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I agree on the medical training part from the RW perspective, but not necessary from game logic one. You do get something great in here, with the med training stuff - but it cannot be too hard to come by. One - you would actually turn a lot of wounds for death sentences for players, and that would be frustrating. Two - because it needs to come to play, otherwise the whole thing is needless complexity for no payoff. It IS oh so tempting to make sure there will be situation where you risk your one and only doctor. But this could cost way too much in terms of gameplay. Implement that system badly and full team wipe-outs due to lack of medical staff are sure to ensue in horrifying numbers.

It may be harder to come by than you think. Is any of your friends a doctor? If yes, ask them. There's a reason why they're paid so well (or used to anyway).

If you read my rules carefully, the only patients that are "doomed" are those who are in the "dying" state. Everyone else will heal on their own. But they will heal very slowly without a doctor around. It is very important to have medical personnel. That means that doctors are not front line fighters. If a situation gets dire they may need to defend themselves. But be prepared that things go bad in that case. But I think if it gets so rough that you absolutely need to count on your last guy, you have a wipe-out on your hands anyway.

For me personally it would be weird if you took, let's say, a deep space miner, gave him a 2 week crash course in human anatomy and he would be able to perform surgery on a dying colonist.

And one more thing on first aid / medical skills. I LOVE the separation, but I don't love having two very similar skills. I would propose one "Medical" skill, that works as first aid if not a speciality and works as a medical skill when colonist reaches first point of speciality in it.

There's a very specific reason why I kept the two separated: To perform actual medical treatment/surgery as opposed to first aid, you need someone who is medically trained. Medical training takes a long time and very good training facilities. I don't see a way to get medical training in the circumstances our colonists find themselves in. That's why I think the medical skill should be deactivated for all colonists who did not go through med school (or something similar) in their past.

Also, I think in a game where you will be able to control upwards of 20 individuals, you should be able to judge their health status instantly by looking at them (or their health bar). Otherwise it will get too fiddly.

But, again I'm just throwing stuff out there. When other people think differently, and most importantly, when the developer of the game thinks differently, so be it.

Me like probably how Tynan was going to do it.  Just a thought, feel free to ignore this but what about if someone needs blood, then you need to take blood from someone who hasn't donated blood for a while and if want to go deeper can make them needing the same blood type.

I don't know how others feel, but for me that would be far to complicated. I think there are so many aspects to a game like RimWorld that it's best to keep the individual things simple. I was aiming for a system that has some depth to it but mostly takes care of itself.

Just take Dwarf Fortress as an example: it's fun to watch, when it's someone who's really good at the game. But I wouldn't really want to play myself, because there's just way too much going on ...

I completely agree, that it's waaaay off the full release. But I wouldn't agree on polish - while some things are not implemented yet, they "work" just fine - additional skills, different unused things you can buy - they are there like they would in release form, they don't break anything, pawns will still gather the unused items and such. There are no game-breaking bugs or glitches, the game flows real well for what it is right now. This is more than some 3-A releases give you. One doesn't need to be a game-designer to tell, that Tynan wanted this pre-alpha to be a good fun in itself and took his time to make sure it is - instead of just screaming "pre-alpha!" while bathing in money during the bug-squishing time.

Yes, if you put it this way, I agree. Tynan has done a very good job on making sure everything works. I now understand where you're coming from. I'm pretty sure you will manage to keep it that way, Ty. 

I think this is quite obvious, lazerlight I can't speak for anyone else, but when I compare this pre-alpha release with other releases I have it in mind, that the game is long to get finished. Yet - as you mentioned - it already shows level of polish that nowadays seems like a joke to many developers: "why bother fixing it, we'll patch it someday!". It's playable, fun and keeps people for hours upon hours - where in indie and small games department it's easy to find games that bore you after an hour or two or even end by that time. Hell, some big titles turn out to be a launch-break long.

I just want people not to look at this through rose-tinted glasses. In fact RimWorld is not terribly polished right now and it will get stale after a while. We need to be realistic here. There's 7 research topics in the game. A half-decently skilled researcher will go through that in a few minutes of play time. Traits are not implemented. There's a very very limited number of things to build, nothing to craft. There are commodities in the game that do nothing. There's 11 skills, which isn't bad, but 4 of them do nothing, which is. The game is not balanced at all ...
I'm fine with these because I know what it is: a pre-alpha. In fact it's decently fun for a few hours despite all this. But saying RimWorld could be a release title is delusional. I see a lot of the guys who say that now being all played out of RimWorld before it even releases.

I'd like to put up some suggestions I had concerning injured colonists and medical care. I like interesting mechanics that are realistic and multilayered while being simple enough to be easy to handle and don't involve too much micromanagement. Also these are just thoughts, not a finished concept. I also think, that RimWorld is too hard in it's current state, so this would be implemented once the game's difficulty is a little more adjustable.

There's one commodity related to this called something like "Medical supplies".

There's two related skills:
Medical skill: this will be disabled on most colonists except those who have gone through medical training in their backstory, like nurses, doctors, veterinarians et al. Leveling up would speed up medical tasks and/or improve the hp gained from performing them.
First aid: all colonists will have this skill. Alternatively this could be tied into some other skill, like Social. Leveling up would speed up first aid tasks.

Colonists can be in a number of injury states. I was thinking maybe five:
100: completely healthy
- Nothing to see here, move along

90 - 99: bruised
- Colonist will heal 1 HP per day.

70 - 89: injured
- Colonist will heal 1 HP per day if untreated.
- Will heal more if treated at least once a day by someone with first aid or medical skill (like randomly heal 1 - 10 HP up to a max of 90 HP)
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are lightly injured can treat themselves

50 - 69: wounded
- Colonist will heal 1 HP per day if untreated
- Will heal more if treated at least once a day by someone with first aid or medical skill (like randomly heal 1 - 10 HP up to a max of 90 HP)
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are wounded cannot treat themselves
- Wounded colonists are slowed down considerably

20 - 49: incapacitated
- Colonist will heal 1 HP per day if untreated
- Will heal more if treated at least once a day by someone with medical skill but not first aid skill (like randomly heal 1 - 10 HP up to a max of 90 HP). This will require an amount of medical supplies and cannot be done if there are none in stock.
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are incapacitated cannot treat themselves
- Incapacitated colonists cannot move

1 - 29: dying
- Colonist will lose 1 - 10 HP per hour if untreated
- Treatment by a colonist with medical skill will stop health loss for 1 day and the dying colonist will regain a small amount of HP. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are dying are also incapacitated of course, meaning they can neither move nor treat themselves.

This would just be an idea for the underlying system. Ideally colonists who have the right preferences set would care for patients automatically so the player would not have to concern himself too much with it. I think it would be a decent simulation of reality within the constraints of game rules. Colonists only heal very slowly when untreated, so no miracle recoveries in just a few days. On the other hand it's gamey enough to insure that the player would have their colonists back in running order in a timely manner if they care for them.

TL;DR: have colonists heal only very slowly on their own, but faster when treated. Make so that healing very severely injured colonists would require medical supplies and a medically trained colonist.

Edit: just corrected a few typos

Basics of me:

Hi, my name is Thomas. I am a human being from planet earth. First I thought I'd wait for RimWorld to release because I have a rather strict rule of not purchasing unfinished games or preordering. Then I decided I'd help kickstart it anyway and just watch the progress till it's mostly done before playing. Then I decided to try the pre-alpha anyway. It's pretty cool and promising, though far from finished. Now I think I want to help if I can. I have absolutely no experience in computer programming or illustration. I have some experience in board game design however and I'm pretty good with game mechanics. I also speak both English and German fluently and I have been to interpreter's school for 4 years with a focus on translation.

-What introduced you to RimWorld? Or to this style of game in general?
I've always enjoyed watching other people play Dwarf Fortress (or more correctly: Slaves of Armok: God of Blood Chapter II: Dwarf Fortress ) and some similar games because of the stories that develop. I discovered RimWorld on Quill18's youtube channel and found it unique enough to keep watching it's progress.

-What's your favorite other game?
It's hard to narrow down, so I'll just name a few: Civilization V, Half-Life 1, XCom Ufo Defense, FTL, Frontier: Elite 2, Torchlight

-Most embarrassing gaming-related story?
Gaming is not embarrassing

-What kind of breakfast cereal is the best?
I very rarely eat breakfast cereal, but when I do I either like flakes with nuts or something very sugary.

Okay, I think I'm done lurking. 
I agree that a friendly and positive community is a breath of fresh air. But I do not agree that RimWorld would be any good as a release title in it's current state and find it pretty astonishing that so many people here seem to think it would.

I love the idea and the concept behind RimWorld and after looking into it I have faith in Tynan, that he will deliver an entertaining experience and allow exactly the right amount of community input. That's why I backed it against my rule of never paying for unfinished games and never preordering and convinced my brother to do so as well.

But that experience is a long way off guys, don't fool yourselves into thinking otherwise. I guess no one knows this better than Tynan himself.

It's good to get a pat on the back once in a while, but there is a lot of work to be done before I would consider RimWorld to be even a game, I think Ty will need a lot more help along the way, maybe even hire a few people. Right now it is very obviously a pre-alpha, a tech-demo, albeit a very enjoyable and promising one. We need to uphold a spirit of progress and diligence. We need to encourage Ty to do his very best and put his all into this project, not "call it done". I think that's what he would appreciate most.