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Medical Education
Medical Student Education

Clinical Studies Assessment and Grading Policy


To outline student assessment in courses/clerkships in the clinical setting in Foundations 2 of the Bridges Curriculum.


UCSF students are expected to achieve competence upon graduation. For each competency, UCSF has developed milestones that students are expected to achieve by defined time points in the four-year curriculum. In the Clinical Core and Advanced Studies, students’ progress in particular competency domains is assessed through a variety of methods within each clerkship or course and longitudinally. Criteria for achievement of competence within each clerkship or course and competency domain are defined by the faculty.

Related LCME Standards:

9.5 Narrative Assessment

9.8 Fair and Timely Summative Feedback


  1. The standard of achievement is a “Pass.” Passing a clerkship clinically demonstrates working knowledge and application of that knowledge in patient care. Passing performance is demonstrated on clerkship evaluations submitted in the electronic evaluation system by supervising residents and attendings, written examinations, other assignments, assessment of professional behavior, and any other required learning activities including makeup work for missed sessions.
  2. Students must demonstrate mastery of core medical knowledge in core clerkships as demonstrated on clerkship examinations.
  3. Students in longitudinal clerkships must make satisfactory progress over the core clerkship year.


Assessment and grades
  • All core clerkships and most four-week advanced clinical courses are graded Honors/Pass/Incomplete/Provisional Non-Pass/Fail (H/P/I/E/F). Two-week clinical electives and non-clinical electives are graded Pass/Incomplete/Provisional Non-Pass/Fail; Honors is not available in these courses. Off-campus clerkships are graded as Pass/Fail only, and are not eligible for Honors.
  • By school policy, Honors are assigned to no more than 45% of students in each core clerkship.
  • Supervising faculty and residents complete evaluations of students including numerical ratings and narrative comments.
  • Summary evaluations of student performance in all required clerkships include numerical ratings and narrative comments about performance across competencies, compiled by the clerkship director working with the grading committee.
  • The Incomplete “I” grade is assigned when a student’s work is of passing quality, but incomplete for a valid reason. The provisional non-passing “E” grade is assigned when a student’s work is below passing quality. Remediation is required for a non-passing performance. Requirements to convert an I or E grade to a “P” grade are established by the course director.
  • Students in longitudinal integrated clerkships (LICs) meeting the standard of achievement receive “In Progress” (IP) grades in the Registrar’s system during the LIC. At the conclusion of the LIC, students are assigned a grade for each clerkship completed within the LIC. For any student whose work is below passing quality in one or more disciplines during the year, the LIC course directors assign a provisional non-passing grade that is equivalent to 6 or more units of the “Provisional Non-Passing” (E) grade for that quarter and has the same academic consequences as receiving an E grade in non-LIC courses. For details about associated academic consequences, please see the Satisfactory Academic Progress Policy and Academic Senate School of Medicine by-laws (section VII. SCHOOL OF MEDICINE STUDENT PROGRESS REQUIREMENTS).

Clerkship Exams

  • Students who do not pass a core clerkship examination on the first attempt but otherwise pass the clerkship clinically receive an I (incomplete) for the clerkship.
  • Students who do not pass a core clerkship examination on the second attempt but otherwise pass the clerkship clinically receive an E (incomplete) for the clerkship.

Grade Timeliness

  • It is the clerkship director’s responsibility to return all clerkship summary evaluations and grades to students within six weeks of the end of the clerkship.
Assessments outside of individual clinical rotations and courses
  • During the clinical years, all students are required to take the Clinical Performance Exam (CPX) series, a standardized patient (SP) program. Passage of the third component of the series, the CPX, is a graduation requirement.
  • Students who have not yet taken the USMLE Step 1 examination will be required to take the CBSE (Comprehensive Basic Science Examination) during an ARCH Week.

Accommodations for students with disabilities

  • Course directors are committed to providing academic accommodations for students with disabilities. To be eligible for accommodations for clerkship or assessment activities on the basis of a disability, students must provide documentation from Medical Student Disability Services well in advance of the clerkship. 

Accountable Dean or Director

Associate Dean for Competency Assessment and Professional Standards


  • For each clerkship, the clerkship/site director will specify during clerkship orientation whether each individual exam, assignment, and/or other required learning activity must be passed OR if passing the clerkship is determined by an aggregate score of all evaluations, exams, assignments and other learning activities.
  • Each clerkship’s CLE site has a grading overview page.
  • The yearlong LICs have periodic global assessment check-ins at which the LIC course directors assess each student’s overall performance.
  • After receipt of an I or an E grade, once a student has subsequently successfully fulfilled clerkship requirements, the student must submit a Removal of Provisional Grade Petition. For more information on grades, see Academic Senate School of Medicine by-laws (section VI. GRADES AND CREDITS FOR CANDIDATES FOR THE DEGREE OF DOCTOR OF MEDICINE and appendix IV section VI
  • Faculty members of grading committees or academic progress committees with a conflict of interest (i.e. personal or family relationship or provision of medical or psychiatric care for the student) must recuse themselves from voting upon or contributing to decisions about a potential adverse action against a student.
Accommodations for students with disabilities
  • Students are advised to notify the clerkship director well in advance of the clerkship about any disability accommodations that are needed and, at a minimum, two weeks before clerkship begins
Assistance with learning
  • While no formal program exists for tutoring or individualized preparation for medical knowledge exams during the third and fourth years, students are encouraged to consult with clerkship directors, staff advisors, the Associate Dean for Students, the Associate Dean for Curriculum, or their coach/Advisory College Mentor if they feel that they are struggling and need additional learning support. The campus Learning Resource Services can also assist with clerkship learning through workshops and individual consultations. The School of Medicine Clinical Skills Guidance Program offers additional clinical skills support and is recommended to students based on performance on performance in clinical skills examinations and clerkships.

Related Policies

  1. UCSF School of Medicine Core Experiences and Midpoint Feedback Policy
  2. UCSF School of Medicine Foundations 1 Assessment and Grading Policy 

Updated Feb. 14, 2018