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Medallion magic is very tricky and some people are better at using their medallions than others. More control usually comes with practice, but some individuals have very fine control over their midform. It’s not fully understood how medallion magic picks the look of the individual’s human disguise and the human disguise is not consciously controlled by the user, but nearly everybody knows a guy who knows a guy who saw a person with such fine control over their medallion that they could change their human body.