Step 4. Customize

Skills are just text files. Anyone can modify them or create new ones.

Anatomy of a Skill

Every skill lives in a single folder as a SKILL.mdfile. This file tells Claude "here is how you should behave in this situation."

SKILL.md basic structure

---
name: my-custom-skill
description: Generate report forms tailored to my hospital
triggers:
  - "report"
  - "template"
tools:
  - Read
  - Write
  - Edit
---

# Rules

1. When the user requests a report, follow the template below.
2. De-identify all patient information.
3. Conclusions must always include supporting evidence.

# Template

## Title
## Findings
## Conclusion
## References

name — Skill name (should match the folder name)

description — Helps Claude understand what this skill is for

triggers — Keywords that automatically activate this skill

tools — List of tools this skill is allowed to use

Body — Specific instructions for Claude (plain language)

Modifying an Existing Skill

1. Open the skill folder you want to edit inside ~/.claude/skills/.

2. Open SKILL.md in any plain-text editor (Notepad, TextEdit, VS Code).

3. Edit the parts you need. For example:

  • Change the default output language
  • Adjust formatting to match a specific journal style
  • Add rules that reflect your institution's policies

4. Save the file and restart Claude Code Desktop.

Creating Your Own Skill

1. Create a new folder inside ~/.claude/skills/.

~/.claude/skills/my-report-template/

2. Add a SKILL.md file inside it, following the structure shown above.

3. Restart Claude Code Desktop and your new skill will be loaded automatically.

Tip

The fastest way is to duplicate an existing skill and modify it. For instance, copy the check-reportingfolder, rename it, and adjust the checklist to match your hospital's standards.

Updating Skills

MedSci Skills are continuously improved. To update to the latest version:

1. Download the latest ZIP from GitHub.

2. Overwrite the existing ~/.claude/skills/ with the skills/ folder from the new ZIP.

If you have customized any skills, back them up before overwriting.

The Role of Orchestrate

The orchestrate skill acts as a traffic controller for all other skills. It figures out what you need and automatically routes your request to the right skill.

When you add your own skills, orchestrate picks them up automatically. Just make sure to write clear triggers and a good description.

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