Inside Sushruta's five-axis grading
What we look at when we score an encounter, and how to use the feedback to improve faster.
When you finish an encounter, Sushruta gives you a score out of 100. That number is the sum of five parts, each matching a stage of the real clinical workflow.
The five axes
1. History
Did you characterise the presenting complaint, screen for red flags and cover the relevant background? Patients hold back some details, so asking the right follow-up questions matters.
2. Examination
Did you examine the body systems that matter for this presentation, and avoid irrelevant ones?
3. Diagnosis
Did you reach the correct diagnosis, and were your differentials sensible? Ordering targeted investigations counts here too. Ordering everything doesn't.
4. Treatment
Is your management appropriate, safe and proportionate to the diagnosis?
5. Follow-up
Did you plan monitoring, safety-netting and when the patient should come back?
How to use your report
- Look at your lowest axis first. That's where the quickest gains are.
- Read the "missed" items. They're specific, and they're usually the questions an examiner would ask.
- Repeat the specialty. Doing a second case in the same area shortly after locks the lesson in.
A note on limits
AI grading is a practice aid, not a formal assessment. It's designed to give you fast, consistent feedback between real teaching sessions, so use it to sharpen your thinking, not as a final verdict.
