First Integration

Integration Table

When you perform an Integration (levels 3, 7, 11, 15, 19), follow this procedure:

Declare your goal trait (always gained).

Roll 1d20 for Critical Failure.

Natural 1 → gain 1 Unstable Mutation trait and all Negative trait rolls have increased chance (roll 1d6, 4–6 = gain).

Roll 1d6 for each Positive Trait (5 entries).

4–6 → gain that positive trait.

1–3 → nothing.

Roll 1d6 for each Negative Trait (5 entries).

5–6 → gain that complication.

1–4 → nothing.

You may gain multiple positives or negatives. Critical failures increase risk.

You will gain the effects in the form of custom feats.

Trait Type	Roll	Result	Notes
Goal Trait	Automatic	Gain	Always acquired.
Positive 1	1d6	4–6 → gain, 1–3 → nothing
Positive 2	1d6	4–6 → gain, 1–3 → nothing
Positive 3	1d6	4–6 → gain, 1–3 → nothing
Positive 4	1d6	4–6 → gain, 1–3 → nothing
Positive 5	1d6	4–6 → gain, 1–3 → nothing
Negative 1	1d6	5–6 → gain, 1–4 → nothing
Negative 2	1d6	5–6 → gain, 1–4 → nothing
Negative 3	1d6	5–6 → gain, 1–4 → nothing
Negative 4	1d6	5–6 → gain, 1–4 → nothing
Negative 5	1d6	5–6 → gain, 1–4 → nothing
Critical Fail	1d20	Natural 1 → gain 1 Unstable Mutation + increase Negative trait chance	Only on nat 1.

 

In the event of a critical failure:

d6	Mutation Outcome	Effect
1	Trait Amplification	One existing negative trait doubles its penalty.
2	Radiation Dependency	If you go 3 days without exposure to mana radiation, gain 1 level of exhaustion.
3	Mutation Spread	A random minor mutation appears (DM’s discretion). In future integration failures, this mutation automatically evolves further.
4	Instability Surge	Once per long rest, the DM may impose disadvantage on a single roll of your choice.
5	Necrotizing Fasciitis	You permanently lose 2 HP per character level. This represents progressive tissue degeneration.
6	Attention of a Higher Being	A powerful entity (archfiend, archangel, archfey, god, etc.) notices you. In crowds, they observe you. They may contact you telepathically to test your usefulness. Details are DM’s discretion.

Work On A Cure

You may attempt to remove complications during downtime (1 week, find a component with a trait that opposes the trait, check required. Resources for the experiment will cost you 400 gold.) 

YOU CANNOT CURE A MUTATION ONCE YOU HAVE ONE.

• Success: removed.

• Failure: remains.

• Critical Failure: gain a permanent mutation related to the component.

Field Chirugeon

Combat Treatment (Bonus Action)

Proficiency Bonus uses per Long Rest.

As a bonus action, a creature within 5 ft may:

• Spend 1 hit die.

• Add your INT modifier.

• Gain temporary HP equal to your proficiency bonus.

  Bleeding Control (Action)

  As an action:

  • End bleeding on a creature within 5 ft.

  • Stabilize automatically.

  • If stabilized this way, creature regains 1 HP.

Second Integration

Integration Table

When you perform an Integration (levels 3, 7, 11, 15, 19), follow this procedure:

Declare your goal trait (always gained).

Roll 1d20 for Critical Failure.

Natural 1 → gain 1 Unstable Mutation trait and all Negative trait rolls have increased chance (roll 1d6, 4–6 = gain).

Roll 1d6 for each Positive Trait (5 entries).

4–6 → gain that positive trait.

1–3 → nothing.

Roll 1d6 for each Negative Trait (5 entries).

5–6 → gain that complication.

1–4 → nothing.

You may gain multiple positives or negatives. Critical failures increase risk.

You will gain the effects in the form of custom feats.

Trait Type	Roll	Result	Notes
Goal Trait	Automatic	Gain	Always acquired.
Positive 1	1d6	4–6 → gain, 1–3 → nothing
Positive 2	1d6	4–6 → gain, 1–3 → nothing
Positive 3	1d6	4–6 → gain, 1–3 → nothing
Positive 4	1d6	4–6 → gain, 1–3 → nothing
Positive 5	1d6	4–6 → gain, 1–3 → nothing
Negative 1	1d6	5–6 → gain, 1–4 → nothing
Negative 2	1d6	5–6 → gain, 1–4 → nothing
Negative 3	1d6	5–6 → gain, 1–4 → nothing
Negative 4	1d6	5–6 → gain, 1–4 → nothing
Negative 5	1d6	5–6 → gain, 1–4 → nothing
Critical Fail	1d20	Natural 1 → gain 1 Unstable Mutation + increase Negative trait chance	Only on nat 1.

 

In the event of a critical failure:

d6	Mutation Outcome	Effect
1	Trait Amplification	One existing negative trait doubles its penalty.
2	Radiation Dependency	If you go 3 days without exposure to mana radiation, gain 1 level of exhaustion.
3	Mutation Spread	A random minor mutation appears (DM’s discretion). In future integration failures, this mutation automatically evolves further.
4	Instability Surge	Once per long rest, the DM may impose disadvantage on a single roll of your choice.
5	Necrotizing Fasciitis	You permanently lose 2 HP per character level. This represents progressive tissue degeneration.
6	Attention of a Higher Being	A powerful entity (archfiend, archangel, archfey, god, etc.) notices you. In crowds, they observe you. They may contact you telepathically to test your usefulness. Details are DM’s discretion.

Emergency Mitigation

Emergency Mitigation

Reaction (1/Long Rest):

When a creature within 10 ft takes damage:

• Reduce damage by 1d10 + your INT modifier.

If damage becomes 0:

• That creature may move 5 ft without provoking opportunity attacks.

Triage

Triage (Action)

Action. INT modifier uses per Long Rest.

Create a 10 ft radius zone centered on you for 1 minute.

While inside the zone:

• Allies have advantage on death saving throws.

• The first time an ally would drop to 0 HP, they drop to 1 instead.

• When an ally spends a hit die, they add your INT modifier.

Third Integration

Integration Table

When you perform an Integration (levels 3, 7, 11, 15, 19), follow this procedure:

Declare your goal trait (always gained).

Roll 1d20 for Critical Failure.

Natural 1 → gain 1 Unstable Mutation trait and all Negative trait rolls have increased chance (roll 1d6, 4–6 = gain).

Roll 1d6 for each Positive Trait (5 entries).

4–6 → gain that positive trait.

1–3 → nothing.

Roll 1d6 for each Negative Trait (5 entries).

5–6 → gain that complication.

1–4 → nothing.

You may gain multiple positives or negatives. Critical failures increase risk.

You will gain the effects in the form of custom feats.

Trait Type	Roll	Result	Notes
Goal Trait	Automatic	Gain	Always acquired.
Positive 1	1d6	4–6 → gain, 1–3 → nothing
Positive 2	1d6	4–6 → gain, 1–3 → nothing
Positive 3	1d6	4–6 → gain, 1–3 → nothing
Positive 4	1d6	4–6 → gain, 1–3 → nothing
Positive 5	1d6	4–6 → gain, 1–3 → nothing
Negative 1	1d6	5–6 → gain, 1–4 → nothing
Negative 2	1d6	5–6 → gain, 1–4 → nothing
Negative 3	1d6	5–6 → gain, 1–4 → nothing
Negative 4	1d6	5–6 → gain, 1–4 → nothing
Negative 5	1d6	5–6 → gain, 1–4 → nothing
Critical Fail	1d20	Natural 1 → gain 1 Unstable Mutation + increase Negative trait chance	Only on nat 1.

 

In the event of a critical failure:

d6	Mutation Outcome	Effect
1	Trait Amplification	One existing negative trait doubles its penalty.
2	Radiation Dependency	If you go 3 days without exposure to mana radiation, gain 1 level of exhaustion.
3	Mutation Spread	A random minor mutation appears (DM’s discretion). In future integration failures, this mutation automatically evolves further.
4	Instability Surge	Once per long rest, the DM may impose disadvantage on a single roll of your choice.
5	Necrotizing Fasciitis	You permanently lose 2 HP per character level. This represents progressive tissue degeneration.
6	Attention of a Higher Being	A powerful entity (archfiend, archangel, archfey, god, etc.) notices you. In crowds, they observe you. They may contact you telepathically to test your usefulness. Details are DM’s discretion.

Surgical Efficiency

Surgical Efficiency (Short Rest Feature)

During a short rest:

• Up to INT modifier creatures may maximize one hit die rolled.

Advanced Surgical Practice

Field Procedure (1 Hour, Out of Combat)

You may perform one of the following on a creature:

• Remove one minor condition.

• Convert 2 spent hit dice into 1 restored hit die.

• Reduce exhaustion by 1 (once per creature per long rest).

• Repair fractured bones or severe non-magical injury.

Requires medical supplies. No limit beyond time and materials.

Fourth Integration

Integration Table

When you perform an Integration (levels 3, 7, 11, 15, 19), follow this procedure:

Declare your goal trait (always gained).

Roll 1d20 for Critical Failure.

Natural 1 → gain 1 Unstable Mutation trait and all Negative trait rolls have increased chance (roll 1d6, 4–6 = gain).

Roll 1d6 for each Positive Trait (5 entries).

4–6 → gain that positive trait.

1–3 → nothing.

Roll 1d6 for each Negative Trait (5 entries).

5–6 → gain that complication.

1–4 → nothing.

You may gain multiple positives or negatives. Critical failures increase risk.

You will gain the effects in the form of custom feats.

Trait Type	Roll	Result	Notes
Goal Trait	Automatic	Gain	Always acquired.
Positive 1	1d6	4–6 → gain, 1–3 → nothing
Positive 2	1d6	4–6 → gain, 1–3 → nothing
Positive 3	1d6	4–6 → gain, 1–3 → nothing
Positive 4	1d6	4–6 → gain, 1–3 → nothing
Positive 5	1d6	4–6 → gain, 1–3 → nothing
Negative 1	1d6	5–6 → gain, 1–4 → nothing
Negative 2	1d6	5–6 → gain, 1–4 → nothing
Negative 3	1d6	5–6 → gain, 1–4 → nothing
Negative 4	1d6	5–6 → gain, 1–4 → nothing
Negative 5	1d6	5–6 → gain, 1–4 → nothing
Critical Fail	1d20	Natural 1 → gain 1 Unstable Mutation + increase Negative trait chance	Only on nat 1.

 

In the event of a critical failure:

d6	Mutation Outcome	Effect
1	Trait Amplification	One existing negative trait doubles its penalty.
2	Radiation Dependency	If you go 3 days without exposure to mana radiation, gain 1 level of exhaustion.
3	Mutation Spread	A random minor mutation appears (DM’s discretion). In future integration failures, this mutation automatically evolves further.
4	Instability Surge	Once per long rest, the DM may impose disadvantage on a single roll of your choice.
5	Necrotizing Fasciitis	You permanently lose 2 HP per character level. This represents progressive tissue degeneration.
6	Attention of a Higher Being	A powerful entity (archfiend, archangel, archfey, god, etc.) notices you. In crowds, they observe you. They may contact you telepathically to test your usefulness. Details are DM’s discretion.

Clinical Override

Complication Override (Action)

Once per Long Rest:

• For 1 minute, you ignore one of your active complications. (Not a mutation.)

Corpsman Extraction (Reaction)

Proficiency Bonus uses per Long Rest.

When a creature within 15 ft drops to 0 HP:

• You may move up to half your speed toward them without provoking opportunity attacks.

• If you reach them, they stabilize immediately.

Pain Suppression Protocol (Bonus Action)

Creature within 10 ft:

For 1 minute:

• Ignores movement penalties.

• Ignores disadvantage caused by injury.

• Cannot be slowed by minor conditions.

After effect ends:

• Gains 1 level of exhaustion.

Permanent Override

Permanent Override

Choose one Complication.
You permanently suppress it.

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Not On My Watch (Passive Aura)

While conscious:

Allies within 10 ft:

• Natural 1 on death saves counts as a single failure.

• Creatures at 0 HP may crawl at half speed.

God Complex

Battlefield Preservation Protocol

Once per Long Rest:

For 1 minute, allies within 20 ft may use their Reaction when taking damage to:

• Spend 1 hit die.

• Add your INT modifier.

• Reduce the damage by the amount rolled.

Master Surgeon

During extended downtime:

You may perform an 8-hour reconstructive procedure to:

• Reattach limbs.

• Restore organ damage.

• Permanently remove lingering injuries.

• Fix disfigurement.