A certificate with "PHD" written on it.


Isaac wears a surgeon's mask.

Changes the effects of all negative Pills to their positive counterparts. Neutral pills, such as Bad Gas, are not affected. Restores two Heart Containers on pick up. Has a 1/150 chance to identify the pill that is currently being held every frame.

If Telepills has not yet been identified as a pill in the current run (i.e. if the player has not yet used a Telepills), PHD guarantees that Telepills cannot show up in the current run.

Also increases coin payout from the Blood Donation Machine and IV Bag from 1-3 to 2-4.

PHD has the potential to be a very powerful starting item, as it turns most pills into permanent stat increases.


1HE3 TWCZ Found in the first floor treasure room



  • PHD is an abbrevation for 'Philosophiae Doctor' (Latin for 'Doctor of Philosophy').

Ad blocker interference detected!

Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers

Wikia is not accessible if you’ve made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected.