I like to think there is some degree of passing down knowledge from one Emdee to another. A former Dentist trains another Dentist and then he passes that down. They might look at other specializations to see how that affects there own but will not practice it in any way. I do see there being a sort of generalist Emdee running around as well and them being very common but they are jack of all trades and are more good for minor things spread across the board than anything serious. Might patch up a bullet wound, but not extract the bullet if its in too deep. That sort of thing.
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