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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 her eyes are the dying to be released of their suffering, and the living left to wallow in the dead. Her services have been sought in many an ailing town. Yet despite the reputation, few seem to survive her 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, Dexterity
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 2
2nd +2 Flight of the Doctor 3
3rd +2 Thanatos' Protection 4 2
4th +2 Ability Score Improvement 4 3
5th +3 Fidelity to the Patient 4 3 2
6th +3 Well-Traveled 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 Side Hobby 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 Pulse Chaser 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 Moratorium 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.

You use Wisdom as your spellcasting ability for your Mage spells.

Spell save DC = 8 + Proficiency bonus + Wisdom Modifier

Spell attack modifier = Proficiency bonus + Wisdom Modifier


At 1st level, you know three cantrips which you may choose from the cleric, sorcerer, or wizard spell lists. You learn additional cantrips of your choice at higher levels, as shown in the Cantrips Known column of the Medico table.

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, sorcerer, or wizard spell list of the appropriate level.

Flight of the Doctor[edit]

You're not exactly the type meant for close combat. Starting 2nd level, you may expend your bonus action to disengage and dash in addition.

Thanatos' Protection[edit]

As you walk in step with life and death, you have some leeway when it comes to kicking the bucket. Starting 3rd 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.

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.

Fidelity to the Patient[edit]

A good Medico, more so than even a doctor, has a good relation with the patient and a knack for secret keeping. Starting 5th level, you gain proficiency in the deception skills. Your proficiency bonus doubles for any ability check you make that uses Deception.


The Medico della Peste are people who've gone far and wide. Knowledge of the local dialect is a must. At 6th level, you learn a language of your choice.

Side Hobby[edit]

Dealing with doom and gloom all the time can make one insane. Medico pass spare time lost in hobbies that relieve the stress of their careers. At 10th level, you gain proficiency in one artisan's tool of your choice and one gaming set of your choice.

Pulse Chaser[edit]

Your staff, combined with your attuned magic powers, can now detect all forms of life within your vicinity. Starting at 14th 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. 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.

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 return to the user.


You are able to stop the onslaught of battle from reaching you. When you reach 20th level, after being hit by an attack and taking damage, you may make a reaction to make it so that no damage is done. You may use this feature twice and you regain all uses of this feature after you finish a long rest.


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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