarbridge]

Like I said before, balancing medbay around the times when not much is happening is silly since medbay definitely gets plenty of stuff to do when people start dying or getting wounded en masse. Dismemberment is already a pretty good layer of "you need to go to medbay for these wounds", gating healing trivial wounds behind time consuming medical procedures that require a fully functioning medbay is silly

I don't really see anything in the design doc about trivial wounds requiring full medbays to treat. Specifically, the concept is that the more severe the wound is the more specialized treatment is required. Profound 3rd degree burns would require more than putting ointment on the booboo and would actually require a medbay trip as opposed to the current case. Its really time we started moving away from the only punishment from floating injury is that you move a little slower and get an annoying overlay on the edges of your screen.

[PKPenguin321]

personally i enjoy playing MD right now, you can start a round by actively seeking out the injured and patching up minor damage and when the round gets moving you can head back to medbay and treat the influx of major injuries. rarely feels like there's nothing to do

[NanookoftheNorth]

personally i enjoy playing MD right now, you can start a round by actively seeking out the injured and patching up minor damage looking for already healed people and when the round gets moving you can head back to medbay and treat watch others treat the influx of major injuries. rarely feels like there's nothing something to do

FIFY

I'm joking and really I'm glad to see someone enjoys it as is. I still have beef with being a doctor and having someone come in with a wounded person and treating them without regard to my job. I feel like the lawyer in security, waiting for a case.

Thinking about it, there is one mechanic that no one really uses, the medical records. Medical Doctors are the only ones who have access to it, and I wouldn't mind filling it out while someone treats steals the patient. Why utilize medical records? The situations where it's useful is for blood transfusions and cloning. If they have an augmentation one can figure that out quickly, and otherwise surgery is a rarity in the fast paced games we have.

[Shaps-cloud]

Honestly as impractical as it would be to do due to map layouts, putting robotics back (at least partially) under the aegis of medical might be a good idea, since they are the foremost source of surgery and surgery related accessories on station.

[NanookoftheNorth]

Honestly as impractical as it would be to do due to map layouts, putting robotics back (at least partially) under the aegis of medical might be a good idea, since they are the foremost source of surgery and surgery related accessories on station.

Robotics usually just bashes off someone's head to get the brain out. I didn't know you could do that since I always did surgery.

[Shaps-cloud]

When it comes to braining them, sure (though I'm fairly sure that leads to more clicks and time than the actual surgery anyway), but they also do augmentations which are fairly significant

[paradox97]

Hello! I'm new on the forums but I have played CMO about 80% of my games for the past few months, I also have a limited knowledge of the system on paradise station.

I find paradise station makes medbay more interesting by reliance on surgery, generally the one thing in medbay that requires any semblance of skill. The new brain trauma system is a step in the right direction in this regards, typically only medical staff performs a surgery, rather than the self-service in everything else. Perhaps the addition of broken bones, sprains (for brute) or 3rd degree burns requiring skin grafts (for burns) could be added as surgeries. Also, sterility protocols and the possibility of infection increase the skill curve. I am aware paradise pulls this off by having longer rounds than TG, but currently surgery doesn't take too long on TG.

Another idea would be an increase in the amount of diseases undetectable by the general population or just more disease in general that cannot be cured via sleeper. As CMO I've never had a patient self-serve when they have appendicitis (it's because they can't xD), they come to me, ask me what the heck is wrong, and then I take them into surgery. Perhaps more diseases from poor life choices could be added (diabetes from surgery food, obesity can become a bigger deal, muscular atrophy from sitting around, lung cancer from cigarettes, a more fleshed out liver disease from alcohol). Diabetes could be a unique system of regular bloodwork and balancing insulin with sugar intake, involving regular doctor visits and chemisty. The obesity system in game is decent, but I don't think people have to eat enough currently, making it so people have to eat more often could tempt them to stuff themselves. Staff like the head of personnel could get muscular atrophy from sitting around too much, perhaps doctors can choose whether to suggest more exercise or risk providing steroids. Cigarettes and radiation exposure could perhaps cause cancer (surgery to remove the tumor with a risk of it coming back or damaging healthy tissue), lung surgery should perhaps require a ventilator to be used simultaneously. Perhaps there could be a 1% of someone arriving on a shuttle having the common cold, or a viral infection. Perhaps surgeries or brute damage could result in bacterial infection requiring novel antibiotics to be researched. If we're really ambitious these antibiotics could eventually spawn resistance.

I would also like to see more medbay roles as opposed to less, with a reduced number of MDs. The first that come to mind are EMT (emergency medical tech) and coroner. I think a coroner is necessary in order to update medical records on the deceased, as well as notify security of suspicious findings, perhaps they could find artifacts that other staff could not find, such as perpetrator hairs, bullets, etc... in some ways this would also buff the detective. A psychologist would be an interesting role to consider but unlike paradise it would need an actual mechanic. I'm not sure what that mechanic would be, but I'd like it to be text based, perhaps x person can only say an unintelligible slur of letters and the psychologist has a a guide (like the DSM) that can be used to decode a cure, the problem here is I can see no possible way this mechanic could be unique for more than few rounds. Perhaps looking at screens too long could induce nearsightedness in players to various degrees, and an optometrist (or just an optometry department for normal docs) would be needed to create the right prescription glasses. If the afforementioned diabetes and infection systems are implemented maybe certain players could be lab techs who synthesize antibiotics and run tests. Nurses could ensure sterility before operations, and take care of patients who are quarantined or maybe waiting on a bone to mend. Overall I would like to see more specialization in medbay, perhaps each department doesn't need to be a role per se, but specialties none the less (akin to RnD, xeno, and toxins inside science).

I was going to suggest something else here but forgot. If anything above seems interesting I'd be happy to try to develop the idea in more detail.

EDIT: Part of the reason I would like to see more specialists, as well as disease involving multiple specialists, is because it would require coordination by the CMO. In addition to the problem of MDs not having much to do, I also find that the CMO being little more than an MD with a cloak is also a problem.