Wed. Jul 6th, 2022
RimWorld 1

Learn how to train the medical skill in the most efficient way with this Rimworld surgery guide. With the aim to start putting bionic parts onto colonists. The aim here is not just to get your medical skill real high. You can do that in time if you wish. The objective is to get your medical just high enough that you can start putting bionic parts onto your colonists. That’s the end goal here. So what’s the minimum amount you want and what’s the fastest way to get there.

Leveling up the medical skill

First, we find an (involuntary) patient, cut off one leg, and attach a peg leg, if the pawn doesn’t have a peg leg already. You’ll be getting medical experience from cutting the leg and attaching a peg leg. Hover over the medical trait to see how much expertise the pawn is getting. If the patient already has a peg leg, remove it and then reattach it.

Be aware that you will most likely max out the learning for the day, especially if the pawn has multiple points of interest in medicine. However, the max learning of the day will reset daily. So the great thing about this is, the moment the pawn recovers the following day, we can remove the peg leg and reattach it again. Rinse and repeat. This is how you train it up. Just chop off someone’s legs and put them back on again, well one at a time. I know this is pretty dark, but it is Rimworld.

Rimworld surgeon in action
Surgeon attaching peg leg onto colonist.

What to look for in a test subject

Though there is one thing, you might want to look out for when you are looking for a patient—pawns and preferably prisoners, with the frail trait. The frail character is handy as it will reduce the moving stat to 0%. The reason being is they have no leg, a peg leg, and the frail trait. All these three, at the same time, reduces their moving to 0%. Which means they can never have a mental break. The downsides to this is you will have to feed them because they will continuously be in bed and can’t get out. But you can keep detaching and reattaching the peg leg again, and they won’t mind at all. Not even a little bit. I know, yes, it is very dark, but it works.

Additionally, the ailment frailty gives them -30% moving as well, meaning they will also be incapacitated, hindered. So if you find someone who is frail or has a bad back, those pawns would be perfect candidates for medical test subjects. If they aren’t frail or don’t have a bad back, you will just have to deal with mental breaks from the prisoner. But you know, what can you do.

If your pawn fails the operation, they will still gain a bunch of medical experience. So it doesn’t even matter if you succeed or not. But it’s best to keep the subject alive and the place nice and clean. Keep test subjects in a nice surgery room so that they are more likely to survive. Do as many surgeries as you want, you can level up the skills on your pawns as quickly as you want.

Minimum skill level for installing bionic parts

Now how high do you want to take the medical skill before you can start installing bionic parts on your pawns with a minimal amount of risk necessary? The first thing to realize about medicine is, there is a built-in 2% failure rate. No matter how high you get your chance of success percentage, max out the medical trait, have 110% medical success chance, and so on. The pawns are still going to fail 2% of the time because it is hardcoded. Therefore you will always have a potential chance to fail. It’s just going to happen no matter how good your chances are.


Let’s have a look at the beds and take a look at how they affect surgery success chance. First of all, stone type material beds are not as comfortable and don’t give as good as a benefit to sleep. So the rest effectiveness is decreased and therefore not so good. It takes longer to finish building a stone type bed, as well. However, their surgery chances are precisely the same as other material beds. In the end, it doesn’t matter from which material you make the bed out of, when it comes to the surgery success chances.

Rimworld sandstone bed

Rimworld wooden bed

Medical room

Don’t ever do surgery on the open field. To have a successful operation make sure you have a nice clean room, make sure it’s floored, roofed, and that there is a light source nearby as well. Light sources reach pretty far, and you will only need about 50% light.

Start adding bionic parts.

At which point can you start adding bionics parts on your pawns? As soon as you have a clean room, have a pawn at level 10 medical, a medical bed that’s of normal quality, or just an excellent quality wooden bed. It is not that hard to go into bionics. Especially considering the way the new patch has gone with a lot more bionics that you can add on with lots of benefits. The new questing system makes it easier to get your hands on them as well. It is quite attainable to get bionics very early on in the game, even with a tribal start. You don’t even need a medical bed. You just need an excellent wooden bed. Wait for some pawn to get some inspiration and get them to build you an excellent wooden bed, and you are good to go.

Everything so far has been reasonably straightforward. You just look at your medical success chance of your pawn; you look at the bed surgery bonus you are going to get from whatever type of bed you are using. You add the two of them together. If the percentage is 98% or above, then you know that your odds have only a 2% chance of failure, which is as good as it is ever going to get. However, Glitterworld medicine is a bit difficult.

Glitterworld Medicine

According to the wiki, it tells you, you should multiply your success by 1.6 or something along the lines. However, it doesn’t work out in practice. Assuming you have just a normal quality wooden bed and a level 9 medic. You can still get about the same percentage chances of any perfectly enhanced hospital. If you can find just one piece of Glitterworld medicine to go with whatever bionic, architect part or whatever you manage to get your hands on. And if you are intent on installing it early on in the game. Then yes, Glitterworld medicine, a level 9 medic, and a normal quality wooden bed will do you just fine.

However, if you are willing to spring not only for the Glitterworld medicine, but also for the excellent quality bed or a normal quality hospital bed, you can use a level 8 medic and get 2% or less chance of failed operations on average. The moment you use a level 7 medic, it gets a little bit iffy it seems.


Before we go any further, though, I would like to look at flooring. People always go and put sterile tiles in the hospitals. However, the effect of flooring on the medical success rate is minuscule. That doesn’t mean that sterile stiles are useless, though. Sterile tiles significantly decrease infection chances from wound tending. Neither does it say that you don’t pay attention to the flooring. When it comes to the cleanliness of the room, flooring is essential.

Vitals monitor

Finally, we have the vitals monitor. It adds a flat plus 5% surgery success chance. However, when it comes to researching the medical tech, please be aware of the following. You only need smithing to get steel or silver tile, which is very low down the tech tree. But if you want to get sterile tiles, it is locked behind electricity. If you wish to research hospital beds, you will need to research microelectronics first. And finally, the vitals monitor is locked behind hospital beds and the multi-analyzer.

So if you want to get bionics installed early, you are not going to have access to vitals monitor, hospital bed, and sterile tiles anytime soon. Even then, you don’t need them. An excellent bed and a half-decent doctor with world medicine can work wonders. But there are also other options; you can increase the abilities of your doctors by feeding them drugs.

Doctors on drugs

If you have a substandard doctor at level 10 medical, they will only have a 90% surgery success chance. Which means 1 in 10 operations are going to fail. What we can do is get the doctor high on wake-up. Wake-up gives them a little bonus to their perception and a few other things. Their surgery success chance jumps up to 99%. Their consciousness, manipulation, and so on are all improved, and these improvements are helping them become better surgeons. Add a normal quality bed, and this doctor can perform entire operations.

Wake-up adds quite a bit of a benefit. However, the pawns run a small risk of heart attacks when using wake-up. It also comes with the chance of addiction due to the recent patch. Taking wake-up even once, can result in instant addiction. In the end, it’s not that great. If you desperately need to get a bionic part on somebody, it is an option now.

Suppose you are desperate and need a bionic part or some sort of operation. You can go-juice up a level 7 medical pawn and have the pawn work on an excellent quality bed. That is how you can install bionics very early on in the game if you want to.

When the unexpected happens

All the above are excellent and all, but during the game, unexpected things happen. For example, what happens if a level 14 medical pawn was to say lose a finger. Due to the loss of the finger, the medical success rate drops from 98% to 90%. Meaning the pawn will need at least an excellent quality bed to do an operation successfully. Before starting a medical procedure, make sure the pawn in question does not have any manipulation problems, consciousness problems, sight problems, that type of thing, or it will affect their success chance.

Go into the pawns stats and check their actual success chance. Once you find out what their medical surgery success chance is, check to see what’s the best bed you have in the entire colony. If you can, make a better bed, do it. The better the bed is, the larger the flat percentage (see bed surgery bonus, below). Just add the bed surgery bonus with the medical success chance. To find out the success chance of the operation.

Bed surgery bonus
Normal: +0%
Good: + 5%
Excellent: +10%
Masterwork: +15%
Legendary: +30%

Say the pawn has a medical success rate of 100% and add the 10% bed surgery bonus for using an excellent quality bed for the operation. If you can get at least a 98% percent chance of success, you are great.

Glitterworld medicine is quite potent, and it adds at least a 13% bonus to your doctor. As a rule of thumb, consider Glitterworld medication +13%. The wiki says it is a 21.6 multiplier, which it is not. Otherwise, it would have been far better than it currently is.


Anyway, after all of that, I think you now should have a good idea of how medicine works, and what you can do. It’s also pretty easy early on to start installing bionic parts, so long as you are willing to do a few minor operations on some test subjects. You can potentially get the doctor to do this quite early on in the game. Probably in the first year or two, it should be quite straightforward.

About the actual acquisition of the bionic parts necessary to install well, it will depend on what quests come your way, and what’s available to buy. But if you are running a drug empire a thing like buying archotech arms and sticking them on your drug production people to make even more money to buy more drugs with more archotech parts and will substantially expand your empire faster.

Hopefully, you enjoyed this article. Good luck in Rimworld.

See also:
Best Rimworld Mods
Rimworld How To Get More Colonists

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