Medicine 101 — 5E D&D Skills and Skill Checks

Fifth edition Dungeons & Dragons revolves around the ideas of ability checks and the proficiency bonus. When it comes to skill checks as ability checks, the check is written like this (for example): Wisdom (Medicine). The reason for this is Wisdom is the applicable ability score and the Medicine proficiency allows further modification of the ability check. Quick Disclaimer: a 5E D&D Dungeon Master can allow or require any ability check or skill proficiency, even outside this purview. This article is meant to act as a guide for new players and DMs to explain how skill checks work and what they look like narratively.

What is Medicine?

Medicine is one of the most underappreciated skills in 5E D&D. It makes sense too, when you consider that magic makes it so a wound can close instantly with a word or a snap of the fingers. It makes sense that not many people would be trained in basic first aid when they could just as easily learn to pluck a few strands of magic and fix the problem better. But the Medicine skill goes beyond circumventing magic, and that’s what we’re talking about today.

Before we go any further, let’s see how the 5E D&D Player’s Handbook defines Medicine skill:

A Wisdom (Medicine) check lets you try to stabilize a dying companion or diagnose an illness.

First Aid

A little about myself as the author of this piece, I also happen to be an instructor for First Aid and CPR. So I’ll be coming at this particular topic from that perspective.

While some might argue Medicine should be an Intelligence-based skill, I disagree. Over the years I’ve been teaching first aid, I’ve seen many, many people who lack the perception and basic understanding to know how to perform first aid. Using Wisdom for this skill check makes sense to me. You have to be keenly aware of your surroundings and all aspects of a situation in order to assess it and offer treatment.

When it comes to first aid, you can’t talk about nonmagical options without noting the existence of a healer’s kit. The healer’s kit is a piece of equipment that allows any character (regardless of proficiency) to expend one use of it to stabilize a dying creature as an action, period. Some might think this cheapens the usefulness of the Medicine skill, but I disagree and I’ll tell you why: the Medicine skill doesn’t require you to expend a use of a healer’s kit. In fact, you don’t need a healer’s kit at all to make a Medicine skill check and stabilize a dying creature.

For the purposes of the first half of Medicine’s description, I tend to use the rule that it requires a successful DC 10 Wisdom (Medicine) check to stabilize a dying creature without using a healer’s kit. A healer’s kit grants automatic success, provided no special circumstances exist. Special circumstances that could complicate this and raise the DC would be things like poison, or possibly a critical hit; things more severe than a simple wound.

What’s more, there might be times in your setting where magic is forbidden or nullified somehow. Maybe your character doesn’t have a spell slot to burn, or maybe (just maybe) something magical prevents the wound from being treated by other magics. In fact, a magical wound that only worsens with spell use could be absolutely fascinating!

First aid is an incredibly valuable skill to possess in real life, and it can be every bit as valuable in-game, if you as the DM allow it to be. The thing with first aid is, it’s really extremely accessible. With a little common sense and some awareness, anyone can help save or drastically improve a life. This is demonstrated well by the healer’s kit’s accessibility, and while Medicine being able to let you finagle your way through first aid without one might seem nerfed, wait until we examine the next part of this skill.

What seems to be the problem?

The bigger (much bigger, in my opinion) use of the Medicine skill comes by way of the ability to accurately diagnose an illness. This is huge, especially in a fantasy context where doctors may not be readily accessible. As a DM I would rule that by proxy of this capability a character with a successful check would also know how to treat said illness. The ability to diagnose a problem is half the battle when it comes to our own world, and the knowledge of how to treat it? Now, that’s really impressive.

However, I think the reason this seldom gets brought up is because DMs so seldomly rely on illness as a plot hook. I never understood why that was, either.
One of my favorite episodes of Avatar: The Last Airbender showed Katara and Sokka being bed-ridden ill, and Aang had to go on a whole side quest just to get the remedy. That’s a great story hook!

How easy would it be to give the players a NPC they love (preferably someone kindhearted or vulnerable), and then twist the narrative knife by making them sick, possibly deathly so? Let the players make a Wisdom (Medicine) roll to know what’s wrong and how to fix it. Maybe a failure offers three potential cures, but only one will work? This would make for a fantastic low-level adventure.

Sadly, something like this would have to be done in a party prior to their reaching level 3, if there are any characters with access to lesser restoration, because that very potent 2nd level spell just circumvents the whole thing without a little working. That being said, the ability to diagnose problems and find cures is absolutely amazing, and I’d love to see it used in more games.

What do you think?

Do you use the Medicine skill at your table? Do you have ideas of how to make nonmagical healing more viable? We want to hear your thoughts in the comments!

*Featured image — Illustrator Robson Michel describes this as a redesign of the Eric character from the old Dungeons & Dragons cartoon. He is older, more experienced and not less arrogant. He has a magic shield that protects him from any harm with a force field. [Art by Robson Michel]