Grading Overview: Third-Year Clerkships

During Foundations 2, students are evaluated largely based on their contributions in the workplace. Thus evaluation occurs somewhat differently than in the previous years of largely classroom-based and CMC training. Clerkships are workplace settings, not classroom settings, and in these environments several factors are much more important than they were previously:

1. Students are evaluated from day one by a number of different supervisors, each of whom has a unique role on the service and a unique set of skills and goals.

a. In team-based environments, students are evaluated through the particular “expectation lens” of each of their supervisors.

b. A student’s evaluation will represent an integrated assessment of all team members’ opinions. There is not a single definition of ‘outstanding’ or ‘poor’ performance.

c. It is helpful to keep in mind that there is no way to ensure total consistency in each individual supervisor’s approach to completing evaluations.

d. Each clerkship director working with a grading committee, however, maintains a consistent approach to integrating all supervisor feedback.

2. Students are evaluated for their ability to communicate knowledge as much as ability to acquire or retain it, as well as ability to demonstrate synthesis of different sources of knowledge (patients, supervisors, textbooks, journal articles, lab tests, interview, and exam findings).

3. Students are expected to achieve proficiency in each of the competencies listed on the evaluation form. This is the basis for a grade of “Pass.”  If a student does not pass, it will be because this student did not achieve proficiency in at least one of the competencies.

Here is a comparison of the grading across core clerkships:

Clerkship

Grading process

Components used for grade

Exam

Anesthesia 110

Grading committee assigns grades. The site director completes the summary evaluation and then the clerkship director completes the final course summary evaluation. The grade is based on both evaluation scores and educator comments.

Evaluation scores and comments.

Completion of all required materials.

No exam

Family & Community Medicine 110

Grading committee assigns grades and writes summaries in a collaborative manner. The grade is based on evaluation scores, educators’ comments, passing the final exam, and participation in FCM seminars.

65% clinical

15% participation in FCM Seminars

10% completing online cases

10% final exam based on FM cases

Also required to pass: active participation in all required teaching activities including completion of all core experiences and submission of preceptor log, required course paperwork, and evaluations in a timely manner.

Final exam counts for 10% and is based only on assigned FM cases.

 

Medicine 110

Grading committee assigns grades, site directors write summaries, and clerkship director approves grades.

Evaluations, numerical scores and qualitative comments; NBME subject exam

Exam counts towards assessment of knowledge; 2 SD below national average is failing score on exam. Must pass the exam to pass the clerkship.

Neurology 110

Grading committee assigns grades. The clerkship director writes the summary evaluation using language drawn from evaluator comments. Grades are based upon evaluation scores and exam scores, which are weighted proportionally then added together to yield a total clerkship score.

80% evaluations, 20% NBME subject exam.

 

Minimum passing score for the exam is 60. Exam counts 20% toward the final grade.

Obstetrics & Gynecology 110

Grading committee assigns grades and writes summary evaluations. The grade is based on evaluation scores and educator comments, and the exam score.

90% evaluation scores and comments, 10% NBME subject exam.

Minimum passing score for the exam is 60. 10% of overall score.

Pediatrics 110

Grading committee assigns grade. The site director writes the summary evaluation which is approved by the clerkship director. The grade is based on evaluation scores and educator comments, and the exam score.

Primarily evaluation scores and comments, additional information provided about performance to site or clerkship director are considered.

Exam supports eval scores in fund of knowledge, 70% to pass.

Psychiatry 110

Grading committee makes recommendations to the clerkship director. The clerkship director assigns grades and writes summaries. The grade is based on evaluation scores and educator comments, and the exam score. For longitudinal clerkships, final RIME weighs more.

Evaluation scores and comments, NBME subject exam.

Must score at or above 3rd percentile to pass exam.

Surgery 110

Grading committee assigns grade. The clerkship director writes summaries. The grade is based on evaluation scores and educator comments, and the exam score.

65% clinical, 10% physical exam, and 25% NBME subject exam.

Passing Score is 59.