Medico della Peste (5e Class)

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Medico della Peste[edit]

A figure in a white flowing outer garment, wide-brimmed hat, and a beaked mask wanders through the streets of the infected city. Reflected in their eyes are the dying to be released of their suffering, and the living left to wallow in the dead. Their services have been sought in many an ailing town. Yet despite the reputation, few seem to survive their treatments.

Death's Shadow[edit]

The Medico della Peste is a so-called healer of the masses, offering doctoral services to those usually unable to afford them. They are afforded an aura of mystery because, unlike regular Plague Doctors, they can utilize magic in their practices. A trail of death follows, so it's a bit hard to say who trails who in the cycle of illness and death.

Creating a Medico della Peste[edit]


The Medico della Peste is an enigmatic figure who walks the line between life and death constantly, while occasionally filling the shoes of the Grim Reaper. You ought to think about the reason your character became a doctor, and subsequently a Medico. Consult your DM on the situations of pestilence your character may have worked in throughout their lives, and how it shaped their views of life, death and suffering. Why does your Medico commit to this seemingly thankless task? How do they rationalize their choices when treating the dying?

Quick Build

You can make a Medico della Peste quickly by following these suggestions. First, Wisdom should be your highest ability score, followed by Dexterity. Second, choose the Hermit background.

Class Features

As a Medico della Peste you gain the following class features.

Hit Points

Hit Dice: 1d8 per Medico della Peste level
Hit Points at 1st Level: 8 + Constitution modifier
Hit Points at Higher Levels: 1d8 (or 5) + Constitution modifier per Medico della Peste level after 1st


Armor: Light Armor
Weapons: simple weapons, Amputation Knives, Bonesaws, Plague Lancets, Scythes
Tools: Doctor's Tools, Plague Doctor's Case, Herbalism Kit, Poisoner's kit
Saving Throws: Wisdom, Charisma
Skills: Choose two from Insight, Acrobatics, History, Religion, Arcana, Perception, or Intimidation


You start with the following equipment, in addition to the equipment granted by your background:

  • Plague Doctor's Case
  • Fine clothes, in the form of a pure black or white layered coat that reaches the ankles, leather dress shoes, a beaked mask, and a wide brimmed hat
  • an arcane focus
  • a quarterstaff, decorated in the style of Hermes
  • If you are using starting wealth, you have 3d10 gp in funds.

Table: The Medico della Peste

Level Proficiency
Features —Spell Slots per Spell Level—
1st 2nd 3rd 4th 5th 6th 7th 8th 9th
1st +2 Spellcasting, Flight of the Doctor 2
2nd +2 Treatment Specialization 3
3rd +2 4 2
4th +2 Ability Score Improvement 4 3
5th +3 4 3 2
6th +3 Treatment Specialization feature 4 3 3
7th +3 4 3 3 1
8th +3 Ability Score Improvement 4 3 3 2
9th +4 4 3 3 3 1
10th +4 Treatment Specialization feature 4 3 3 3 2
11th +4 4 3 3 3 2 1
12th +4 Ability Score Improvement 4 3 3 3 2 1
13th +5 4 3 3 3 2 1 1
14th +5 Treatment Specialization feature 4 3 3 3 2 1 1
15th +5 4 3 3 3 2 1 1 1
16th +5 Ability Score Improvement 4 3 3 3 2 1 1 1
17th +6 4 3 3 3 2 1 1 1 1
18th +6 Aethereal Lancets 4 3 3 3 3 1 1 1 1
19th +6 Ability Score Improvement 4 3 3 3 3 2 1 1 1
20th +6 Doctor's Recovery 4 3 3 3 3 2 2 1 1


As a doctor well versed in the ways of the mystic, it makes no sense if you didn't know how to use magic to heal. Or kill, whichever you prefer.
You use Wisdom as your spellcasting ability for your spells.

Spell save DC = 8 + Proficiency bonus + Wisdom Modifier

Spell attack modifier = Proficiency bonus + Wisdom Modifier

Casting Spells

The Medico table shows how many spell slots you have to cast your spells of 1st level and higher. To cast one of these spells, you must expend a spell slot of the spell's level or higher. You regain all expended spell slots when you finish a long rest. You prepare each spell only once, imbuing it into your focus. An effective shortcut around the age-old practice of preparing spells each morning, you can cast each as many times as your spell slots will allow.

Learning Spells of 1st Level and Higher

Each time you gain access to a new level of spell, you learn a single spell chosen from the cleric spell list of the appropriate level.

Flight of the Doctor[edit]

You're not exactly the type meant for close combat. As a medic of the field, it's your job to actually run from conflict anyway. Starting 1st level, you may expend your bonus action to disengage and dash.

Treatment Specialization[edit]

Within this specific profession, there are really only two ways you really treat any one. One is death, and the other is actual medicine. At 2nd level, you choose one subclass from either the Follower of Flies, or the Remover of Blight, both detailed at the bottom of the class description. You gain features from your subclass at 2nd, 6th, 10th and 14th levels.

Ability Score Increase[edit]

When you reach 4th level, and again at 8th, 12th, 16th and 19th level, you can increase one ability score of your choice by 2, or you can increase two ability scores of your choice by 1. As normal, you can't increase an ability score above 20 using this feature.

Aethereal Lancets[edit]

In the nightmare scenario you lose your doctor's bag, you remain at beck and call of patients. You must improvise. Luckily, you can conjure solid lancets out of magic that you can control freely.

Starting at 18th level, you gain Aethereal Lancets as a bonus spell which you may cast without using a spell slot. For purposes of Counterspell etc, this spell's level is equal to your proficiency bonus.
Casting time: 1 action
Range: 60 feet
Components: Somatic
Duration: 1d10 turns
You create up to three lancets with magic and magically fling them at your target. Each lancet hits a creature of your choice that you can see within range. The lancets all strike simultaneously and you can direct them to hit one creature or several. On a hit, each lancet deals 4d4 slashing damage. The lancets vanish after the spell ends.

Doctor's Recovery[edit]

Starting 20th level, little rest does a lot for you, as you must be expected to do much with little time for reprieve. You regain up to a level 8 spell slot when you complete a short rest.

Follower of Flies[edit]

You are the half of this profession which specializes in the living. You utilize bizarre treatment options to make patients well according to humorism.


These little buggers are excellent for maintaining the balance of the four humors. Starting 2nd level, by expending an action, you can conjure leeches onto a creature of your choice within 10 feet of you and have one of the following effects occur:

Blood. The target takes one stack of exhaustion.
Yellow Bile. The target becomes overwhelmed by a wave of nausea and can do nothing but vomit uncontrollably until the beginning of their next turn. They are considered incapacitated while vomiting. This has no effect on creatures that do not eat.
Black Bile. The target must succeed a Constitution saving throw (DC 8 + your Wisdom modifier) or get light-headed and suddenly feel faint, falling prone. They may expend half their movement speed on their next turn to get back up.
Phlegm. The target suddenly gets wheezy and feels short of breath. They have disadvantage on Constitution saving throws until the beginning of their next turn, when their breathing returns to normal. This has no effect on creatures that do not need to breathe.

You can use each of the effects once. You regain all use after you finish a long rest.

Pulse Chaser

Your staff, combined with your attuned magic powers, can now detect all forms of life within your vicinity. Starting at 6th level, so long as you physically hold your staff, you can expend an action to sense the activity of all living creatures within a 300 ft radius from yourself and become aware of their locations as well as their condition. You cannot detect constructs or undead with this feature. You may use this feature a number of times equal to your Wisdom modifier, and you regain all uses of this feature after you finish a long rest.

Doctors Orders

You can have your little medical helpers spawn on patients, even if they try to run. Starting 10th level, so long as you know the location of a creature, you may conjure your Leeches on them.

Thanatos' Protection

As you walk in step with life and death, you have earned some leeway when it comes to kicking the bucket. Starting 14th level, you gain advantage on death saving throws. You may touch a creature as an action, giving this feature to them and making you lose access to this feature until you expend a bonus action to recall it to you.

Remover of Blight[edit]

Your job is to put your patients to permanent ease and rest. Sounds relaxing right?

Hearse's Lament

Starting 2nd level, you have had some secret talents that were pushed aside for this job. You gain proficiency in one skill and two artisan's tools of your choice.

Doctor's Immunity

As a person who treats, you must be hardened against what plights may turn on you. You gain immunity to disease and poison at level 6.

Double Dose

You must administer your pacifying treatments quickly and effectively, perhaps two at a time even. At level 10 when you use your action to cast a spell, you may cast an additional spell.

Vengeful Disease

Starting 14th level, you bring fear to those who dare strike at such an important figure to society as yourself. By using a bonus action, you may double the damage die of any spells you cast until the end of your turn. You must finish a long rest to regain use of this feature.


Prerequisites. To qualify for multiclassing into the Medico della Peste class, you must meet these prerequisites: Wisdom 13

Proficiencies. When you multiclass into the Medico della Peste class, you gain the following proficiencies: Medicine

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