Medicine Operative
Last Updated: 3/27/20
Table of Contents
Overview
About the Class
Medicine is a very powerful healing class when played with skill. Medicine specializes in Heal over Time (HoT) effects and powerful AoE healing. Skillful play of Medicine will depend upon balancing the generation and use of Tactical Advantages, a specialized resource specific to all Operative disciplines. Energy management is somewhat easier for Medicine Operatives than Bodyguard Mercenaries but is still very challenging in high stress situations. In most circumstances, Operative healers should output the highest raw healing per second (EPS). The key to mastering the discipline is balancing healing to maximize effective healing per second (eHPS), as unskilled play can result in a lot of “fluff” healing through ticking HoTs on players already at full health or AoE healing where single target healing should be utilized instead.
Utility and Mobility
Operatives have good mobility though overall likely rate slightly lower than the other healing classes due to the inability to burst heal on the move. Exfiltrate is a useful roll for relocating and can be used twice when needed, but I feel it is less useful than Force Speed for Sorcs and Hydraulic Overrides for Mercenaries. Holotraverse is a great option and is able to be used to teleport to a friendly or enemy player (the only gap closer in the game with that feature) but is prone to being buggy so it is generally unwise to rely on it too much. From an ability perspective, Operatives can do great raid healing on the move as Kolto Probe, Surgical Probe and Recuperative Nanotech are all instant. Operatives cannot provide burst single target healing on the move due to the cast times required for Kolto Injection and Kolto Infusion.
From a utility perspective, Operatives bring their own raid buff (though it costs an Tactical Advantage) and have the standard suite of interrupts, stuns, slows, etc. Their greatest utility is definitely the stealth rez capability, which can be re-used during a fight as often as combat stealth is available. Skilled Medicine players can get out 2-3 stealth rezzes on many fights, which is amazingly helpful to salvage a fight and avoid a wipe particularly in HM or progression situations.
Role in Operations
Medicine Operatives excel at group healing. That isn’t to suggest that Medicine is unable to perform well in single target or burst healing, as they can do so in any content in the game. However, more setup is required to enable strong burst healing and knowledge of mechanics is critical to predicting damage so that the Operative can be prepared to heal. The mark of a truly skilled Operative healer is being able to maintain strong team healing while still being able to provide burst heals on demand. When healing with a Sorcerer or Mercenary, the most common (and easiest) set of assignments during stressful phases is to have the Operative focus on raid healing while the other healer focuses on burst healing tanks. Medicine Operatives should also endeavor to be as prepared as possible for stealth rezzes, as if the group does not include a Operative DPS player then they will be the only person able to get out multiple stealth rezzes in an encounter.
6.0 Impact on Discipline
The 6.0 expansion gave Operative healers some powerful buffs and a variety of situationally useful Tactical items and one very strong multi-purpose Tactical. The Tactician set bonus is hands down the ideal one for all Operative players regardless of discipline (healer or DPS). The set bonus should provide buffs of +10% critical chance and +5% healing with a very high uptime, and when paired with the Diagnostics Probe Tactical the discipline’s most powerful burst heal, Kolto Injection, will have a reduced cooldown in most situations. Altogether, the discipline should have more powerful sustained healing, more frequent procs of Tactical Advantage through higher critical chances, and an improved ability to burst heal.
Survivability
Operatives offer good survivability that is best measured like their healing as incremental survivability that adds up during a fight. Via utilities buffing Shield Probe, enabling Kolto Probe to provide a damage resistance buff, and the frequent use of Evasion, Operatives can easily have the best average mitigation of healers. They lack the same ability to cheese mechanics via the Sorc “god bubble” or the Mercenary reflect (Operatives have a reflect but it doesn’t mitigate damage) and they also lack a powerful self heal (Sorcs have an off-GCD self heal and Mercenaries have a self heal cooldown). As such, Operatives do best by being very careful to avoid big hitting mechanics and letting their superior average mitigation play out over time. They do bring situationally powerful utility and survivability for any mechanics where Evasion mitigation and self-cleanse is useful, though do to the use of Evasion being restricted to melee/ranged and its short duration it is only useful for specific mechanics.
Utilities
I usually take some combination of the following Utilities, though the optimal combination can change from fight to fight. As of 6.0, the tiers have been reorganized.
Skillfull Tier
You must take 3 to advanced to Masterful.
Chem-resistant Inlays: 5% damage reduction.
This utility is always a must take, as anything you can do to increase damage mitigation is incredibly helpful.
Nanotech Suit: 30% AoE damage reduction.
This utility is nearly always useful due to most PVE encounters having some AoE damage mechanics.
Infiltrator: 15% extra movement speed and +3 to stealth level.
Due to the low cooldown of Exfiltrate as a movement ability, I do not typically find this utility to be that helpful. However, its alternatives are even less useful as they consist of PVP utilities and a buff to a weak conal AoE attack.
Masterful Tier
You must take 6 between Heroic and Masterful.
Med Shield: Heals you for 5% of your maximum health when defense screen collapses.
You should be using Shield Probe regularly to mitigate damage, so over the course of an operations encounter this will cumulatively grant you a sizeable amount of healing. As such, this is a boost to survivability and should be taken. I also find as a Medicine player that I try as much as possible to rely on 2 stacks of HoTs, defensives, and AoE healing to take care of any self healing so I can focus on healing other team members, so I find buffs to Shield Probe to be very useful in that regard.
Endorphin Rush: Adrenaline Probe immediately restores 15 additional energy.
This utility sounds great but depends greatly on player playstyle. On one side, this lets Medicine go deeper into the red on energy before hitting Adrenaline Probe to regen. That lets Medicine extend burst heal phases. That said, Adrenaline Probe has a long cooldown and can only be used 1-2 times per fight on average. I feel like this isn’t very helpful because (1) it breeds bad habits for Medicine to routinely wreck their energy; and (2) a player can already regen their way back from 45-55% energy with 1-2 channels of Diagnostic Scan. As such, I feel like the default regen from Adrenaline Probe is more than sufficient so long as I discipline myself to use Diagnostic Scan aggressively whenever possible.
Fortified Kolto: While your Kolto Probe is active on yourself, your damage reduction is increased by 3% (can stack x2 to 6%).
This is a mixed bag of a utility. +6% damage reduction here combined with Chem-resistant Inlays and Nanotech Suit gives you +11% damage reduction for single target damage and +41% AoE damage reduction. It is very situational for DPS disciplines as it requires trading DPS for healing (usually not a great trade-off), but is very helpful for healers and should frequently be taken in any fight that has a lot of AoE damage.
Advanced Cloaking: Reduces the cooldown of your combat stealth by 30s and using combat stealth will also increase your movement speed by 50% for 6s.
I view this utility as situational and only should be considered when the player knows that it is likely that several stealth rezzes will be needed in a fight (i.e., in a progression situation or when dealing with very new players). In 6.0 this utility is less useful due to the common availability of combat revival on a 30 second cooldown (instead of a 5 minute cooldown).
Evasive Screen: Using combat stealth grants 2 seconds of Evasion.
This can be useful to enable a second defensive/cleanse, and can be helpful when attempting a stealth rez given Evasion’s use as a purge of DoTs.
Heroic Tier
A maximum of 3 utilities
Evasive Imperative: Every time you get attacked, the active cooldown of Evasion is reduced by 3 seconds (can occur every 1.5 seconds).
Evasion is a great utility that makes you temporarily immune to certain types of damage and can be used as self cleanse. This should be taken nearly always.
Escape Plan: Reduces the cooldown of Escape by 30 seconds, Shield Probe by 5 seconds, and Infiltrate by 60 seconds.
The biggest benefit here in PVE is the Shield Probe cooldown reduction. When combined with the Med Shield utility, this benefit is even better.
Curative Agent: Countermeasures grants Curative Agent, causing your next Kolto Probe on a new target to grant two stacks. Also, Countermeasures heals you for 1% of your maximum health every second for 10s and makes Kolto Infusion provide a combined burst/HoT instead of a burst heal.
I love this utility for Medicine. The instant 2 stack of HoTs is amazing for jump starting burst heals and I feel gives players a lot more cushion to avoid “over-HoT’ing” players. The self heals and Kolto Infusion change are helpful to avoid over-healing through its normal burst heal.
Revitalizers: Stim Boost now also grants Revitalizers, reducing damage taken by 20% for its duration and restores 5% of maximum health every 3 seconds (cumulative heal of 25%).
This utility makes Stim Boost an amazing defensive cooldown and should be taken for any fights that have difficult heal checks, though for other fights it can be substituted for utilities below if they provide more utility.
Augmented Shields: Increases the amount of damage absorbed by Shield Probe by 30%.
If taking Escape Plan and Med Shield to boost Shield Probe, this utility makes a lot of sense. I take this utility over Revitalizers in fights where I know I am going to take steady moderate damage, as in those cases the overall mitigation from Shield Probe over a fight will outweigh Revitalizers’ buff to Stim Boost that can be used 1-2 times per fight.
Blow for Blow: Activating Evasion grants Back at Ya, reflecting 150% of single target force or tech damage during Evasion’s duration.
This utility is worth mentioning even for healers as in progression situations being able to use a reflect to kick out 1-2k DPS without having to sacrifice healing (apart from needing extra self heals for the damage you take while reflecting). I rarely take it but it is an option for skilled players.
Circumvention: Reduces the cooldown of Holotraverse by 10 seconds and allows it to be used while Immobilized, and using Holotraverse now generates an Tactical Advantage.
This utility is great for generating Tactical Advantages for DPS disciplines. I mention it as an FYI but never take it for Medicine since they should be generating lots of Tactical Advantages anyway through HoTs and casting Kolto Injection.
Example Utility Build
Here is what I run for most encounters, though I frequently take other situational utilities for specific fights.
Key Passives
Incisive Action - Reduces the activation time of Kolto Injection by 0.5 seconds and allows it to grant Tactical Advantage when activated.
This passive is notable for making Kolto Injection the only casting ability that is guaranteed to grant an Tactical Advantage. It will not generally be your main source of Tactical Advantages but should be a regular part of the rotation due to its large and energy efficient heal whenever you can spare enough time to cast it.
Prognosis: Critical - Increases the critical chance of Diagnostic Scan and Kolto Waves by 10%.
This passive is notable primarily as it makes Diagnostic Scan significantly more likely to crit and restore energy via the Patient Studies passive.
Surprise Surgery - Exiting Stealth grants 2 stacks of Tactical Advantage. Also, Diagnostic Scan can now be channeled while moving.
Due to this, every fight should begin in stealth to ensure you have 2 stacks. Combat stealth can also be used for this purpose if you have 0 stacks and need them for casting Kolto Infusion.
Medical Engineering - Each tick of Kolto Probe, Recuperative Nanotech, and Kolto Waves has a 10% chance to grant Tactical Advantage. This effect cannot occur more than once every 6 seconds.
This passive is very important. The more ticking heals, particularly Kolto Probe, on people the more efficient your Tactical Advantage generation. Due to this passive, strive to always have ticking HoTs on at least 3 people to ensure you get an Tactical Advantage every 6 seconds or so.
Patient Studies - Increases the speed at which Diagnostic Scan channels by 30%. Also, critical Diagnostic Scan heals restore 2 energy.
This reduces the effective channel time from 3.0 seconds to 2.1 seconds and makes Diagnostic Scan far more effective (if RNG dependent) to regenerating energy. Due to the reduced cast time and presence of 3 ticks, spending 1 GCD then clipping the cast will typically get 2 out of 3 ticks so is usually sufficient in most cases.
Medical Therapy - The energy cost of Recuperative Nanotech is reduced by 5, and targets affected by Recuperative Nanotech are Invigorated (+3% healing from all sources) for 45 seconds.
Notable for the Invigorated debuff, endeavor to use Recuperative Nanotech as least occasionally even outside of heavy AoE situations to maintain this buff on as many people as possible.
Surgical Precision - Increases the max stack limit of Tactical Advantage by 1. Also, Surgical Probe immediately regrants Tactical Advantage once every 10 seconds.
This passive lets Medicine store up to 3 Tactical Advantages, and just as importantly lets Surgical Probe refund its Tactical Advantage once every 10 seconds. These are hugely influential to the frequency of using Surgical Probe in the rotation discussion below.
Accomplished Doctor - Increases the critical healing bonus of Kolto Injection and Kolto Infusion by 10%. Also, healing a target with Surgical Probe will refresh the duration of your Kolto Probe on that target, if that target has 2 stacks of your Kolto Probe.
The critical bonus is nice but the refresh capability of Surgical Probe is enormously powerful. See the discussion of Surgical Probe further below, but in short Medicine should be looking to refresh as many HoTs as possible using this process.
Medical Consult - Increases the critical chance of Kolto Probe by 3%. Also, Kolto Infusion makes it target Resistant (+3% internal/elemental resistance) for 45 seconds.
Notable for providing a helpful damage resistance that should be maintained on tanks as much as possible. Since Kolto Infusion is arguably the “best” heal for Medicine since it has burst and a HoT component, try to save Kolto Infusion for tanks most of the time.
Tactical Medicine - Exploiting an Tactical Advantage with a healing ability increases all healing done by 3% for 6 seconds. Also, the range of Toxic Haze is increased by 30 meters.
This passive boost to all heals is very short duration but 3% is still very nice, so this should be maintained as much as possible. Generally casting Kolto Infusion on cooldown, using Surgical Probe after most casts of Kolto Injection, and using Surgical Probe to refresh HoTs should take care of managing very high uptime of this buff.
Enduring Kolto - Increases the duration of Kolto Probe by 3 seconds. Also, Stim Boost grants Enduring Kolto when activated, making your next Kolto Infusion or Kolto Injection activate instantly.
The duration is helpful to get more power out of HoTs and have to refresh them less often. The key to this passive is the buff to Stim Boost. I try to save Stim Boost for unexpected burst situations as my “oh s**t” button. Using Stim Boost to instant cast Kolto Injection (grants 1 UH) then Kolto Infusion provides a really powerful combo of single target heals that rivals any punch Sorcs or Mercenaries can offer.
Curative Jolt - Kolto Infusion grants Curative Jolt, increasing the critical chance of your next Surgical Probe by 100%.
This effect can only occur once every 18 seconds. This passive explains why Surgical Probe will glow every so often. If the Tactical Advantages are available, this makes Kolto Infusion > Surgical Probe (glowing) a powerful and very energy efficient healing combo.
Gearing in 6.0
Gearing Stat Allocation
Please see my Gearing Guide for a detailed overview of gearing in 6.x in SWTOR.
For Medicine Operative, I gear as follows:
Set Bonus: Tactician
Tactical: Diagnostics Probe (I sometimes take Critical Surgery instead and may swap to Regenerative Waves for heavy AoE healing encounters)
Amplifiers: Medtech & Periodic Restoration (I mostly use Periodic Restoration but have a few Medtech as well)
Mods: Unlettered Lethal Mods
Relics: Devastating Vengeance & Primeval Fatesealer (Serendipitous Assault & Focused Retribution for Dxun/PVP)
Stim: Proficient
Adrenal: Critical (Triage for Dxun only)
For Medicine Operative, I allocate my tertiary stats as follows:
Accuracy: 264 (Heals don't miss! However I run a Proficient Stim in capped content so get some Accuracy, and may occasionally run a bit more Accuracy for a few prog fights like Revan where healers need to get an interrupt and want to avoid their interrupts missing.)
Alacrity: >2,204 for the 1.3s GCD w/ guild perk or 1.4s GCD w/o guild perk. At this level of alacrity you reach a breakpoint in energy regeneration that can be very helpful and is conveniently very nearly the same regardless of whether you are running the guild perk or not! The alternative (standard) approach is 1,895 w/ guild perk for 1.3s GCD or >1,213 w/o guild perk for 1.4s GCD.
Critical: all remaining tertiary points go into Critical
Shield: None
Absorb: None
Set Bonus
Tactician
Increased drop rate from conquest.
(2) +2% Mastery
(4) Tactical Overdrive additionally resets the cooldown Sever Tendon and Toxic Scan. Gaining an Tactical Advantage increases your Critical Chance by 10% for 10 seconds. Can only happen once every 18 seconds.
(6) Tactical Advantage gets an additional stack. Having an Tactical Advantage increases your damage and healing by 5%.
Analysis: A really great set bonus, Tactician should provide very high uptime on both the +10% Critical Chance buff and the +5% damage/healing. Medicine should always have HoTs ticking on multiple targets that lead to frequent procs to generate Tactical Advantage via the Medical Engineering passive. In addition, healers can and should be regularly using Surgical Probe to refund an Tactical Advantage via the Surgical Precision passive. Finally, healers should be casting Kolto Injection regularly for baseline heals, which also generates an Tactical Advantage to proc the 4 piece set bonus. Given these many sources, healers should have more than half uptime on the +10% Critical Chance buff and should always keep at least 1 to maintain the 5% healing buff.
In addition, the extra charge is very helpful as well. For healers, it makes running HoTs on multiple targets more energy efficient via an extra charge to refresh a double stack of Kolto Probe. It also makes it easier for healers to avoid over-healing by using Surgical Probe to refresh HoTs on players more often in lieu of Kolto Injection or Kolto Infusion, more powerful heals that may not always be needed to top off someone at 80% or so health.
Impact on Rotation: No change in priority. Generating Tactical Advantage as quickly as possible has always been a rotational priority. Running the same priority system as in 5.X will take full advantage of this set bonus.
When to Take: All situations. The Aggressive Treatment set bonus has some interesting potential options for AoE healing by making Toxic Haze free and causing it to provide an AoE healing effect similar to Kolto Waves. This could give Medicine out-of-this-world AoE sustained healing via spam of Kolto Waves, Recuperative Nanotech and Toxic Haze (while also providing some additional DPS). With all that said, Operative is already really strong at AoE healing, so Tactician’s broader healing buff is optimal in nearly all circumstances.
Aggressive Treatment
Increased drop rate from operations.
(2) +2% Alacrity rating
(4) Toxic Haze refunds all its energy.
(6) Toxic Haze heals any allies standing inside it by a minor amount.
Analysis: This set bonus offers a substantial increase to the already-impressive AoE healing capability of Medicine Operative. Early testing indicates that with the set bonus Toxic Haze over its duration heals for approximately the same as Kolto Waves. It has a 15 second cooldown that is slightly longer than Kolto Waves, but is still fairly low. The capability for a healer to apply HoTs to 4 players via Recuperative Nanotech, drop a Toxic Haze for its AoE heal, then channel Kolto Waves (all while HoTs are ticking on 3-4 targets), is really powerful for sustained AoE healing. It is also worth noting that if the group stacks near the boss (which usually will be optimal so as to include the tank(s) and melee DPS in the AoE healing), that a decent amount of damage will be done by Toxic Haze without sacrificing any healing.
The downside is that outside of very heavy AoE damage phases (e.g., Gharj in hard mode, Dread Council burn phase, Red encounter in the Dxun operation), in any other case the extra AoE heal has very low utility and likely will result in lots of overhealing and ineffective heals. It still provides some utility via its free energy cost, making it a good way to provide some heals while energy is tight.
Impact on Rotation: Use on cooldown in any AoE situations. Outside AoE, save its use for when energy is relatively low and try to always place it so that it provides effective heals for its full amount on at least 3 players.
When to Take: Fights with very heavy AoE damage. This set will be strictly inferior to Tactician in the vast majority of encounters, so it is only recommended when/if a player has excess Tech fragments to have a second set bonus or if it is acquired naturally through RNG drops (and when/if augmenting and min-maxing amplifiers on a second set bonus set is affordable). In all honesty, Aggressive Treatment will likely see its primary use for prog healers for AoE healing fights or for memes to see how ridiculously high they can push healing parse numbers on AoE heavy fights.
Tactical Items
Diagnostics Probe
Increased drop rate from flashpoints.
Activating Surgical Probe reduces the cast time of your next Kolto Injection by 0.25 seconds. At 3 stacks, Kolto Injection can be cast instantly and consumes all stacks.
Analysis: As discussed below in Key Abilities, Kolto Injection is the discipline’s most powerful single target heal. A really common “filler combo” for Medicine is to chain together Kolto Injection + Surgical Probe, since it comes very close to energy neutral and immediately spends the Tactical Advantage generated by the cast (hopefully to refresh a double stack of HoTs on someone).
Even if that is the only use of Surgical Probe, that still essentially guarantees each use of Kolto Injection will have its cast time reduced (pre-alacrity) from 2.0 seconds to 1.75 seconds. That alone will improve the HPS provided by your biggest heal by 14% due to the reduced cast time! When you consider that you should be using Surgical Probe more often to burn excess Tactical Advantage and to refresh HoTs on players, the benefit is even more!
It is worth noting that there is no difference in HPS provided between 2 and 3 stacks of this Tactical. At 2 or 3 stacks, the cooldown of Kolto Injection is reduced to the global cooldown. At this cooldown, the HPS increase should be 33%!! The third stack is useful only to make the ability an instant cast that can be used on the move.
Impact on Rotation: Healers can follow the same priority or “rotation” as in 5.X and should see a strong benefit from the reduced cast time on Kolto Injection. That said, optimal play will usually be to only cast Kolto Injection at 2 stacks from this Tactical, as that provides the greatest increase in HPS relative to the number of uses of Surgical Probe required. When predictable burst healing is required, pre-emptively stacking 3 charges of this Tactical to enable an instant Kolto Injection may be situationally useful. Finally, in any high movement fights either 2 stacks (to minimize the cast time) or 3 stacks (to be instant) should be leveraged based on the need to refresh HoTs to improve burst healing on the move.
When to Take: Diagnostics Probe should be optimal on most fights. Combat Medic Training is very helpful for movement but does not provide any direct increase in healing output. Critical Surgery is helpful for emergency triage healing when players are below 50% health but its buff is to the weakest individual heal in the Medicine healing kit and due to the discipline’s playstyle they perform best by pro-actively keeping players above 50% health anyway. Lastly, Regenerative Waves is nice for some extra punch to AoE healing but Medicine is already very strong for AoE healing so that is unnecessary.
Critical Surgery
Increased drop rate from operations.
Surgical Probe always critically hits on targets below 50% health.
Analysis: This tactical is helpful for triage situations. Surgical Probe being used on a player with 2 stacks of Kolto Probe is by far the most energy efficient heal between the ability base heal, the extra tick from both HoTs, and refreshing the HoT duration. Where Operative can sometimes struggle is trying to balance burst healing while maintaining HoTs on various targets, as not using Surgical Probe to refresh HoTs will reduce overall sustained healing but on its own is usually not enough burst healing as compared to a hard cast of Kolto Infusion or Kolto Injection.
This tactical makes Surgical Probe much more reliable in triage situations by guaranteeing it will do at least 50% more healing. That along with the additional HoT ticks and refreshing the duration on HoTs should be enough to stabilize any non-tank in most fights (where big hits are usually infrequent and predictable). The more often a Operative healer can rely on HoTs and Surgical Probe to their healing the better their energy situation (and reserve for burst healing) will be to handle the unexpected.
The downside to this Tactical is that it runs counter to the overall goals of the discipline. Operative healers are most powerful focusing their heals on players in the 50% - 80% range. At those levels, players are unlikely to die in the next GCD but still have enough room to heal that overhealing is not a major concern as HoTs play out. In most phases of a fight, you would only expect the tank(s) to be consistently and regularly below 50% and to need much more powerful burst healing than Surgical Probe can provide on its own.
Impact on Rotation: In situations where you need to refresh HoTs and have insufficient Tactical Advantage for everyone, prioritize using Surgical Probe to refresh HoTs on players with health below 50% to maximize the usage of the tactical buff. Manually refresh HoTs on anyone left using Kolto Probe.
When to Take: It is a good choice if Diagnostics Probe is not available.
Regenerative Waves
Increased drop rate from flashpoints.
Kolto Waves consumes an Tactical Advantage and heals 20% more per tick.
Analysis: Regenerative Waves provides an AoE healing buff to Operative healing that is already very strong at AoE sustained healing. This tactical synergizes well with the Tactician set bonus providing a fourth Tactical Advantage, which makes the change in Kolto Waves cost barely noticeable in practice.
With respect to AoE healing, Regenerative Waves + Tactician set bonus is unlikely to provide as strong AoE healing as Regenerative Waves + Aggressive Treatment set bonus, but will definitely provide stronger throughput single target healing. Also, the Tactician set bonus’ high uptime 15% critical chance buff and 5% healing buff go a fair way towards offsetting the lack of a Toxic Haze free AoE heal provided by the Aggressive Treatment set bonus.
Impact on Rotation: No change. This tactical item buffs Kolto Waves but does not change the analysis as to when it should be employed.
When to Take: Encounters with heavy AoE healing (e.g., Underlurker in Temple of Sacrifice, Red in Dxun). This tactical is a must-have since it provides a heavy boost and lets Operative really carry an operations group through heavy AoE healing checks, and is a much better alternative given the cost of obtaining one tactical item versus grinding (and augmenting and min-maxing amplifiers) for an Aggressive Treatment set.
Amplifiers
Medtech or Periodic Restoration
Medicine is a tech-based healing class so Medtech (increases tech healing) is a good choice for amplifiers to buff all healing output. Running Medtech amplifiers on all armoring/barrel items modifications and with one item being an Amplified Champion piece getting an extra Amplifier at reduced benefit, the discipline can see up to a 9% or so increase in healing output via Amplifiers. Theorycrafting generally suggests Medtech is the optimal choice.
An alternative is the Periodic Restoration amplifier buff that applies a stronger base increase to healing but is limited to heal-over-time (HoT) effects. The maximum buff can exceed 20%. As such, it is up to the player whether they prefer significantly stronger HoTs or a smaller increase to all healing abilities. If going with this set-up, the player should be aware and try to emphasize Kolto Probe and Recuperative Nanotech especially when healing to maximize the benefit.
Key Abilities
Tactical Overdrive (instant, free, 3 minute cooldown) NEW IN 6.0 - Resets the cooldown of Stim Boost, Recuperative Nanotech, Volatile Substance, Lethal Strike, and Shield Probe and increases your Mastery by 20% for 15 seconds.
A new cooldown in 6.0, it provides both offensive and defensive boosts.
Diagnostic Scan (2.1s channel, free, no cooldown, range 30m) - Heals a friendly target for a low amount over 3 seconds.
Diagnostic Scan is Medicine’s free filler heal. It is notable for the Patient Studies passive which makes crits restore 2 energy. As such, Diagnostic Scan should be used whenever energy drops below 60%. The ability ticks three times, so it is possible to clip the cast after 1 GCD if just using for energy regen purpose.
Kolto Probe (10 energy, 21s duration, no cooldown, range 30m) - Heals a low amount over 21 seconds. Stacks up to 2 times.
Kolto Probe is the foundation of the Medicine healer as a HoT healing discipline. The HoT provides gradual heals, as with 2 stacks it should heal for around 7-9% of max health over 21 seconds.
Best At: Providing energy efficient raw healing over time
When to Use: Anytime you are not in a “stressful” healing situation, apply to other players. The more the encounter leans towards AoE damage, the most players you should keep on.
When Not to Use: In the middle of high stress burst healing situations.
Surgical Probe (5 energy, no cooldown, range 30m) - Exploits Tactical Advantage to instantly heal the target for a low amount. Requires and consumes 1 Tactical Advantage.
Surgical Probe is a really powerful ability when used correctly due to (1) its very low energy cost (half that of Kolto Probe); (2) its periodic refund of an Tactical Advantage every 10 seconds; and most importantly (3) its ability to refresh a 2 stack of Kolto Probe. Using Surgical Probe to refresh 2 stacks of HoTs does the base heal for Surgical Probe and forces the 2 HoTs to tick immediately, which provides a reasonable amount of instant healing and is arguable the most energy efficient heal in the game when considering the long term HoT healing for 2 stacks of HoTs. A good rotation looks to maximize the use of Surgical Probe without delaying Kolto Infusion.
Best At: Providing instant moderate burst heals, providing energy efficient heal through its own heal plus the additional heals provided by refreshing 2 stacks of Kolto Probe. topping off a player without HoTs when at 90% or so health.
When to Use: (If HoTs not on player) use in lieu of a HoT when at 85-90% to mostly heal them to full health. (If HoTs on player) use at the beginning of a burst heal combo to get some instant heals (since Kolto Infusion and Kolto Injection both have cast times), use to refresh HoTs instead of recasting Kolto Probe since it costs less energy and provides more overall healing.
When Not to Use: Any time you are certain you can complete a cast of Kolto Infusion or Kolto Injection before the player dies, or anytime you can predict damage and can pre-cast those abilities.
Kolto Infusion (20 energy, 9s cooldown, range 30m) - Exploits your Tactical Advantage to heal the target for a medium amount. Requires and consumes 1 Tactical Advantage.
Kolto Infusion is the most well rounded healing ability in a Medicine’s kit, as it provides a powerful heal in a 1 GCD cast time. The only negative is the requirement for an Tactical Advantage, though given the abundant ways to generate Tactical Advantages for Medicine this isn’t a huge issue. Kolto Infusion is the one ability that should be used very nearly on cooldown. As it grants a helpful I/E damage resistance buff, it should be prioritized for tanks most of the time.
Best At: Best overall cast healing ability.
When to Use: Anytime you need burst healing and an Tactical Advantage is available.
When Not to Use: In very high AoE damage phase, it may be preferable to avoid its use to save the Tactical Advantage for using Surgical Probe to refresh HoTs in between casts of AoE heals.
Kolto Injection (20 energy, 2s cast time, no cooldown, range 30m) - Heals a friendly target for a large amount.
Kolto Injection is a very powerful but long cast time heal. It also generates an Tactical Advantage and (due to the longer cast time) is relatively energy efficient due to natural energy regeneration during its cast time. A healing combo of Kolto Injection > Surgical Probe (to refresh a 2 stack of HoTs) is a good healing combo to get a tank from half to mostly full health. When Kolto Infusion is on cooldown, Kolto Injection is the Medicine only way to burst heal. Knowing when to cast Kolto Injection v. HoTs (and knowing which one should go first in which situation) is a big key to successful prog healing as a Operative.
Best At: Most energy efficient cast healing ability
When to Use: When you are need burst healing and are sure the target will live the 1.5 GCD cast time, any time healing is not stressful (due to it being very energy efficient), any time you are not capped on Tactical Advantages. Situationally, it is a great ability to use within an AoE rotation to provide some burst healing to the tank.
When Not to Use: When the target may die before the cast completes, during AoE healing it should be used very sparingly.
Recuperative Nanotech (15 energy, 15s cooldown, range 30m) - Heals the target and up to 3 allies within 10 meters for a low amount over 9 seconds.
Recuperative Nanotech provides the second primary HoT ability for Operatives and is very energy efficient when it is affecting at least 3 (preferably 4) players and is providing effective healing. In AoE situations it should be used on cooldown. In single target situations, it is recommended to use on a tank to provide some healing to melee DPS that are nearby.
Best At: Low level AoE healing, AoE healing on the move
When to Use: When at least 2 players will benefit from its HoT, when needing to AoE heal on the move, any AoE sustained healing situation, when primarily single target burst healing but a little AoE healing would be helpful (but not enough to warrant stacking HoTs or Kolto Waves)
When Not to Use: It should be used after Kolto Waves in burst AoE healing situations, it doesn’t have much place in single target rotations
Kolto Waves (28 energy, 3s channel, 10s cooldown, range 30m) - Heals up to 8 allies that remain within 8 meters of the targeted area for a medium amount over the channel duration.
Kolto Waves and its very short cooldown are the primary reason Medicine Operatives are the kings of AoE healing. In AoE situations where the 8 person team is grouped up (e.g., burn phase in Dread Council fight in Dread Palace operation), Medicine can output amazing healing. The challenge outside of large AoE situations is knowing when it should be used versus Recuperative Nanotech and spreading single target healing. I usually feel like Kolto Waves is fine to use when it hits at least 4 players or when 2 players need moderate healing immediately or they will die.
Best At: Powerful channelled AoE healing
When to Use: When AoE healing is needed and the AoE will affect at least 3-4 players, use to stabilize in AoE healing if HoTs are not rolling on players
When Not to Use: Any single target healing situations
Toxin Scan (10 energy, 12s duration, range 30M) - Cleanse ability that will cleanse up two 2 Tech/Mental/Physical debuffs or DoTs. Does not cleanse Force debuffs/DoTs.
The Medicine cleanse is notable for not cleansing Force debuffs but can cleanse the overwhelming majority of cleanseable debuffs in operations. The main point to note is that Medicine should generally use Toxin Scan to cleanse other players, as Evasion and potentially combat stealth (with utility grants Evasion as well) can be used to self-cleanse.
Rotation
PLEASE NOTE THAT THE ROTATION BELOW IS BASED ON THE 5.X ROTATION AND DOES NOT INCLUDE ANY CONSIDERATIONS FOR 6.0 SET BONUS AND/OR TACTICAL ITEMS UNLESS OTHERWISE NOTED. PLEASE SEE THE ‘GEARING IN 6.0’ DISCUSSION ABOVE FOR DETAILS OF HOW TO MODIFY THIS ROTATION DEPENDING ON YOUR USE OF 6.0 SET BONUS AND/OR TACTICAL ITEMS.
Healing Combos
Healing is a very reactive class compared to tanks (defined high threat rotation intermingled with taunts) and DPS (very defined rotation/priority system). As such, it is easier to think in terms of healing “combos” that will vary depending on the situation. Here are some of the most common situations and how a Medicine might generally approach them.
Two quick caveats though. First, healers have different philosophies that guide their choice of heals in any given situation. Medicine especially has to choose between highly efficient healing over time via HoTs and Surgical Probe use, and stronger but more expensive burst healing through Kolto Infusion and Kolto Injection. Some healers prefer to be proactive and try to get everyone relatively high quickly, thereby saving time later to regen energy if needed. Other healers try to maintain great energy states even if it means letting health levels go a little lower than average, trusting in their knowledge of fights to predict damage phases and letting HoTs do the work.
My philosophy is to try and split the difference. I try to prioritize healing people into the 80-90% health range and then letting HoTs do the rest of the work. I also try to be aggressive in healing even if it means going a little below 60% energy when I know the fight will permit me some recovery time.
A second and related point is managing effective heals. Some healers prefer again to be proactive in healing to full and maintaining HoTs on as many players as possible, usually due to a philosophy that having HoTs ticking on many targets will provide a cushion for healing that enables Medicine to get their big casts of for Kolto Infusion and Kolto Injection. This is certainly needed to a degree but when overdone can lead to massive overhealing and wasted energy that can leave the player without enough energy to heal through difficult burn phases.
Again, my philosophy is to split the difference. Having HoTs ticking when damage hits is critical to effective, timely and efficient healing. That said, I hate overhealing and try to hoard my energy as much as I can. I keep HoTs on the main tank, off-tank (if the fight results in them tanking a second boss or taking steady damage), and maybe 1 other player (or 2 if the off-tank doesn’t need HoTs). I only HoT up a lot of players if I know a big damage phase is coming.
All of this is to simply emphasize that the below works for me but may not work for your philosophy to healing, approach to fights, and comfort level with players being less than 100%. Especially if you are not as familiar with operation mechanics and damage phases, it is usually best to err on the side of being more aggressive and tolerating more overhealing in order to maximize the healing when you need it. Just be aware that overhealing wastes energy so try to pick your spots.
Everyone has Max Health:
1
2
Kolto Probe - 2 stacks on both tanks, self, and may be any other players likely to take sustained damage in upcoming mechanics
Diagnostic Scan - If not at max energy or to quickly recover after setting up the HoTs
Need to provide larger burst heals to a single target (w/ 2 HoTs on target):
1
2
3
4
Surgical Probe - Refreshes HoTs, provides a small immediate heal and causes both HoTs to tick, collectively gives them a little immediate recovery and hopefully enough cushion to get a cast off to provide larger heals
Kolto Infusion - Most effective heal and in 1 GCD
Kolto Injection - Thanks to earlier heals, should have enough cushion to get the bigger cast heal off here
Surgical Probe - Kolto Injection generated an extra TA so using here to get a little extra cheap heals to compensate for the high energy cost of Kolto Infusion + Kolto Injection
Summary - This is a relatively energy efficient combo that can heal for easily half of a player’s health bar or more. It should also leave the player with a fresh 2 stack of HoTs that can gradually heal another 10-15% of a health bar while you move on to other players needing triage.
Need to provide large burst heals to a single target (w/o HoTs):
1
5
2
3
4
Kolto Infusion - Most effective heal in 1 GCD, gives cushion for a larger cast heal
Kolto Injection - Bigger heal over a longer time
Kolto Probe #1 (if tank or likely to take additional damage soon) - This depends on the circumstances but if there is a need to burst heal (player is below 50-60%) the 2 previous GCDs are unlikely to have healed them to full. As such, the best course of action is to get a 2 HoT stack going to cover another 10-15% healing while you move on to other players.
Kolto Probe #2
Diagnostic Scan - These four abilities collectively will take a lot of energy, which will mandate a quick channel of Diagnostic Scan to recover energy
Summary - This is a less effective healing combo due to the lack of HoTs and provides significantly less healing over the same 4 GCDs at a much higher cost. It is okay but the key takeaway is the importance of having HoTs on several players.
Need to provide a medium burst heal and small heal to 2 players, low/medium stress:
1
2
Kolto Injection - Provides a large burst heal
Surgical Probe - Spending the Tactical Advantage generated by Kolto Injection
Summary - This is a small combo but one that should be used regularly as it is very close to energy neutral and Tactical Advantage neutral.
Need to provide burst heals to tank with low steady AoE damage (w/ 2 HoTs, medium stress):
1
5
2
3
4
Surgical Probe - If a Tactical Advantage is available, provides some immediate heals and refreshes HoTs
Kolto Injection - Big burst heal to tank
Kolto Infusion - Second burst heal to tank, spending TA generated by Kolto Injection
Recuperative Nanotech - Providing some low AoE healing now that tank is topped off
Diagnostic Scan - Will need to regen some energy after this combo
Summary - This provides some heavy burst healing and slips in some AoE. Depending on how much AoE healing is needed and how many players are nearby, Kolto Waves could be substituted for Recuperative Nanotech.
Need burst heals to tank with high steady AoE damage (w/ 2 HoTs on several players):
1
5
9
13
2
6
10
14
3
7
11
15
4
8
12
16
Kolto Waves - Provides strong burst AoE healing and collectively about as much immediate healing to the tank as Surgical Probe would
Stim Boost - Used to proc an instant cast heal in the next GCD
Kolto Injection (Instant) - Providing an instant Kolto Injection heal gives the tank some needed cushion, which along with Kolto Waves should provide 1-2 GCDs of stabilization to steady energy levels and move to efficient healing
Surgical Probe - Refreshes HoTs and gives some less expensive healing
Diagnostic Scan - Using another cast ability here would likely go below 60% so a Diagnostic Scan channel is required unless Adrenaline Probe is available
Recuperative Nanotech - Providing another set of AoE HoTs to nearby players
Kolto Infusion - More burst heals for the tank
Surgical Probe - We are relatively low on energy at this point, so a cheap heal provides some incremental healing and refreshes a 2nd stack of HoTs
Diagnostic Scan - Regenerating energy for more casts
Surgical Probe - Refreshing HoTs on 3nd player to avoid expiration
Kolto Waves - Adding more burst AoE healing
Diagnostic Scan - Regen of energy
Kolto Injection - Providing burst heals to tank
Diagnostic Scan - More energy regen
Surgical Probe - Refreshing HoTs on 1st player
Kolto Infusion - Final burst healing in rotation
Summary - This is an example of a much more extended healing phase while trying to manage burst single target heals, HoTs on 3 players, and AoE healing for the group. The key takeaway is that there is no way to burst heal without sprinkling in some Diagnostic Scans every 3-4 GCDs. In a lower stress scenario, it is likely possible to sprinkle in more Surgical Probes and trying to add more HoTs.
Energy Management
Energy management for Operatives depends mostly on a healer’s ability to judge how many HoTs can and should be maintained on players at a time as well as when single target burst heals are needed versus letting the HoTs gradually top off health bars. The biggest downfall for Operatives healers in energy management is trying to maintain HoTs on the entire ops team. This leads to wasted energy, overhealing, and leaves relatively few GCDs for burst healing. The next biggest downfall is being afraid to use Diagnostic Scan or to temporarily dip below 60% for 1-2 GCDs. When HoTs are ticking, taking a GCD off in between damage phases to regen is doable in every fight in the game as long as you now when it is safe to do so.
Come up with a strategy to monitor the duration of Kolto Probes and know when to refresh them (preferably relatively close to their expiration but without letting them expire). There are various ways and some even create timers in parsing tools. Personally, I usually maintain 2 stacks of HoTs on myself (to get the extra DR via utility) and then monitor the stacks on my bar to determine when to refresh them. By putting mine on first, I know whenever I refresh mine I need to refresh the other HoTs.
Be extremely careful about when to HoT more than 3 or so targets (preferably both tanks, yourself, and maybe a melee DPS if you know they will be taking consistent damage that a periodic Recuperative Nanotech can’t handle). Some Operative healers insist you should HoT at least 5 if not the entire 8 person ops group. Let me be very clear....THEY ARE WRONG.
Outside of really big AoE healing situations (in which Operatives already have really strong AoEs), putting HoTs on more than 3 targets (4 with the Tactician set bonus or maybe 5 at the very most) is a bad idea for several reasons. It becomes very difficult logistically to track them and refresh them on time, and if you can’t refresh 2 stacks with 1 Kolto Probe or Surgical Probe then the efficiency of the strategy is lost. The real power of Kolto Probe is when you can refresh most with Surgical Probe, which simply isn’t possible with more than 3 HoTs in most instances due to the internal rate limit on proccing Tactical Advantages. Also, HoTs on so many targets nearly always leads to significant over-healing that isn’t useful, as relatively few fights have such intense AoE healing on the entire raid. Lastly, it leaves the healer unable to provide burst heals to players because they are spending 8 out of every 14 GCDs refreshing HoTs.
Try to use Surgical Probe as often as possible and try to always use it to refresh 2 stacks of Kolto Probes. The more often you can use this strategy for HoTs versus using Kolto Probe to refresh, or worst of all by having to recast 2 stacks, the better and more energy efficient your healing will be.
Avoid putting just 1 stack of Kolto Probe on targets whenever possible. You can’t refresh just 1 stack with Surgical Probe, as 2 are necessary for it to work. You can’t always predict when damage will go out so it is usually best to put the extra stack so that later you can refresh with the highly efficient Surgical Probe.
The only exception to the above is a non-tank player in the 85-95% HP range. Assuming the operation does not have any impending high AoE damage or other mechanics that might expose them to lots of damage, I find putting 1 Kolto Probe is enough to mostly top them off. That approach is more energy efficient than using 2 HoTs (would overheal) or casting Kolto Infusion or Kolto Injection (as those would take more energy, may use an Tactical Advantage and likely overheal).
Try to be very proactive in using Diagnostic Scan. I always want to be in the 80-85% energy range on average, as it leaves me close enough to full to leave room to burst heal but avoiding capping energy that could be spent healing. Any time I get into the 60-75% range, I look really hard for a single GCD where I can channel Diagnostic Scan safely.
I find as a Operative healer that dipping into the high 40’s or low 50’s on energy isn’t a big deal if you burst heal and can afford to channel Diagnostic Scan twice in a row afterwards. A full channel of Diagnostic Scan in the middle energy regen area should regen 7 energy naturally plus anywhere from 4-8 energy from crits, so 11-18 total energy. If you can channel Diagnostic Scan fully twice consecutively, you can go from 50% to 72-86% depending on your crits.
That said, being proactive is key here. You can output a LOT of healing going from 85% energy to 45% energy, but far far less going from 65% to 45%, so try to be ahead of the game on energy management.
I highly suggest the Curative Agent utility both for burst healing and for energy management. Using your threat drop ability causes Kolto Probe to grant 2 stacks the next time you use it on a target that doesn’t have any stacks. This gets you double the healing for the same cost. I find it incredibly useful to jump start burst AoE healing phases by letting me put a double stack on a player. That energy efficiency lets me handle burst phases for longer before energy levels get so low to force me to start sprinkling in Diagnostic Scan.
Get familiar with triage in stressful healing situations. Overall healing output isn’t an issue for Operatives - if you see a group that is all taking damage, that is when Operatives really shine compared to their counterparts. That said, it means you need to be really careful about identifying players in danger of dying before your HoTs and AoEs can heal them up. Tanks getting below 50%, DPS/healers getting below 30% when no major damage is expected or below 50% where high damage is possible. Be as strategic with healing as possible and know your fights to know when the DPS at 50% health will be fine by leaving 2 HoTs on them and refreshing periodically with Surgical Probe.
As much as possible, try to use the Kolto Injection > Surgical Probe combo. Kolto Injection is reasonably energy efficient given its longer cast time and Surgical Probe is very cheap. Especially if the target has 2 HoTs going, heals by this combo (as well as ongoing heals from the HoTs, and the future healing by the refreshed HoTs) are very powerful and energy efficient. It also works great to divide up a big heal and small heal to two players - Kolto Injection on the player needing a bigger heal and Surgical Probe on the player needing a top off.
Be thoughtful about when to use Kolto Waves as it is expensive. Based on your gear, learn how much of a player’s health bar it will typically heal (including the potential for several crits during its channel). Then you can visually determine if 3 or more players are close enough and low enough to make it worthwhile. If 3 players will benefit from its full channel, then it is fairly neutral and provides good burst compared to other healing options. If 4 or more players will benefit, it is an amazing heal and should be used on cooldown as long as that continues to be the case.