The first step is creating your doctor. There is a decided lack of options. You can choose from a very small number of heads, skin color, and scrub color, and they all basically look the same anyway. You also assign points to the various attributes in order to establish your starting point in the game. This process could also be improved. You only get ten points to assign, but each attribute had ten spots to hold points, so if you evenly distributed the points it seemed like there were hardly any at all. I forgot to name my doctor when I was done, thus my character was "Unnamed" for the whole game.

At least there is a tutorial to get you started. The tutorial is pretty comprehensive and starts you off quickly, as Dr. Carter walks you through treating patients and managing your stats. You also learn about perks, which are items that patients and other staff members can give you that can boost your stats or gain extra experience. The secret to perks is in either using them or giving and trading them to other doctors, but it soon becomes apparent that you should really just keep them for yourself.

For all that Carter stresses the social interaction of the game, it turns out to be pretty unnecessary. You occasionally have to talk to a doctor as part of a task, but otherwise you can safely ignore everyone. There are cliques that you should aspire to join, but you seem to automatically join them whenever you talk to someone and they also appear to have no effect on game play. Supposedly, you can get close enough to someone to retire to a handy broom closet for a little make-out session, but I couldn't get it to happen.

If socialization is out, then it must all be about healing people, right? Well, sort of. You do spend a lot of time in the waiting room doing triage. If you choose to take them as your patient, you assign them to a bed and then try to heal them. There's no finesse to the doctoring process, as you merely click on the patient and see what happens. The patient could get better, they could get worse, or they might need some lab work done.

Something all doctors must face is the possibility of losing a patient. It should be a rare event, one fraught with emotion and uncertainty about one's skills as a doctor. In ER, the patient dies and…no one cares. Sure, after the first or second corpse, you share a word with Dr. Lewis about how hard it is to lose a patient. After that, though, you kill them left and right, and just move on to the next bed. Maybe it would seem more painful if it felt like there was some way to influence the outcome, but since the healing process is not interactive, there isn't.

The most interesting parts of the game are the tasks that are given to you by other doctors. Many of them are quite dull, like treating a certain number of patients, but others can get a bit weird. Maybe there's been a fire at the convention center, or maybe the chief of staff wants you to try a new cocktail that's supposed to make you a super doctor. For the most part you don't have to complete these tasks, but rejecting some of them are fireable offenses and the game will end if you don't do them.

When handling the crowds in the waiting room, pathing issues become glaringly obvious. They seemed to get worse the longer I played the game, and it became pretty comical (and frustrating) after awhile. I'd click on the ground to get my doctor to move there, and the doctor would bump into a patient or a nurse then spin around and do it again two or three times before finally making it to the right spot. Also, mouse clicks seemed pretty imprecise, like when triaging patients and it seemed like I was always clicking on the wrong patient.

Throughout the game, the graphics are decent if not perfect. There are only two screen resolutions to pick from, and you can only zoom in and out by a small degree, so there's not much detail to be had. In addition, the camera angle is fixed which makes it hard to see everything you need to see. You have to manually rotate the camera, and it felt like I was doing so constantly. More camera movement is really essential to this type of game, so this is a painful oversight.

I also need to mention that there's no manual, not even a one-page "getting started" guide or a CD booklet. The box contents consisted of the game disc in a cardboard sleeve. While it may cost more to print and ship the manual than it does the actual game CD, I just don't think that this is an optional component for a family game. A PDF user manual is included when the game is installed but that doesn't do you much good once you're in the game and need to figure something out. This became evident when I wanted to save my game and go to bed, and I realized there was no Menu or Exit button on the screen. A few seconds' thought, and I hit the Escape button - sure enough, that was the key to accessing the game menu. But I play a lot of games so I knew to try that. What about someone who doesn't play many games? Right, they'll be calling their computer-savvy neighbor for help.

ER might sell itself as a hospital sim, but it's really a barebones game meant to appeal to the TV show fan, not the hardcore sim fans. The celebrity voices add a nice touch to the game but can't disguise the repetitious gameplay and lack of options. I'm sure I'm spoiled by the likes of Sims 2, but I expect more than a few face and body choices for my doctor. Heck, I should be able to move my camera angle, too. However, the crazy situations that occur (super hero convention, anyone?) do add some fun and at times the pressure to get everything done feels very realistic. Also, there's no blood at all, making it appropriate for older children. Show fans may enjoy interacting with Dr. Carter and Dr. Lewis and trying their hand at being a doctor, but the novelty quickly wears thin.