Grading Policy
Principles
Here are the principles that underly our grading system:
- Clinical grades are determined using the P/RIME evaluation system. Students who function at a Manager level more than 75% of the time are considered for Honors. Students who function at a Interpreter level more than 75% of the time are considered for High Pass.
- Students whose professionalism prompts concerns will see that reflected in their grade for the clerkship. Major professionalism issues may result in a Fail for the clerkship regardless of clinical grades or final exam performance.
- The final exam has influence on the final grade: i.e. students whose clinical grades are between Honors and High Pass and do very well on the exam have a better chance of getting a final Honors grade; those who do poorly will likely get High Pass. The same would be true for students on the borderline between High Pass and Pass, or Pass and Fail. There are also absolute cutoffs for the final exam:
- Students must perform at or higher than the mean score on the final to be eligible for Honors.
- Students must perform at or higher than one standard deviation below the mean to be eligible for High Pass.
- Students who perform lower than two standard deviations below the mean on the final exam will not be eligible to pass the clerkship without remediation. This may be retaking the exam, or may require repeating all or part of the clerkship based on the student's clinical performance.
- Students who do not complete clerkship requirements (e.g. clerkship logs, faculty/site evaluations, and the Mini-CEX) in a timely fashion are ineligible for Honors regardless of their clinical evaluations and exam performance. We feel strongly that education is a two-way street, and the formal feedback we receive from students is crucial to improving the clerkship as a whole. Part of the "Honors" grade credits the student for helping us with this process, and those who are unwilling to participate are not entitled to a grade of distinction.
- There is no final grade of "Marginal Pass." Students whose evaluations fall in the "Marginal" category are reviewed in detail by the clerkship's Grading Committee and will receive a final grade of Pass or Fail based on their overall performance in the clerkship.
Here is the evaluation form: Evaluation of Student Performance in the Clinical Curriculum
Determining the final grade
Here is how we compute your final grade:
Clinical GPA
Before the final exam, a clinical GPA (grade point average) is assigned. The final recommended grade noted by the evaluators is averaged to determine the clinical score. The table below illustrates how the GPA is determined:
The clinical GPA is determined by the Recommended Grade score found near the end of the Evaluation of Student Performance in the Clinical Curriculum form:
| Grade | Points |
|---|---|
| Unacceptable performance (Fail) | 1 |
| Reporter < 75% of the time (Marginal) | 2 |
Reporter > 75% of the time (Pass) |
3 |
| Interpreter > 75% of the time (High Pass) | 4 |
| Manager > 75% of the time (Honors) | 5 |
The other scores which appear on the first portion of your Student Performance Evaluation forms are averaged and appear on your School of Medicine final grade form. These scores are for feedback only and are not factored into your GPA.
Final Exam
To incorporate the final exam, an average score and standard deviation are computed for the group taking the exam that quarter and added to your clinical GPA using the following formula:
Final Grade
The final grade is assigned based on the following table:
| Final GPA | Final Grade |
|---|---|
| 4.6 or greater | Honors (Students below the mean on the final exam will drop to high pass) |
| 4.00-4.59 | High pass (Students more than one standard deviation below the mean on the final exam will drop to pass) |
| Less than 4.0 | Pass |
The Medicine Clerkship Grade Committee believes that a high pass final grade is a "near honors" performance. The absolute lowest cumulative grade point average for a high pass final grade is 4.0. There will be no exceptions made to this policy. A GPA of 3.98 is assigned a final grade of pass as this is not a near honors performance.
All final grades of fail are reviewed in detail by the course grading committee. In general they represent students who have multiple evaluations in the “below expected” categories or have a pattern of comments on all the evaluations that demonstrate an area of major concern that has not shown improvement over the twelve weeks of the clerkship. Students who show major areas of concern in professionalism or clinical performance may fail the clerkship or require remediation REGARDLESS of GPA.
Students who finish more than two standard deviations below the mean on the final exam receive an incomplete final grade. Students have six weeks to study, meet with an Educator in the Department of Medical Education to review the exam and re-take the exam. If they pass the re-take a final grade of Pass is sent to the Dean’s Office. If the student does not take the exam in the allotted time limit, a failure grade is sent to the Dean’s Office.
Students who fail to complete and submit the mini-CEX prior to final exam day will be ineligible for honors REGARDLESS of GPA.
Feedback
If you have concerns about an individual evaluation, we strongly encourage you to bring them to your Site Coordinator as soon as possible. Although the Site Coordinator can't change the evaluation, they can help you design a plan to work on the issues raised by your evaluators. They can also contact the evaluators to solicit additional feedback if necessary. We strongly discourage students from directly confronting their evaluators once the evaluations are final. Although two-way feedback is essential while you are working together, for a student to directly challenge an evaluator (or vice versa) after the final evaluation is complete is usually seen as unprofessional, and rarely helps. Working with the Site Coordinator or Clerkship Director is generally much more productive.
If you have concerns about your overall grade for the clerkship, you can dispute your grade in writing using our Grade Dispute Form (pdf). Disputes put in after final clerkship grades are determined rarely succeed. Circumstances in which a dispute would be appropriate may include an apparent mathematical error in computing your final grade or a technical problem with the final exam that wasn't apparent when you were taking it. Grade disputes focusing on individual evaluations have never resulted in a change in the overall grade for the clerkship.
If you have questions or suggestions about grading and evaluation in general, please contact the Clerkship Director or the Associate Clerkship Director. We particularly value input from both students and faculty during summer quarter as the new evaluation forms are put into place. To be fair to all students, once we have finalized the grading policy we will leave it unchanged for the remainder of the academic year, so if you have comments, now is the time!