I think Physician skill should be a VH skill.

[Celjabba]

A modern physician(the job) in Gurps already need half a dozen skills (1 VH, 4 H, 1 A) + several background skills, most of them also H or VH.
And contrary to most professions, some of those primary Hard skills should preferably be at skill 14+ instead of 12+.

I think that cover the "broadness and difficulty"

Besides, if you make the skill VH it would also impact nurses.

[Rupert]

I think at a minimum they need Diagnosis-12, First Aid-12, Electronics Operation (Medical)-12, Physician-12, and Physiology-12. They'll also be expected to learn foundational levels of Biology, Chemistry, and possibly Maths and Physics early on. Research at default off the skill they're writing for will do, and no need for Writing, though a researcher would raise these once they're working rather than studying/training.

A good GP (General Practitioner) probably has a few points in Psychology, Body Language, Diplomacy, etc. as well. A specialist might not, but will have an optional specialisation in Diagnosis and Physician and/or Surgeon.

With IQ12 the minimum skills cost 1+2+(4x3)=15 points. At IQ11 they cost 2+4+(3x8)=30, and at IQ10 they cost 4+8+(3x12)=48. I don't see any reason to make Physician any harder.

Note that a Surgeon adds 8/12/16 points to that, four fewer is they specialise, which they probably will.

A Nurse would have lower Physiology, and possibly Diagnosis (or might have quite a high level, but specialised in something like 'minor illnesses'). I'm not sure how you'd reflect an experienced nurse's skill in minor surgeries like freezing off warts, removing stitches, and so on.

The nurses in intensive care wards will have higher First Aid and Electronic Operation, and so on.

[Pectus Solentis]

I thought on the fact that the default level of Physician is IQ-7, like most IQ-based VH skills. and thought that curriculum of College of Medicine is notorious for very high difficulty and having a lot of study, I felt the 2 facts match well.

[johndallman]

Originally Posted by Pectus Solentis

I thought on the fact that the default level of Physician is IQ-7, like most IQ-based VH skills ...

Default penalties are not solely determined by the difficulty of the skill. That's important, yes, but some skills have harder defaults because the "obvious" way to do them is not effective, or even counter-productive. Physician is an obvious case: it is explicitly "scientific" medicine, and does not exist (by default) before TL5. That's a possible reason why it has a worse default than most IQ/H skills.

[Pectus Solentis]

Originally Posted by johndallman

Default penalties are not solely determined by the difficulty of the skill. That's important, yes, but some skills have harder defaults because the "obvious" way to do them is not effective, or even counter-productive. Physician is an obvious case: it is explicitly "scientific" medicine, and does not exist (by default) before TL5. That's a possible reason why it has a worse default than most IQ/H skills.

Well. I thought that Physician skill is not a VH skill but a Hard skill is a typo.

[Ejidoth]

Originally Posted by Pectus Solentis

IQ-7, like most IQ-based VH skills.

As far as I can tell, there are two skills in all of Basic Set: Characters with an IQ-7 default: Physician, and Thaumatology. I'm not sure you can extrapolate a pattern of "most IQ-based VH skills" from just Thaumatology.

Let's look at the actual list of IQ/VH skills:

Alchemy, Herb Lore, Ritual Magic, Thaumatology are 'magic' skills. Computer Hacking, Invisibility Art, Musical Influence, Pressure Secrets, Weird Science, and Zen Archery are all unrealistic/cinematic skills.

Unless I'm missing something, then, Biology, Physics, and Surgery are the only mundane, realistic skills that are rated IQ/VH.

It makes sense to me that Surgery is a step harder than Physician, the way GURPS uses both skills.

[Pectus Solentis]

Originally Posted by Ejidoth

As far as I can tell, there are two skills in all of Basic Set: Characters with an IQ-7 default: Physician, and Thaumatology. I'm not sure you can extrapolate a pattern of "most IQ-based VH skills" from just Thaumatology.

Let's look at the actual list of IQ/VH skills:

Alchemy, Herb Lore, Ritual Magic, Thaumatology are 'magic' skills. Computer Hacking, Invisibility Art, Musical Influence, Pressure Secrets, Weird Science, and Zen Archery are all unrealistic/cinematic skills.

Unless I'm missing something, then, Biology, Physics, and Surgery are the only mundane, realistic skills that are rated IQ/VH.

It makes sense to me that Surgery is a step harder than Physician, the way GURPS uses both skills.

Many Easy skills default at Attribute-4.
Many Average skills default at Attribute-5.
Many Hard skills default at Attribute-6.
So I thought many VH skills default at Attribute-7.
It was my deduction.

Well, As you said, there are a few VH skills in Basic Set primarily.

[Kromm]

Physician is intended to be an IQ/H skill with an IQ-7 default, not an IQ/VH skill with an IQ-7 default or an IQ/H skill with an IQ-6 default. That is not a typo.

It's "only" Hard because it isn't a complete skill. "All the stuff a doctor has to learn to pass their boards" is a daunting list: Physician, sure, but also an equal amount of Diagnosis, a ton of Physiology before either of those (and realistically, also a BS degree in Biology, Chemistry, or whatever), and at least a modicum of Pharmacy, Psychology (even for non-psychologists), and Surgery (even for non-surgeons) – oh, and in today's world, Electronics Operation (Medical). Collectively, learning all that stuff makes becoming a doctor a lot of work that involves a lot of study to earn a lot of points.

From a gamist perspective, you can kind of, sort of finesse this by learning just Physician at an obscene level and defaulting most of the other skills to it. Fine. But to be good enough at all the other stuff, you'll need four or five extra levels of Physician, so in effect the core skill becomes the equivalent of "IQ/VVVVH" or something. And there are still some parts of the required training you'll have to learn separately, like Psychology.

By comparison, it's possible (if unlikely) to become a Physicist with just Mathematics and a single IQ/Hard specialty of Physics – something I know because I actually did it.

As for the default, that's unusually tough because, in most settings, practical experience with the knowledge in question is carefully guarded by an exclusive professional order. Yes, this is a "social" control and not a gamist one, but defaults are essentially social in nature. You don't even get them if your character lacks the right background, for instance!

Consider: You can do your own taxes with Accounting at default, defend yourself in a court of law using Law at default, invest your own money with Market Analysis at default, and so on. Yes, there are orders of people who specialize in these things, and yes, to do these things for other people you need to be certified. But nothing prevents you from reading the books and doing it for yourself.

Physician is in a similar boat, except that even the instruments and medications needed to use the skill are controlled, and it's a crime to practice the procedures on others to understand them. This isn't even a particularly new development in human society. So there's an extra -1 to reflect the fact that regardless of how hard to understand the knowledge is, it's hard to find out about without study.

Note that this is actually generous. You can't even try certain IQ/Hard skills at default from IQ! Some are considered too abstruse (not hard – abstruse) to attempt without study: Bioengineering, Computer Programming, Engineer, Expert Skill, Linguistics, etc. Others are considered so controlled and secret that the knowledge isn't out there to be found out, even at default; e.g., Brainwashing and Cryptography. The latter is a "social" explanation, like the extra -1 on Physician. All of these things have defaults to other skills, but not to IQ.

[AlexanderHowl]

A character with high Physician who defaults other medical skills is probably a very experience or very gifted nurse rather than a doctor (a doctor should also have points in Diagnosis, at the very least, even if they have a stellar default.

For example, you could have a nurse and a doctor with Physician-16. They will both have Diagnosis-12 at a default, but the doctor should probably spend sufficient points to raise Diagnosis a level or two (this is realistic given that the majority of medical education is not 'hands on'). Of course, if you have a doctor with Physician-20, you can probably waive the requirement to raise Diagnosis from default, as their default makes them superior to the vast majority of doctors.

[Kromm]

How you get your levels isn't important. You can shuffle points around until you have the levels you want as cheaply as you can manage (p. B173 states this explicitly), but that doesn't have any effect on the meaning of those levels. Someone with huge Physician and other stuff at default from it is just "a PC played by a better optimizer"; in the game world, the player can claim precisely the same background as a less-efficient PC with similar levels bought the hard way.

Or put another way: The numbers you roll against exist in the game world. The points don't – they exist only in the real world, and cease to be relevant in play.