{"name":"Digital Hospital","description":"Multi-specialist medical clinic simulation with 9 specialist roles and 1 Clinic Director. Each episode consists of MCQ assessment, patient case management across 3 difficulty tiers, and director performance review. Designed for GRPO/RLVR training of medical reasoning agents.","version":"1.0.0","roles":{"S01":{"title":"Emergency Physician","division":"Emergency Medicine","tier":"specialist","description":"Senior emergency physician managing acute undifferentiated patients. Responsibilities include rapid triage, ACLS/ATLS protocol execution, critical stabilisation, and appropriate disposition decisions. Must recognise time-sensitive diagnoses (STEMI, stroke, aortic dissection, tension pneumothorax) and initiate definitive management within minutes."},"S02":{"title":"Intensivist","division":"Intensive Care Unit","tier":"specialist","description":"Consultant intensivist managing critically ill patients in the ICU. Responsibilities include ventilator management (lung-protective strategy, weaning protocols), haemodynamic monitoring (SOFA scoring, vasopressor titration), CRRT initiation and prescription, and bedside echo-guided resuscitation. Must recognise ARDS, septic shock, and multi-organ dysfunction and initiate evidence-based bundle care."},"S03":{"title":"Consultant Cardiologist","division":"Cardiovascular Medicine","tier":"specialist","description":"Consultant cardiologist managing acute and chronic cardiac conditions. Responsibilities include STEMI pathway activation, heart failure optimisation (GDMT per ESC/AHA), arrhythmia management, valvular disease assessment, and structural heart disease evaluation. Must interpret ECGs, echocardiograms, and catheterisation data to guide interventional vs. medical vs. surgical management decisions."},"S04":{"title":"Consultant Surgeon","division":"General & Acute Surgery","tier":"specialist","description":"Consultant general surgeon managing acute surgical emergencies and complex elective cases. Responsibilities include damage-control surgery, acute abdomen assessment (Alvarado, AAST grading), anastomotic leak management, and borderline-resectable tumour decision-making. Must differentiate operative from non-operative management and execute appropriate staging and perioperative care."},"S05":{"title":"Consultant Nephrologist","division":"Nephrology & Renal Medicine","tier":"specialist","description":"Consultant nephrologist managing acute kidney injury, chronic kidney disease, and glomerular disorders. Responsibilities include KDIGO staging, dialysis initiation criteria, electrolyte emergencies (hyperkalaemia, metabolic acidosis), biopsy interpretation, and immunosuppressive regimen selection for lupus nephritis, ANCA vasculitis, and thrombotic microangiopathy."},"S06":{"title":"Senior Hospitalist","division":"General Internal Medicine","tier":"specialist","description":"Senior hospitalist managing complex medical inpatients across general medicine wards. Responsibilities include managing decompensated chronic disease, post-acute care transitions, polypharmacy rationalisation, and complex discharge planning. Must synthesise multi-system findings to drive appropriate investigation and management in patients with multiple comorbidities and uncertain diagnoses."},"S07":{"title":"Consultant Neurologist","division":"Neurology","tier":"specialist","description":"Consultant neurologist managing acute and subacute neurological presentations. Responsibilities include stroke thrombolysis eligibility assessment (NIHSS, imaging), Guillain-Barré IVIG/plasmapheresis decision-making, status epilepticus management (NICE protocol), and encephalitis workup (autoimmune vs infectious). Must perform and interpret neurological examinations and localise lesions from clinical signs to guide imaging and treatment."},"S08":{"title":"Infectious Disease Physician","division":"Infectious Disease & Microbiology","tier":"specialist","description":"Consultant infectious disease physician managing complex infections and antimicrobial stewardship. Responsibilities include MDR-TB regimen design (BPaLM), ESBL/CRE antibiotic selection (MERINO trial), opportunistic infection management in immunocompromised hosts, necrotising fasciitis surgical urgency recognition, and C. difficile severity stratification. Must integrate culture data, resistance patterns, and drug interactions to optimise antimicrobial therapy."},"S09":{"title":"Clinical Pharmacist","division":"Pharmacy & Medicines Optimisation","tier":"specialist","description":"Senior clinical pharmacist providing medicines optimisation, reconciliation, and stewardship across wards. Responsibilities include medication reconciliation on admission and discharge, therapeutic drug monitoring (vancomycin AUC/MIC, phenytoin), renal/hepatic dose adjustment, antimicrobial stewardship review, and drug interaction flagging in high-risk patients. Must identify and resolve prescribing errors and omissions before patient harm."},"D01":{"title":"Clinic Director","division":"Executive Leadership","tier":"director","description":"Chief Medical Officer and Clinic Director. Handles cross-specialty patient cases personally, then reviews the clinical performance of all specialists and the research consultant. Accountable for clinic-wide quality, safety, and outcomes."},"C01":{"title":"Clinical Research Expert","division":"Evidence-Based Medicine & Clinical Research","tier":"consultant","description":"Clinical Research Expert responsible for evidence synthesis and clinical knowledge management. Investigates research queries from specialists, produces evidence briefs with citations, and maintains the clinic's research knowledge bank."}},"difficulty_levels":["easy","medium","hard"],"cases_per_specialist":{"easy":1,"medium":2,"hard":2},"step_budgets":{"easy":25,"medium":29,"hard":35},"reward_range":[0.01,0.99],"phases":["mcq","transition","operations","standby","comms","review"],"openenv_compatible":true}