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Darkest Dungeon 2 Plague Doctor Guide

The Plague doctor serves well in almost any comp, offering great DoT and very consistent healing options. She fits into rank 4 quite nicely, and just using a kit comprised of her blight moves, mag rain, and her heals will perform quite admirably with a wanderer or Alchemist PD.

Darkest Dungeon 2 Plague Doctor Guide


  • 28 HP
  • 4 Speed
  • 30 bleed resist, 50 Blight resist, 40 burn resist
  • 50 Disease resist, 20 debuff resist, 20 move resist, 10 stun resist
  • Movement (this is how you can move with the move command): 1 Back, 1 Up


You are always able to see what exactly paths do at The Altar of Hope’s hero unlocks screen, and on your character select.

Surgeon: An incision and healing focused path, that also grants PD more HP. Useful for rank 3 or 2 PDs that want to heal and press incision.

Alchemist: More reliable blight DoTs and higher DoT resists. The various resists are also quite notable. This all comes at the cost of Max HP: She’ll have 22 at base with this path. Which you really feel if she does end up getting targeted. Definitely a backline PD path.

Physician: A path that favors PD’s support and mitigation skills primarily, at the cost of 2 DoT output for any blight or bleed move. Probably her weakest path, but one can do some fun things with it, and the DoT output still existing allows her to still use that side of her kit for DD checking and some output when needed.


Noxious Blast: Used in 4-3-2, Targets 1-2. Deals 2-3/3-4 direct damage, and 4/6 blight DoT at 5 crit. Ignore 33 percentage points of blight resist with combo.

The combo effect serves as a pseudo-accuracy buff and can represent a lot of damage in areas with blight resistant enemies. Most of the time though, the combo effect will feel like it’s a hindrance, since you’ll want someone else to use the combo. Otherwise, it’s the highest no strings attached single target DoT in the game. This makes it great for enemies that take multiple turns or for hitting moderate thresholds in particular, and it will be a mainstay on any PD that wants to deal damage, unless you’re taking a path that weakens it in particular.

Blinding Gas: Used in 4-3, targets 3+4. Inflicts 1 blind/1 blind and 1 daze to rank 3 and 4, with a 25/33% chance to inflict combo on each (rolled individually for every enemy). Cooldown of 1

Biggest glow down in history? Well, it’s not a double stun anymore, but it isn’t bad either. Blinding gas is a high alpha cleave type debuff that tries to inflict blind to the enemy backline. This means that high alpha teams that focus on blowing up the frontline can front load this debuff when PD’s damage isn’t needed, with the intention that you’ll bring their backline up front very quickly. Unfortunately, the nature of the move means that it’s bad against comps with a size 2 in the back, small parties, or comps where you’d rather just debuff one strong enemy for more (meaning most bosses). It’s a bit niche, but it can serve well in certain circumstances. The daze and combo portion of the move are fairly secondary, as if you were going to kill the backline quickly enough for daze by itself to be relevant you wouldn’t need the blind, and the combo, while powerful when it goes off, is random. The daze will sometimes give you extra time to corpse clear and bring the back up to the front, though. The 1 cooldown prevents you from using this as a double stun + quad blind with Encore or bonus turn trinkets, sadly. I probably wouldn’t usually run this and plague grenade together, as they benefit separate strategies.

Incision: Used in 3-2-1, targets 1-2. Deals 3-6/4-7 direct damage at 10/15 crit, and inflicts 3/4 bleed. Ignores 33 percentage points of bleed resist with combo.

This move is normally used as her damage move with Surgeon, which greatly buffs it and nerfs her blight kit. Otherwise its niche is a little different than Noxious. Noxious generally deals more damage outside of the Foetor and allows her to sit in 4, incision deals more direct damage and applies a lower DoT, meaning it’s better for setting enemies to death’s door that you then immediately check using the bleed DoT, as incision can do it when they have somewhat higher HP. Outside of this niche and surgeon, the move isn’t bad, but you’ll normally just run Noxious blast instead, since it tends to do more damage and since you can use noxious in rank 4.

Battlefield Medicine: Used in 4-3, targets any valid friendly. Heals 20/25% of a Target’s HP if they’re below half health, clears all DoTs from the target/the target and PD herself. The move can be used to do the latter whenever a character has a DoT, but it won’t heal if they’re above 50%. The move has a use limit of 3.

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It’s a no nonsense heal with a very forgiving HP threshold. That makes it quite valuable, even when it’s not clearing DoTs. When it is clearing DoTs and healing, its effective heal can be very powerful. Its biggest weakness is the use limit, though in most cases if you’d use it more than 3 times in a fight you’re playing at a very low tempo, something went wrong, you’re healing from earlier fights, or the fight is very very long.

Ounce of Prevention: Used in 4-3, Targets all friendlies. Buffs everyone’s DoT resists by 15/25 percentage points, Buffs everyone’s disease resist by 15/30 percentage points. Cooldown 3/2 turns.

This actually does amount to a very noticeable party wide damage reduction against specifically DoT damage. The problem is that it’s slow and there are tons of fights where you don’t need to mitigate that, especially if you’re going reasonably fast. The disease resistance can be especially nice in the Foetor, because the Foetor is Hemic Rot city. It’s also nice in the sluice against the little pigs and other disease giving enemies for the same reason. It’s not a bad move, it’s just a rare pick due to how long it takes to pay off and how few fights are going to allow it to pay off with that much value. It’s also a high variance damage reduction, which is usually worse for slower strategies, though the fact that it’s supposed to be used when multiple DoTs are coming in over a few turns means that the variance tends to smooth out. Physician also gives this stress resist which makes it more usable but still fairly niche.

Plague Grenade: Used in 4-3, targets 3+4. Deals 1-2/2-3 damage and 3/4 blight DoT to both targets at 5 crit.

It’s a good high damage backline cleave. There are actually quite a few fights where having some moves that focus on the backline is quite valuable, such as cultist fights in particular. This one does a lot of damage and is quite reliable at its job, especially with an alchemist PD. It’s pretty common for a normal PD to run this, unless the comp is completely hyper focused on killing the front line, or you’re running her other two paths. You will be happy you have this move when killing enemies like Heralds. It’s not that complex: just chuck it and watch things melt. Often the choice will be between this and blinding gas, as blinding gas tends to support a front heavy and alpha heavy playstyle, whereas this move supports more flexible or backline focused comps.

Plague Doctor (II)

Emboldening Vapors: Use anywhere, target any friendly. Give one strength token/1 strength and one speed token. It’s worth noting that the physician path makes this give 2 strength instead of 1. Cooldown 1/0

Emboldening Vapors is a damage transfer, and not a particularly good one. There are two reasons for this. The first is that PD’s damage is actually pretty good by itself: A Noxious blast+, for example, will do 9 or 10 damage turn 1 if the blight sticks, and more as time goes on. Blight resist lowers that a little mathematically, but unless you’re in the foetor you’re probably looking at a good 6-8 damage on average, and that’s just accounting for the initial turn. The second reason is that emboldening gives strength, which means that unlike moves like vuln hex which do care about the other boosts your heroes have, outside of crit tokens strength won’t care. Physician’s lowered DoT damage and extra strength make this move pretty good on that path, but otherwise it’s very difficult to find a good place for emboldening in any comp, even when considering the extra reliability of extra direct damage over DoT damage.

Disorienting Blast: Use in 4-3-2, Target 2-3-4. Shuffle and inflict daze to enemy, as well as a 25% chance at inflicting weak. Upgraded version applies stun on combo.

Movement skills can be quite effective, but shuffles are worse than many pulls and pushes because they’re unreliable; you don’t know if the enemy is going to be shuffled somewhere where they’re crippled or one slot over where they don’t care. The chance at weak is really… weird. The weak still has to go through debuff resist, so you’re probably looking at a real 20% chance, give or take a few points. It’s a little added value, but if you were after a debuff, why not just use blinding gas or some other character’s debuff? Finally, the stun on combo use is useful if you have a lot of combo and no one to use it or no stuns, however the other combo stuns (pistol shot and rampart for example), are typically just better, and you’ll usually have a use for combo in mind other than this if you’re carrying it. Physician adds Vuln to this move which does make it noticeably better, but outside of that path I would only use this if haven’t built for another flexible stun option and want a combo stun option, or you really feel like you need a movement skill.

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Indiscriminate Science: Use 4-3-2, Target any friendly below 50% HP. Remove all positive tokens/positive and negative tokens, heal target 10% + 10% for each positive token/+ 10% for each positive and + 5% for each negative. Cooldown 1

This is PD’s other heal, and boy is it something. This move can either be used to heal a boatload, especially on characters like Dismas and Barristan who can generate a lot of tokens, or can be used as a debuff cleanse, as the upgraded version just removes all negative tokens. Sounds great, and it is. It’s mainly held back by two things: The fact that it requires the target has tokens to be worth it, which usually means that two turns go in to making it a heal, and the fact that the target has to be under 50% HP to be a target at all, meaning you can’t just cleanse debuffs with this unless they’re already hurt. Despite these caveats this move is frequently very useful and makes its way onto almost any PD kit. It’s even usable from 2, which means the frontline PD madmen among you get to run this.

Cause of Death: Used in 3-2-1, Targets 1-2-3. Its damage is 75%/100% of the remaining DoT on the enemy, accounting for every turn that the DoTs would tick. It ignores ALL damage modifiers and it can not crit. It removes the DoT from the enemy, and the upgraded version applies combo as a consolation prize.

What this move does is accelerate damage. Take all the DoT that will happen in future turns, and apply it all now. That means that this move turns slow damage into alpha damage. Which is great, except that this move only does that. Despite that fact, this move can serve very well in all sorts of fights with big enemies. Particularly useful for bypassing certain HP thresholds in the act 2 boss, or for speeding up the act 3 and act 1 final bosses, as well as certain slower lair bosses. Synergizes well with other DoT characters (duh), and DoT heavy strategies that need a burst of alpha in some fights. Generally if you equip this you have a specific use in mind for it, rather than it being something you use just generally. Remember that she can’t use it in 4; you don’t want to make a strategy with it and realize you have to move her mid-combat.

Magnesium Rain: Used in 4-3, targets all enemies. Applies 3 burn DoT, clears all corpses. 1 turn cooldown.

Magnesium rain is great. It deals a decent amount of damage, gets rid of stinky corpses, and pings off dodge tokens from the entire enemy team since it’s an omni cleave. Not that useful in boss fights generally, so you should switch it off for those. Corpse clear is highly valuable in all sorts of comps in this game, and magnesium rain is perhaps the best omni corpse clear. The high spread also means you can use this to try to apply DoT to low or Death’s doored enemies while still putting some damage elsewhere too. It’s hard to beat the sheer utility that this move has, though it’s notably less useful if your comp wants to kill enemies back to front in most fights (though even then it still checks dodge on everyone). Its lack of direct damage component means it also doesn’t affect block tokens. Just make sure to time it right; you don’t want it to be on cooldown when you need to clear corpses.

Plague Doctor Analysis and Sample Comp

Darkest Dungeon 2 Plague Doctor Guide
Interested in some Medical malpractice?

The Plague doctor serves well in almost any comp, offering great DoT and very consistent healing options. She fits into rank 4 quite nicely, and just using a kit comprised of her blight moves, mag rain, and her heals will perform quite admirably with a wanderer or Alchemist PD.

This kind of PD will tend to focus on three things damage-wise. The first is backline destruction, something that PD excels at, especially when paired up with heroes like Bonnie, Occultist, and Hellion. Plague grenade just does a crap ton of damage, and when combined with even one other move, such as abyssal artillery, iron swan, firefly, or pistol shot, it’s fairly common to see a one or two turn kill on one or both of the backliners. The second thing it does is damage smoothing and threshold hitting. Given Noxious Blast and grenade’s very consistent damage output and profile, it’s common to use one of these moves to finish off units that have less than ten health, or even more if that unit has been mitigated by a move like weakening curse or smokescreen. Because we know that if the blight sticks, Noxious+ will do at least 9 damage, we can rely on it to finish off those weakened enemies on the first tick, especially with Alchemist PD. The third thing that she, and every DoT character, does well is Deaths’ door checking. Moves like noxious blast do very well against targets with very low HP and a DBR, because the initial hit will put them on Death’s Door and the blight will then check them when their turn rolls around, allowing for high action efficiency compared to direct damage. Incision builds do this well in particular, and Surgeon PD will perform well in frontline focused comps that can appreciate the move and the extra healing as well as the corpse clear from mag rain.

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Speaking of healing, let’s look at that side of her kit. Battlefield Medicine absolutely screams reliability, and unless you’re trying to run a surgeon PD in rank 2, there is pretty much no situation where you won’t be equipping the move. Indiscriminate science is less consistent, but it has higher value upswings, delivering very powerful healing and cleansing debuffs with the right setup. Just due to her consistency alone, PD is arguably the best healer, and definitely the most reliable. Even though characters like Vestal have more heals and more powerful heals some of the time, no character’s targeted heals are as reliable and easily accessible as PD’s are. The only thing that holds this side of her kit back is Battlefield medicine’s use limit, and even then only slightly.

Finally, let’s talk about PD’s utility kit. Magnesium rain is fantastic, clearing corpses and being an omnicleave that pings off dodge and delivers some DoTs. There are countless situations where you can find incredibly high value from Magnesium rain, and certain trinkets can also make it obscene as a damage option too. The rest of her utility kit is more niche and mainly seen with the physician path. Blinding gas does okay against certain enemy comps and if your team doesn’t favor running plague grenade, but moves like ounce, disorienting blast, and vapors really struggle against the rest of her kit. The worst of these is probably vapors, as outside of the double strength version within physician its value is too low and PD doesn’t really appreciate a damage transfer like Vapours. Moves like Disorienting and Ounce aren’t bad per se, and in fact Ounce in particular can produce a lot of value in the right case, but they struggle against the universal use that many of her other skills bring to the table.

Overall, Plague Doctor is a character that is reliable on most teams. She’s often seen as the most or one of the most powerful characters in DD2 by new players, but as you get better at the game and things like healing become less necessary, PD doesn’t quite break into that ranking. She is almost never a bad pick, and performs quite well in all sorts of situations.

Sample Comp

PD (alchemist) – Runaway (Arsonist) – Man-At-Arms (Vanguard) – Hellion (Ravager)

This is one of my favorite comps to bring to act 3 in particular. It offers a ton of Mitigation in the form of Man at Arms in general and Runaway’s Smokescreen. It also immediately gives you the ability to smash backlines with Plague grenade, Iron Swan, Crush, and Firefly, something very potent against cultist fights and the tangle in particular. Hellion is very useful here for that iron swan and for her huge alpha dump move in howling end, allowing a team that is otherwise specialized in dismantling backlines and putting out DoT damage to access incredibly high Alpha whenever it needs it. She also synergizes very well with the Runaway’s smokescreen, using the vuln token and the combo token very well with her wicked hack. Barristan is just generally good here, and is probably best in his vanguard path, but any will work well enough. Crush reaches into rank 3 giving the comp even more reach, and moves like retribution, defender, and stand fast offer consistent and reliable mitigation to a comp that really appreciates it. Bolster works as the team’s reliable stress heal to ensure that this comp won’t end up over-stressed from slower fights. The team also has plenty of healing: PD’s heal options, Cauterize from Runaway, Adrenaline rush and Raucous’s self heal, and even strategic retreat in a pinch if you choose to run it, meaning that if you ever get into a bind, you’ll have a way out. Finally, the omni cleaves from both Runaway and PD mean that enemy dodge will peel off as soon as it goes up.

This team will shred the act 3 boss in particular, provided you don’t massively screw up in phase 1, though it will perform well against all of them. Hellion will typically be better with ravager (especially for act 2), however running her as a wanderer for the ability to swap Howling end to bleed out for specifically the act 3 boss isn’t a bad move. This team is very easy to run and to understand, and tends to perform well in nearly any scenario.

Written by SpiderKhan

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