Elise is instantly good at everything medically, which makes sense, but only to an extent. It would have been more entertaining for Elise to have to adjust to the less modern medical field, with things to overcome such as not having modern medical equipment, or proving medical treatments are effective before she goes ahead with them. The medical side of the anime is by far the most interesting, but Elise's lack of growth and apparent "all-knowing medical goddess" -ness makes it feel a bit flat.
As for the being the queen side of things, we start with some interesting political input from the main character, which would be cool to explore further, but instead, there's lots of screen time spent on rather boring scenes like being at a ball. I'd personally much prefer if they were to spend less time on noble life, and if there was focus on her engagement for it to be focused on her political opinions and solutions she would implement in the slums to prevent famine or plagues, and how she would prove this is a good idea.
As far as the romance goes, it kind of feels forced. There isn't much chemistry between the main couple, and I'm sorry to disappoint but nearly every guy falls in love with her. Her brother is overprotective too, in that weird reverse harem way. The characters that like her don't have a personality anyways. It's kind of disappointing to see this premise force so much attempted romance into the plot when thats not really what we're here for. Romance is fine, but maybe try to keep it to one or two characters. Just my opinion, as an avid romance enjoyer, this feels kind of badly done.
But the show is enjoyable. At the very least its more interesting than most reverse harems, or isekais, but it's left me disappointed because it had so much potential and was let down a bit.
