Medicine in 5.5: Hottie’s Impressions

About the Author

Hottie has played Medicine exclusively for over two years and has extensive solo and group ranked experience across multiple seasons, playing at a high level. She’s written/coauthored three guides to Medicine in PvP and is working on an updated version for 5.x. She now keeps herself entertained by casually playing PvP; you can watch her stream over at twitch.tv/kissingaiur.

Introduction

The stated aim of the changes in game update 5.5 was to address Medicine in PvE, which the developers felt was overperforming. Unfortunately, as with all patches, these changes also have repercussions in PvP. What follows is a brief overview of these changes and Hottie’s analysis of their impact on Medicine in the current PvP environment.

Patch 5.5 Highlights

Operative

• Kolto Infusion no longer applies a heal over time; instead, the initial heal now heals for 44.51% more.
• Curative Agent now changes Kolto Infusion back to its heal over time version, and the rest of Curative Agent’s effects are unchanged.

Medicine

• Each tick of Recuperative Nanotech now heals for 12% less.
• The critical chance bonus given to Diagnostic Scan by Prognosis: Critical is now 10% [down from 25%].
• Accomplished Doctor no longer affects Surgical Probe, and the critical healing bonus it grants to Kolto Injection and Kolto Infusion is now 10% [down from 20%], while its other effect remains unchanged.
• Medical Therapy no longer increases the healing done by periodic effects, but its other effects remain unchanged.
• Durable Meds no longer increases the healing done by each tick of Recuperative Nanotech, but still increases its duration.
• Surgical Precision no longer increases the healing done by Surgical Probe, but its other effects remain unchanged.
• The chance of getting a Tactical Advantage from a Kolto Waves, Kolto Probe, or Recuperative Nanotech tick granted by Medical Engineering is now 10% [down from 30%].

Nerf to Tactical Advantage Generation

Quick refresher on what a Tactical Advantage is: Operative healing revolves around generating and spending charges of Tactical Advantage. This resource, which stacks up to three times, is needed to activate two key abilities: Kolto Infusion (cast) and Surgical Probe (instant). With the changes to the Medical Engineering passive in 5.5, the chance of being granted a Tactical Advantage with each tick of your HoTs (Kolto Probe, Recuperative Nanotech and Kolto Waves) is reduced from 30% down to 10% (on a 6-second rate limit). Additionally, every 10 seconds, Surgical Probe will regrant a Tactical Advantage charge. Lastly, each successful cast of Kolto Injection will generate a Tactical Advantage.

Prior to patch 5.5, you often had a surplus of TAs, even with poor HoT uptime. It is now much harder to generate enough TAs to cast Kolto Infusion or Surgical Probe when needed. This is particularly punishing for new (or even average) players who cannot maintain a healthy HoT uptime (two stacks of Kolto Probe ticking on at least three allies) and are not using Recuperative Nanotech on cooldown. In PvP, if you get into situations where you are forced to heal fewer than three targets, the TA nerf is felt heavily; in these situations, all you can do is try to cast Kolto Injection and/or hope you get lucky with RNG. I’ve personally been up against a wall versus three players, healing just myself and a friend: I died because I couldn’t get a cast off and was starved of TAs. This is a situation I’ve rarely been in prior to this patch; there is no way to really solve this issue without some form of reliable interrupt immunity.

Again, before 5.5, the Medical Engineering passive gave us a 30% chance to generate a TA for each tick of Kolto Waves, Kolto Probe and Recuperative Nanotech (on a 6-second rate limit). With good HoT uptime, you were getting more procs than needed and hitting TA’s stack limit constantly. Presently, I have found that in AoE situations where you are healing multiple targets, you are still able to maintain a healthy number of TAs—the hit to TA generation is hardly noticeable. However, PvP is fluid and the number of targets you are healing can change: it's more important than ever to keep an eye on your TAs and not to spam Surgical Probe mindlessly. I would also strongly advise (if you don’t already) that you generate a full stack of TAs in spawn/before getting into combat. Playing catch-up with your TAs after this nerf is pretty brutal so it pays to be prepared.

New (and Improved?) Kolto Infusion

This patch also saw changes to Kolto Infusion. Its HoT component has been removed but it now heals for more upfront, i.e., it’s “burstier”. Additionally, the Curative Agent utility was adjusted: it restores the HoT component of Kolto Infusion at the cost of a smaller upfront heal.

Is Kolto Infusion better with or without Curative Agent? I don’t think there’s a definitive answer; it comes down to your preferences and playstyle. With Curative Agent, Kolto Infusion heals for more overall. Without Curative Agent, Kolto Infusion heals for less overall but more upfront. If you prefer a HoT-based style with slightly greater HPS, pick Curative Agent. If you’d rather have more upfront burst, ignore this utility.

Don’t forget that Curative Agent also buffs Countermeasures: on use, it grants you an instant double stack of Kolto Probe (saving you a GCD every 45 seconds) and heals you for 10% of your maximum HP over 10 seconds. These are small but tangible benefits on top of buffing your Kolto Infusion.

If you do choose to spec into Curative Agent, the next question is which Legendary utility to drop for it? Revitalizers is still one of the best DCDs in the game: dropping it is out of the question. So the choice is between Curative Agent and Augmented Shields. Curative Agent provides slightly more HPS while Augmented Shields buffs your Shield Probe, which is one of your main DCDs (and on a short cooldown). This decision is yours.

Other Thoughts

Overall, I think these nerfs will make Operative healing in solo ranked even more difficult and disheartening. Prior to 5.5, only a handful of healing Operatives (five or so in all of SWTOR) were able to climb in solo ranked, in a scene dominated by Sorcerer healers (even after the heavy nerfs to Corruption). The flat surge/HPS nerf to Medicine’s rotation is yet another hurdle to overcome in solo ranked. I think the worst part of these nerfs is that TA generation/management will be that much harder in an arena environment. Because of its small format, if you are forced into a 2 vs 2 situation, you will be at a real disadvantage. This is owing not only to your weak burst heals but your inability to generate enough TAs without using Kolto Injection, which has an approx. 2-second cast time and is easily interrupted/pushed back.

In short, Operatives will still be one of the most solid AoE healers in solo/group ranked but weak in small skirmishes, which are commonplace in solo ranked. That’s why I foresee even strong, veteran players struggling after this patch.

In closing, I would argue that Medicine is the most challenging and punishing healing spec to play in PvP—with these nerfs, even more so. Veterans of the spec will struggle slightly more but these changes are in no way “re-roll” scary or “game breaking”. With 5.5, Medicine’s skill ceiling has been raised even further. My concern is that this will discourage new players from trying Medicine or becoming a Medicine main. My message to all those who play or plan to play Medicine is this: don’t quit. These changes aren’t as bad as they look: just make sure to keep your HoTs up and use Nanotech on cooldown. Let’s hope there is more to come in future patches to address Medicine’s weaknesses and make it more appealing to new players.

TL;DR

• TA nerf is punishing for inexperienced players and new players picking up the class. Healing 2–3 players makes TA maintenance really difficult. When healing 3+ players (assuming good Kolto Probe uptime and use of Recuperative Nanotech on cooldown), you should be able to generate enough TAs.
• Changes to Kolto Infusion might prompt you to spec into Curative Agent for more HPS and to drop Augmented Shields.
• I foresee Operatives struggling even more than in previous patches in solo ranked due to the 20% hit to TA generation (Medical Engineering passive).
• Don’t stop playing Operative because of these changes—they aren’t game breaking. Observe good gameplay, be disciplined with your rotation and pay a little more attention to your TA stacks and you will be still be an asset on the battlefield.