Revised Physicians Ranks

[Cellan]

Hi everyone,

By popular demand, I've recently been revising the rankings and sub-rankings for the Physicians Guild. Although we're going to be discussing this internally at an IC meeting, I'd love for any general feedback for the preliminary, very rough draft that I've written up.

In particular (for those of you who know how the guild currently works), I've removed the two streams of 'Medicia' and 'Materia', and have replaced them with specialties. This is primarily because, a) most our physicians train in both medicine and herbalism, b) I think this adds more flavour to the RP, c) it means that the Physicians ranks are more fully integrated into the IC world (i.e. field/combat medics might have a closer relationship with knights and reeves, paramedics with merchants, midwives with families, etc.), and d) I think it provides more interesting character career progression than we currently have. Finally, this seems to be the model that physician characters have pushed for in the past, where, although they might be classed as a 'Medicia' or 'Materia', they often prefer to say, 'I'm a field medic', 'I specialise in every day/city-based injuries', or 'I'm a doctor, but especially a midwife'.

I've also cut down the number of promotion ranks and have substituted them with simplified replacements that I think match more closely with other guilds. In this scheme, an orderly should be considered (internally) a knight's page or a merchant's apprentice, nursia a squire/journeyman, physician a fully-belted knight, clergyman, reeve, or vetted merchant, and supervisor a templar, magistrate, or master craftsman. Note that I'm not implying that each rank should be considered to have the same IC, kingdom-wide clout or influence of any of these other roles (though I'd like them to, if possible); it's just an explanation of how I see their internal importance in the guild relative to other ranks.

So, any feedback would be very much appreciated. I'm planning on revising my draft within the next week, as per any advice you could all kindly provide. Thank you in advance!

Shaylei

P.S. I'm not sold on 'Supervisor' as a rank name. Any suggestions of alternatives that aren't difficult to remember or spell would be especially appreciated.

Also, any suggestions for additional specialties/thematic flavour would be awesome.

Ranks:
Orderly: The lowest rank in the guild. Orderlies are assigned to fully-fledged physicians, and are responsible for providing their masters with the support necessary to undertaking more complex tasks. This includes the day-to-day washing, feeding, and monitoring of patients under their physician’s care, ensuring that all medical equipment is kept clean and ready for use, and the cleaning of hospital wards and main work areas. In addition, orderlies are expected to observe medical procedures regularly, and to undertake any tasks required by their physicians. OOC: This rank does not yet grant its holder the right to use the honorific ‘Doctor’.
Promotion requirements (to Nursia):
Observe at least one basic and one complex general procedure.
Complete two successful rounds of a sick ward with Nursia rank or higher.
Have their progress approved by their attending physician.
(OOC requirements: 20+ Medicine/20+ Herbalism)
Example tasks:
Wash, feed, and monitor patients in the ward.
Keep ward, private hospital rooms, and storage rooms clean.
Change and wash bed linens and hospital gowns daily.
Weed and sweep greenhouse.
Man the Triage and attend to any incoming patients under guidance of a physician. (OOC: Can be NPC is PCs are offline/unavailable)

Nursia: Once a student passes their basic training and induction to the hospital, they are promoted to the rank of Nursia. It is in this rank that a student undertakes the bulk of their training in their chosen specialty and sub-specialty. They are assigned a supervising physician in each specialty, both of which are responsible for overseeing their training and eventually recommending them for a full induction into the physicking ranks. They also begin learning the basics of medical-related training, and are responsible for training newcomers to the guild in the very basics of their craft. (OOC: This rank does not yet grant its holder the right to use the honorific ‘Doctor’)
Promotion requirements (to Physician):
Demonstrate ability in treating and caring for two conditions central to specialisation.
Demonstrate ability in treating and caring for one condition central to sub-specialisation.
Demonstrate basic knowledge of caring for a working medicine garden.
Take the Physicians’ oath.
Devise and deliver a training session for an orderly, supervised by physician rank or higher. (OOC note: can be NPC orderly if PCs are offline/unavailable)
(OOC requirements: 36+ Medicine/36+ Herbalism. Demonstrated OOC ability of the ‘treat’ command and sourcing/preparing ingredients for/concocting four complex recipes)
Example tasks:
Tend and harvest plants in greenhouse.
Keep storage room stocked with herbs, common medicines, and everyday items.
Lessons with specialty physician.
Lessons with sub-specialty physician.
Oversee treatment of lower-level recovery cases.
Man the Triage and attend to any low- and mid-level incoming patients.
Monitor patients in recovery ward and private rooms.
Attend house calls with a supervising physician. (OOC: Can be NPC is PC is offline/unavailable)

Physician: A fully-fledged, vetted member of the Physicians’ Guild. This rank should be considered equal to that of a belted knight or a full reeve in terms of (internal) guild importance. Members of this rank are trusted to oversee, manage, and undertake all guild activities both inside and outside the limits of the Hospital. Members of this rank have the right to be called ‘doctor’.
Example tasks:
Train lower ranks in relevant specialty/sub-specialty of their preference.
Monitor lower ranks in day-to-day tasks where necessary.
Process, treat, and monitor patients of all levels of care.
Liaise with other guilds about city- and kingdom-wide care in specialty area.
Assist other specialty doctors in high-level treatments for sub-specialties.
Take house calls for all levels of care.
Supervise training for lower ranks and write promotion recommendations.
Promotion requirements (to Supervisor):
Demonstrate ability in treating and caring for three conditions central to specialisation.
Demonstrate ability in treating and caring for two conditions central to sub-specialisation.
Devise and deliver a training session for a Nursia, supervised by a higher rank.
(OOC: requirements: 47+ Medicine/36+ Herbalism OR 47+ Herbalism/36+ Medicine)

Supervisor: The highest attainable rank below that of the leadership, a physician is responsible for complex treatments and for overseeing the running of the Hospital, should both the Epion and the Prime Medicus be absent. Where there is a question of medical misconduct in the guild, supervisors form a panel by which the actions of the accused are discussed and punishment (if necessary) is determined. This rank is considered of an (internal) importance to that of a Templar, Master Craftsman, or Magistrate.

Epion: The second-in-command of the guild. The Epion is primarily responsible for the day-to-day running of the Madison Hospital, organisation of internal guild events (in tandem with the Prime Medicus), and day-to-day aid of guild members. In these senses, the Epion is intended as a complement to the Prime Medicus, in that he deals with more immediate, hospital-based concerns while the Prime looks beyond, to the procurement of funds and promotion of the guild.

Prime Medicus: The highest rank of the guild. The Prime Medicus is responsible for the overall kingdom-wide running of the guild, procurement of funds for the running of the Madison and other city-based clinics, and the promotion of the guild’s interests in the kingdom. He is the first point of call for other guild leaders.

Subranks:
OOC: Although each of these subranks represents different ‘classes’ of medic, they are intended to, a) represent learning in both coded medicine and herbalism, b) complement the other sub-classes listed here and c) add some flavour to character backgrounds, IC progression, and on-the-ground RP scenes. Because of guild numbers, it is important that each physician take on both a specialty and a sub-specialty; this will help with mentoring and RP in the Hospital itself. I aim to have each of the specialties listed at the entrance to the Madison Hospital; as much as possible, please try and call on people in each specialty to deal with cases specific to them (on an IC level, you might work in tandem so that you are still getting RP from it).

Preliminary care: Field medics, paramedics, and bonesetters are specialists in what is terms “preliminary care”: often the first to attend a scene, these three specialties deal primarily in trauma medicine, and involve (for example) the quick re-setting of bones, binding of series wounds, treatment of burns, and emergency amputations. Often, these three specialties are responsible for stabilising their patient until they can be taken to a larger hospital or clinic for further treatment by a surgeon or apothecary.
Field medic: Alternatively designated ‘combat medics’, field medics specialise in providing first aid and frontline trauma care on the battlefield. Known for their quick response rate and ability to work coolly under pressure, they deal in particular with broken bones, burns, slash wounds, and amputations. Though they are typically found in the provinces, field medics serve as physicians for the more martial (i.e. Reeves and Knights) city guilds. They often have some form of combat training themselves, enabling them to move safely and efficiently through troubled regions. This class of physician is the first port-of-call for inmates in Ahalin Tower.
Paramedic: Paramedics and field medics complement each other in many ways, though the former is more often found in civic contexts, while the latter is more common on the field of battle. Although there isn’t traditionally much a difference between the two, greater population density in the major cities of Lithmore has meant that paramedics and field doctors have begun to diverge in speciality and focus. Paramedics deal with the immediate, primary treatment of serious injuries on-site, readying their patients for transportation to one of the larger clinics or hospitals in the city. They usually work from a horse/mule-and-cart, and are normally of the freeman class; this enables them to pass through city-limits without being harassed by passers-by.
Bonesetter: Bonesetters are specialists in the human skeleton, and deal in particular with broken bones, muscular injuries, and hereditary skeletal conditions. As their job requires a considerable amount of strength in order to complete their tasks efficiently, it is not uncommon for retired blacksmiths, stonecutters, and hard labourers to fill these roles. Though they are most often found in civic contexts, they sometimes accompany field medics on the front lines.

Secondary care: Surgeons, apothecaries, and midwives usually fall under the banner of ‘secondary care’ in that they are most normally responsible for treating and monitory long-term ailments and conditions in hospitals and clinics. They work in tandem with field medics, paramedics, and bonesetters in order to help a patient from the site of injury, to hospital, to surgery, to recovery.
Surgeon: Surgeons are responsible for precise, invasive surgeries than involve cutting into the human body. Unlike field medics, whose work context requires them to operate quickly and efficiently, surgeons are known for their attention to detail and stamina, tending to focus on more complex, time-consuming procedures. Because of their fine-detail work, surgeons most often work from one of the larger hospitals; this means that they are usually required to also act as hospital supervisors when other classes of traveling doctor are away on duty.
Apothecary: An apothecary is responsible for creating and dispensing medicines and herbal remedies to physicians and patients. These physicians appear in all sorts of contexts, though they (along with midwives) are usually the highest-ranking doctors in rural contexts. Experts in herb-craft, they are most often the go-to of other physicking classes when it comes to the treatment of ailments and illnesses. Though an apothecary takes a major role in the treatment of these conditions, they are best known in larger hospitals for providing and monitoring pain relief, minor anaesthetics, and post-surgery care; they thus straddle the divide between preliminary and secondary care.
Midwife: Midwives specialise in childbirth, postpartum, and general pregnancy-related issues. The actual duties of the midwife consist mainly in assisting the birthing process, although they also help with other medical problems relating to women when needed. They often work in tandem with surgeons for more complicated births, though many midwives chose to undertake training in surgery in addition to their own studies. Like an apothecary, midwives are often the highest-ranking doctors in smaller towns and villages. Because of this, they often have some small training in other areas of medicine. They are known to also deliver non-human babies on farms when there are none more suited to the task.

[Kinaed]

I really like this. Instead of Supervisor, how about Master Physician?

[Beronica]

I agree with Kinky. Master Physician is much better than that of Supervisor. Or you can just call them Doctor.

[Gavin]

I'm always a fan of condensing ranks to the equivalent of "trainee," "adept," and "master" -- so I completely support this rewrite. As far as the subranks go, I think it's sound to divide people into specialties (with the tacit understanding, naturally, that a Physician [Midwife] is probably equipped, and might be called upon, to stitch up a cut if need be, given the fact that guilds top out at a certain number of players).

Like Cellan and Kinaed, I'm not married to the word "supervisor," but I'm not quite able to come up with something better. I think that "Master Physician" is fairly unwieldy, but honestly, it's not bad. On the other hand, I question whether one's necessary (in the sense that, as an outsider, I sort of view Master Physician and Epion as synonymous) -- and I suspect that it's one of those ranks that, if the guild only has, say, 5 members, might go unfilled. Just my two cents, there.

Otherwise, solid effort: I agree with this completely. Brava!

[Voxumo]

Hmm... I like this ranking so far except the need for herbalism. I see herbalism as one of those things that shouldn't be necessary to be a physician. Afterall in real life doctors are not the ones creating the pills but instead are just prescribing them. I feel that if you want to learn herbalism along with your regular medicine skill that is perfectly fine and is encouraged, but not mandatory.

So yeah that is just my view. Everything else looks perfect in my opinion.