When ER hit our TV screens more than ten years ago it was a breath of fresh air. It combined great acting, brilliant storylines and intense action, to give us something we hadn't really seen before. Anyone used to British drama 'Casualty' was blown away by the scale of set-pieces on the show, with barely a week going by without a horrific car pile-up or huge blazing inferno - a far cry from the stubbed toes and splinters in thumbs that shocked viewers on British medical dramas (perhaps a slight exaggeration).

A game based on the ER licence has a chance of being great then. You'd play an all-action doctor who goes out on a limb, risking his own life in order to save his patients. Levels could be set all over the world, with sections as an aid worker in a war-torn country, and a number of levels playing as a medic in the military. It could have been the best videogame based around doctors ever to be created. But unfortunately, it isn't. Developers Legacy Interactive have seen to that by making the game a 'Sims' clone of sorts (although more in appearance than gameplay), and in the process forgot what ER is all about.

When you start the game you're an intern and your first task is to create your character and choose his/her medical skills. This is pretty basic, with none of the customisation you'd expect from bigger budget titles. You can choose your basic look, including the colour of your scrubs and lab coat, but unless you look like a generic videogame character you won't be able to create your own face. Of more importance are your personality and medical aptitude stats.

Your personality is split into Intelligence, Constitution, Dexterity and Charm, and these affect your medical strengths and weaknesses. You must also choose your skills in Neurology, Toxicology, Paediatrics, Orthopaedics, Cardiology and Gen. Surgery. You can't be good in all areas, but your initial choice will determine how quickly you advance in these areas throughout the game.

Working in the ER isn't actually as exciting as the TV show suggests. After some on-the-job training you're let loose to treat patients, and this is where the real problems arise. You're given various missions based on treating patients (as expected), but giving treatment is the biggest letdown in the game. Clicking on a patient will let you diagnose their problem and then select where you wish to send them for treatment. This is about the only real challenging decision you have to make in the game, as you don't really want to send critical patients to the exam room and sprained ankles to trauma, jeopardising their treatment.

Once they're in a bed you treat them by simply left-clicking on them. You'll proceed to dance around the patient (there's no physical interaction with patients) while a metre is shown on the screen. This shows the patient's health. You'll often be unable to handle serious conditions yourself, so you can call on other doctors for help. That is pretty much all there is to treating patients. It's very disappointing given that the skill of the ER doctors is one of the most exciting aspects to the TV show.

To make things worse, your performance is affected by your hygiene, energy and composure. Certain missions are made very hard because of this, with frequent hand washes, showers, sleep, working out and talks to other members of staff all getting in the way of you doing your job. The camera is also rather cumbersome, rarely letting you get the view you're after. This, combined with the fact that you have to be within a few feet of a patient in order to select them, makes for a level of annoyance that wasn't necessary.

Special abilities can be earned and used to help you out of tricky situations, as can 'perks'. You can carry up to four of these at a time and they are used to boost certain stats or to improve the opinion other characters have of you. Even with the varying abilities of your character and the 'perks', the scope you have to act as you wish is rather limited. You can't choose to be some reckless, but brilliant doctor, nor can you choose to be evil (well, you could just ignore patients, but this wouldn't get you anywhere in the game).

The game lacks all of the TV show's excitment

The presentation is good enough and depicts County General (the hospital) well, but is more 'cartoony' than realistic, and it lacks the gloss of higher profile games. Three of the show's main characters, Carter, Pratt and Lewis, are featured in the game and lend their voices, but a few more characters would have been nice, especially as Carter is no longer in the show.

I'm a big fan of the TV show and have watched it from the beginning, but the game totally misses the mark. What is an energetic, on the edge, and exciting TV show, has been turned into a run of the mill, dull, and rather simple hospital sim. Casual gamers may appreciate the fairly simple game mechanics, but fans of the TV show and experienced gamers will be very disappointed.