Editorial Standards · The Published Scale · Reachable Without an Account
How we score
What a number means, and how we reach it
Every score on this site is a single figure between 1.0 and 5.0, produced by one open method against one published scale. This is that scale, written out — with a worked example for every grade — together with how a finding is made, how the figures combine, and a candid account of what we have and haven’t yet assessed. It is the scale you can hold us to.
“Researched and assessed by the Epidaurus editorial pipeline against our published scale, from [N] dated sources. Methodology and scale are public.” This sentence is stamped on every finding; [N] is that finding’s own count of dated sources. No individual clinician grades a report — the method is a pipeline, and it is open.
The framework, in numbers
Eight specialties, 112 factors, 19 countries
Our coverage is a matrix: every country is assessed factor by factor, each factor scored against the scale below. The counts are live, and every one of them ships with its denominator.
The published scale · v2.3
The 1–5 scale, with a worked example for every grade
A factor is scored on a coarse, honest five-point scale — coarse on purpose, so a number asserts a band you can trust, not a false precision we cannot defend. Higher is always better. Each grade below carries the badge a reader meets on the site, what the number asserts, and a concrete finding scored at that grade.
World-leading, and fully open to foreigners
Delivered at internationally accredited, high-volume centres; outcomes are published and benchmark at or above the leading systems; the service is unambiguously legal and routinely available to non-residents, with transparent pricing and a formal international-patient pathway.
A 5 looks like
South Korea · Robotic-assisted prostatectomy. Several JCI-accredited tertiary centres publish surgeon-specific volumes above 500/year; oncological outcomes sit within 2 points of the US SEER benchmark; international offices quote fixed bundled prices and issue visa letters. Legal, no residency requirement. Assessed from 41 dated sources
Strong and accessible, with minor frictions
Reputable accredited providers exist and serve foreigners; quality is well-documented and good, though not class-leading; legality is clear. A real but manageable friction remains — in pricing transparency, wait times, or continuity of aftercare.
A 4 looks like
Türkiye · FUE hair transplantation. A deep field of accredited clinics with large published case volumes and competitive fixed pricing; legal and openly offered to foreigners. Held below a 5 only because outcome reporting is clinic-self-reported rather than independently audited. Assessed from 33 dated sources
Available, but materially qualified
The service can be obtained, but a real constraint applies that a reader must weigh — uneven quality, thin or inconsistent accreditation, a restricted legality, or a foreigner-access barrier.
A 3 looks like
Mexico · Bariatric surgery. Excellent border-city centres sit alongside lightly-regulated operators; accreditation is inconsistent and revision pathways for returning patients are not standardised. Legal and accessible, but provider selection carries real outcome variance. Assessed from 28 dated sources
Largely inadvisable for foreigners
Legal-grey, poorly accredited, or carrying documented safety or access problems for non-residents. The downside is significant and hard to mitigate from abroad.
A 2 looks like
India · Commercial gestational surrogacy. Under the 2021 Surrogacy (Regulation) Act, surrogacy for foreign nationals is effectively prohibited; the routes that remain are legally precarious and ethically contested, with no reliable foreigner pathway. Assessed from 24 dated sources
Prohibited, unsafe, or absent
Illegal, unavailable, or so unsafe that no responsible reader should pursue it in this jurisdiction.
A 1 looks like
Thailand · Unlicensed stem-cell “therapies” for neurological disease. Marketed to foreigners but not approved by the Thai FDA; no credible efficacy evidence, documented patient harm, and standing regulatory warnings against the clinics offering it. Assessed from 19 dated sources
From a number to a band — the thresholds
Round, then band
A displayed figure is rounded to one decimal place first; its band is then read from that rounded value. A 4.0 bands Good; a 3.9 does not. We never round a band up to flatter a finding, and we never colour a score without also printing its numeral and its band word — no score is ever colour alone. This is the same Ink Key that legends the map.
The method, end to end
How a finding is made
Four passes turn a question into a published, cited number. None of them is a clinician sitting in judgement; all of them leave a dated, checkable trail.
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Research, one factor at a time
For each country × factor pair, the editorial pipeline runs deep, autonomous web research and writes a structured report — every claim tied to a dated, public source. 1 Sources are recorded with their publisher and publication date so a reader can re-check them and judge how current the picture is. A finding standing on few sources is flagged as such, never quietly published. Government registers, accreditation bodies, peer-reviewed outcomes, and provider disclosures are weighed over marketing material.
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Scoring against this scale
A second pass maps each report to a 1–5 anchor against the published scale above, and writes the justification — the few sentences of reasoning that escort the number. 2 The justification is free to read on every finding, before any account or payment. The verdict is the proof; the full evidence is the report. The scale is deliberately coarse: a five-point band we can defend beats a two-decimal score we cannot.
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Aggregation, in the open
A category average is the mean of its scored factors over its denominator. A country’s overall is the mean of its eight category averages — the eight specialties weigh equally — rounded to one decimal, with the band read from that rounded value. 3 Equal weighting is a stated editorial choice, not a hidden one: we do not privilege the specialty a given country happens to be strong in. Where our coverage is too thin to support an average, we suppress it rather than print a flattering figure — see below.
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Review, dating & versioning
Findings carry the date they were assessed and a review-due date; the scale itself is versioned, and every change to it is published in the changelog at the foot of this page. When the scale moves, we say so, in the open.
What we have, and what we don’t
The candid edge of coverage
Candour is the credential. The framework has 2,128 possible findings (19 countries × 112 factors). We have assessed 2,128 of them, and we publish a country only once its full set of findings is complete. Here is exactly where that stands.
Findings assessed, by specialty — across the 19 published countries
When our coverage is too thin, we suppress
We never print a flattering average over a handful of factors. A category average is suppressed below three scored factors or 50% of the category; a country overall is suppressed below four of its eight specialties. Where that floor isn’t met you will see Insufficient coverage under a denser hatch — never a thin number dressed up as a verdict.
Three honest absences, never one grey
An absence is not a zero and not a last place. Not assessed — no report yet — shows a diagonal hatch on bare paper. Insufficient coverage — assessed too thinly to publish — shows a denser cross-hatch. Poor — assessed, and genuinely bad — is its own brick at full strength. Leaderboards list the unassessed below a printed rule; they are never dropped to fake a ranking.
Why the scale can be trusted
Independent, and changed in the open
Independence
No provider pays to influence a finding
Epidaurus is reader-funded. Clinics, hospitals, agents, and destinations cannot buy a score, a place in a ranking, or a softer word in a justification — there is no mechanism by which money from the assessed reaches the assessment. We take no provider advertising and no referral commissions. This is stated here and reaffirmed in the footer on every page.
Openness
The method is a published pipeline, not a private opinion
The scale, the thresholds, the aggregation, and the suppression floors are all on this page. No individual clinician is named as the grader of any report, because none is: the method is an editorial pipeline, and we would rather you trust a process you can read than a name you cannot check.
The scale changelog — every change, dated
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v2.3 18 May 2026
Added an explicit foreigner-access criterion to anchors 3 and 4, so a service that is excellent for residents but hard for non-residents to actually reach can no longer score as a clean Good. Tightened the legality language at anchor 2.
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v2.2 02 Feb 2026
Raised the suppression floor for a country overall from three of eight specialties to four of eight, after early profiles published thin overalls that read as more complete than our coverage warranted.
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v2.1 10 Nov 2025
Split outcome-reporting guidance for Aesthetic & Cosmetic factors: independently audited outcomes are now required for a 5; clinic-self-reported volumes cap at a 4.
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v2.0 01 Sep 2025
First public scale. Established the five anchors, the band thresholds (≥4.0 / ≥2.5 / <2.5), and the round-then-band rule.
Where this leads
See the scale at work
Every prominent score on the site links back to this page. The fastest way to trust the scale is to watch it grade something — no account required.