Free tables Natural 20 — skill checks

Natural 20 Table — Medicine Skill Checks, d20

A free d20 table for a natural 20 on a Medicine check in 5e. Twenty outcomes, from solid to legendary.

A natural 20 on a skill check is not a critical success in fifth edition — criticals apply to attack rolls only, and a 20 on a check is simply a 20. Which is why a legendary roll so often feels like nothing happened. This table gives it somewhere to land.

Twenty results written for Medicine specifically. A legendary Medicine roll has nothing in common with a legendary roll at anything else, which is why there are eighteen of these and not one.

Roll d20 when a player rolls a natural 20 on a skill check and succeeding quietly would be a waste.

Severity tiers

Each result names its tier, so you can see at a glance how bad a roll was without decoding a colour.

Solid 1–10 — Cleanly done, with something small to show for it.
Impressive 11–17 — Better than anyone expected. Momentum, or an obstacle gone.
Legendary 18–20 — Scene-shaping. The kind of success people repeat afterwards.

The table

20 results. Roll d20.

d20	Result	Tier	What happens
1	Stabilised	Solid	The dying creature is stable and comfortable. No extra effect.
2	And Awake	Solid	They regain consciousness at 1 hit point rather than merely stabilising.
3	Named the Poison	Solid	You identify exactly what is wrong — the poison, disease, or ailment, by name.
4	Clean Work	Solid	No scar, no complication, no lasting effect from the injury.
5	Bought Time	Solid	Whatever is killing them is slowed considerably. The party has longer than they thought.
6	Read the Wound	Solid	You determine exactly what caused it — the weapon, the creature, how long ago.
7	Steady Hands	Solid	You have advantage on your next Medicine check this scene.
8	Supplies Held	Solid	You use no charges from your healer's kit doing it.
9	Taught as You Went	Solid	One ally watching has advantage on their next Medicine check.
10	Made Them Comfortable	Solid	The patient has advantage on their next saving throw against this condition.
11	Back on Their Feet	Impressive	They regain hit points equal to one Hit Die plus their Constitution modifier, without spending one.
12	Drew the Poison	Impressive	The poison or disease ends now, with no further saving throws.
13	Set It Properly	Impressive	A broken bone, dislocation, or lingering injury is fully corrected. It will not trouble them again.
14	Triage	Impressive	You stabilise or treat every wounded creature within 30 feet, not just one.
15	Read the Body	Impressive	Examining a corpse, you learn how they died, when, and one thing they were carrying that is now missing.
16	Field Remedy	Impressive	You produce a dose of an antidote or remedy from what's to hand. It works once, for anyone.
17	Rest Well Spent	Impressive	The patient's next short rest counts as a long rest for the purpose of recovering from this condition.
18	Pulled Them Back	Legendary	A creature that died within the last minute is alive again at 1 hit point. No spell, no components — just you, and it should cost the DM nothing to allow it once.
19	Named the Cure	Legendary	You determine exactly what will cure an affliction the party thought incurable, and where to obtain it.
20	The One They'll Talk About	Legendary	You save someone who was beyond saving, in front of people who know how impossible that was. Word of it travels, and someone will come looking for you because of it.

Questions

Is a natural 20 a critical success on a skill check?

Not by the rules. Criticals apply to attack rolls. A 20 on a check is a 20 — which is why a spectacular roll so often produces a shrug. This table is the house rule that fixes that.

Does a natural 20 automatically succeed?

No. On an ability check there is no automatic success — if the DC is 25 and your total is 22, you failed with a 20.