Someone did (JTAS? A 3rd party?) Imperial Medical Academy or some such with lots of specializations, etc. Sadly, my Traveller stuff is now boxed and in storage or I could look it up (I was, for many years, a completist). It had quite a few variations including ones we don't have current sub-specializations for. I forget what their list included, but I'm sure Xenomedicine and Xenopsychology were both represented.

And also, let's not forget that doctor's that treat disease, vs. doctors that deal with physical trauma, vs. doctors who deal with mental health issues and psychological trauma... well, there's a lot of difference in their day to day practice and their most practiced skills. If we throw in trying to treat all sorts of aliens...well, there's a wide breadth of possibilities in a Traveller medical career.

Paramedics, nurses, PAs/NPs, doctors, doctors who are surgeons, doctors who are specialists, etc. - all have fairly different career routes, skills, and job demands. And half the time, we kind of ignore the mental health practitioners when we talk about doctors.

Ken Barns pitched in with comments about when and where you might have doctors in a typical Traveller scenario. I kind of agree with his outlook (small liners, cargo haulers, and free traders couldn't afford a doctor, they'll be lucky to have a good medic), but I will point out a few things:

a) Larger ships in our world have doctors and nurses. A Royal Caribbean liner has 3 nurses and a doctor (one of the nurses is a crew nurse) and they tend to be highly competent (my mom was a nurse and a close friend of hers who also was a nurse was recruited to be a crew nurse - they wanted her because she had a lot of experience in a variety of roles including ER, surgery, geriatrics, etc).

b) That said, those liners may be out at sea, but in a lot of places, they aren't so far from a port or from a medevac as to mean they need the same level of medical support as starships navigating the spacelanes may. Note also space is the MOST dangerous environment we know of (even worse than Deep Ocean trenches or near vicinity of volcanoes or consuming plate margins). It may well be the requirement for good medical support and a very capable sickbay (technologically) is considerably greater than Earth-based commercial shipping or even military shipping (military ships probably need more docs and nurses/corpsmen too because of the greater possibility of injuries).

c) Throw in treating aliens (quite possible in OTU and other places) and you might well need more or better trained medical personel for big liners (not something you'd get to do in your first term or two). Different biology, different psychology, different cultures, different environmental conditions, etc... aliens bring a lot of complexity to the table.

Those things noted:

Expert systems (fancy powerful algorithms) and robots are going to threaten a high % of all employment in the next 100 years. In the next 10-20, they are going to seriously dent many jobs. As TL goes up in Traveller, these systems will get more powerful (even taking into account the OTU's anti-AI and not so advanced Robot views).

What could I see expert systems doing:

a) Force multiplier for a small ship's medic with limited training or for larger ship medics for rarer injuries/diseases or dealing with alien psychology, physiology, etc.

b) If your tech is high enough, autodocs for trauma

c) Diagnosis could be vastly improved by powerful AIs and their ability to recognize patterns in health data and their huge library of decision trees

d) Robots could do manual tasks (hospital cleanup, transfers, bathing) but they could also do a lot of other things: Help dementia patients, help with physiotherapy or helping crippled patients, cooking, cleaning, but they could go as far as robot medics (more expendable in combat, capable of picking up battle dressed Marines and hauling them out at high speed), surgeons or at least surgeons aides, companions for those in long term care etc. They are also likely to be able to be cranked out faster so if you have a few orbital teams powered down who can power up and drop into a disaster area to begin triage, trauma treatment, etc or into an area with an outbreak (to deal with vaccinations, triage, treatment, dealing with sanitation issues) and so on, that kind of capability could make a real difference. Even getting an armoured mule to help carry the wounded to safer areas is a big step.

A lot of how any given medical character's trajectory and skills and practice would look is a result of the needs (higher with space travel, higher with high risk activities, higher with alien needs) and also with the technology that can exist as a force multiplier (expert systems, robots, AIs).

A TL-15 military hospital ship that deploys with task groups and has all the latest gear is going to differ a lot from a barely trained young medic (or a non-medic with a level in med) supported by a cheap medical diagnostic computer which will in turn look very different than the medical complement on a high tech hospital in a high pop world or from the crew and passenger medical care team on a long-liner.

TomB

On Wed, Dec 11, 2019 at 5:56 AM Thomas Jones-Low < xxxxxx@gmail.com> wrote:

Having known several nurses and doctors, the difference between an LPN, RN, EMT, and doctor specialists isn’t skill level, but regulations about who can do what. And this is shifting constantly. And at higher TLs you may well employ robots to perform the grunt work (e.g. bathing patients) that used to be performed by Nurses.

For the simple approach, I would have a single medical career, and assign titles as ranks. For a more complicated approach I would think about splitting into tracks for nursing, EMed, general Practice doctor, and specialist doctor.

The only other thing is Loren's advice, which is just because there isn’t a Shoemaker career does not mean there are no shoe makers. This should be focused on PCs.

On Wed, Dec 11, 2019 at 2:35 AM shadow at shadowgard.com (via tml list) < xxxxxx@simplelists.com> wrote:

On 6 Dec 2019 at 7:12, Jeff Zeitlin wrote:

> ... a MEDICAL career in Traveller.
>
> What should it look like?

Well, there are likely "nurse" and "doctor" tracks. though reality
gets even stranger with things like "nurse practioner".

> In the Classic/Mega model, obviously College and Medical School
> "pre-enlistment" options should be required, not options.
>
> In any version, what skills should be included in the career, and of
> them, which should be converted to cascade/cluster - or which should
> be converted from cascade/cluster to single skill?

Not sure, but the ranks/skil tree may want to go thru a couple levels
of first aid and on up to several levels of "first responder"/EMT.

Not sure if you want to go thru a "pre-med", "med student",
"intern/resident", doctor sequence or not.

--
Leonard Erickson (aka shadow)
shadow at shadowgard dot com

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