It's really not well put together. From what I've gathered, you give candy/chocolate at the start of the examination to lower the impact of what you do--usually 3 or 4 chocolates is enough to get away with everything currently implemented, though maybe give 5 to patients with low obedience. A lot of stuff doesn't seem to be implemented yet, or is sporadically implemented--for example, some patients can have the rectal thermometer done to them, some can't. It's really easy to screw up a run early on by missing things--get the coffee machine and syringe ASAP. Do the student health checkup as soon as it's an option, even if you'd miss out on doing an exam with someone else. The only way to examine Samara is to use the syringe on her. Tongue depressor and otoscope don't seem to do anything currently. I have no idea what the purpose of the modeling minigame is--you can get some money, but not much. You're better off doing the minigame in the hospital. Also, doing the minigame in the hospital ends your time in town, no matter what.