The game has a lot of great ideas: stamina, camouflage, and the cure system are all inventive and interesting ideas. They aren't a problem, at least until it becomes clear that all the cure system and stamina does is provide a huge inconvenience that gets more and more annoying as the game progresses. Get hit during a boss fight? Time to, in the middle of the boss, open 3 separate menus, do shit in a correct order, then go back to the boss having all its pace and intensity ruined by the fact you are practically forced to go into the menu and spend 3 minutes doing surgery on yourself. Stamina isn't a bad system except for the fact I can never quite figure out how the fuck the game decides when to deplete it fast and when to slowly. It starts to get in the way of gameplay and creates tedious sidetracks where you shoot a snake every few minutes and open another 4 fucking menus just to eat the fucking thing. I grew to hate these systems that were pretty good ideas. Surely the system would be better if say, you only had to choose what you needed to heal the injury the first time you receive it then you could bind a button or two to performing that surgery once you've gotten it again and it uses the supplies and takes some time to do while not forcing the player to pause. There, its easier, doesn't get in the way of gameplay, and actually increases the intensity since the player needs the time to heal. Was putting it under a bunch of menus really the best way to execute this?

The game story-wise is great, characters are great (especially para-medic), the scenery and level design is mostly fine. It even has some of the highest highs in the series like The Sorrows boss fight(?), the ending, and the motorcycle sequence. It's far from bad and while I don't think it even touches MGS2's quality; it still feels like the ideas and concepts presented in 2 were expanded upon and there was at least clearly an attempt to improve upon the games formula. The problem doesn't come from its ideas, but how they were implemented. There were also some very annoying hitbox issues and sometimes the level design got confusing but I can live with that. It's the poorly handled cure and stamina systems that dampened what was otherwise a great game.

It's not a bad game, far from it. It's not even the worst MGS. But is it the best? No. Not even close.