You cannot force someone to do something they don’t wanna do, even making it 50 hours requirement people would still play nurse while watching yt or something else to bypass the timelock. Cultivate the environment so that people who play doctors actually wanna play it and they will perfect the procedures by themselves.
To the main point, even replacing nurse with a mandatory tutorial people can still do it on automode and not remembering a single thing about which surgery requires what.