From the Super Mario Wiki, the Mario encyclopedia
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Skill Up is a booster item in Dr. Mario World. When activated, it fills up a doctor's skill meter prior to starting a stage in Stage Mode, making it similar in function to the Skill charger and Skill filler in terms of fully charging up skill meters. Players are first given a free use of it, where subsequent ones must be gained by spending 10 diamonds or by completing certain events such as clinic events.