I did not like Tom as a nurse/medic, it offended me a little bit to be honest. I'm a nurse myself and I trained several years to become one, it's not something you just pick up on the side while also doing your actual full time job of piloting the ship, being part of away teams, having senior officers meetings etc.
On the other hand nursing on Star Trek was usually portrayed as being a doctor's assistant, you certainly don't need intensive training for things like:
Doctor: This!
Nurse: *takes two steps to the left to grab a hypospray and hands it to the doctor*
Doctor: That!
Nurse: *presses a single button*
That's not nursing! And having an assistant is not even necessary for Voyager's doctor, he could do it all by himself. He's integrated into sickbay, he should be able to turn things on or off without pushing a button and he could have floating limbs grabbing stuff all over the place, as a hologram he should be able to treat several patients simultaneously without a problem.
The holo doc was in interesting concept but the execution was flawed, most of the time he was written as a quirky humanoid who couldn't leave sickbay and even that limitation was removed with the mobile emitter.