Foundations 2 and Career Launch Grading and Assessment Policy

Purpose

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

Overview

UCSF students are expected to achieve competence on the graduation milestones by the time they complete medical school. For each UCSF competency, UCSF has developed milestones that students are expected to achieve by defined time points in the four-year curriculum. In Foundations 2 and Career Launch clerkships, 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

Principles

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.
Students must demonstrate mastery of core medical knowledge in core clerkships as demonstrated on clerkship examinations.
Students in longitudinal integrated clerkships must make satisfactory progress over Foundations 2.

Policy

Assessment and grades

All core clerkships (as of January 2019; see information on core clerkship grading change here), two-week clinical electives, and non-clinical electives are graded Pass/Incomplete/Provisional Non-Pass/Fail; Honors is not available in these courses.
Most four-week advanced clinical courses in Career Launch are graded Honors/Pass/Incomplete/Provisional Non-Pass/Fail (H/P/I/E/F).
Off-campus clerkships are graded as Pass/Fail only, and are not eligible for Honors.
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 bylaws (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) grade 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 (provisional non-passing) grade for the clerkship.

Grade Timeliness

It is the clerkship director’s responsibility to return all clerkship summary evaluations and grades within 38 days of the end of the clerkship. Please see block vs. longitudinal clerkships procedures below.

Assessments outside of individual clinical rotations and courses

All students are required to take 2 standardized patient (SP) clinical performance exams during Foundations 2/Career Launch: the Mini-CPX and CPX. Passage of the CPX is a graduation requirement.
Students who have not yet taken the USMLE Step 1 examination are required to take the CBSE (Comprehensive Basic Science Examination) during an ARCH/PI Week.

Accommodations for students with disabilities

Clerkship 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.

Procedure

To optimize timely feedback to students and ensure compliance with the 38-day policy:
- All clerkship block rotations are asked to submit grades 30 days after the end of the block rotation.
- Longitudinal clerkships (KLIC-SF, KLIC-EB, PISCES, FCM 110) must submit quarterly progress grades (winter, spring, fall) within 30 days. Final grades must be submitted 38 days after the end of the Foundations 2 year.
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 iROCKET 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 clerkship will submit a revised clerkship summary evaluation.
For more information on grades, see Academic Senate School of Medicine bylaws (section VI. GRADES AND CREDITS FOR CANDIDATES FOR THE DEGREE OF DOCTOR OF MEDICINE).
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 the student begins clerkship.

Assistance with learning

For preparation for medical knowledge exams during Foundations 2, students are encouraged to consult with clerkship directors, staff advisors, the Associate Dean for Students, the Associate Dean for Curriculum, or their coach for learning support. All students have access to the UWorld question bank through the school. \The campus Learning Resource Services can also assist with clerkship learning through workshops and individual consultations. Tutors for clerkship exam preparation are available by referral. The School of Medicine Clinical Skills Guidance Program offers additional clinical skills support and is recommended to students based on performance in clinical skills examinations and clerkships.

Related Policies

Accountable Dean or Director: Associate Dean for Competency Assessment and Professional Standards

Approval Date and Governing Body: October 2, 2017, CCEP; January 7, 2019, Executive Committee

Last Updated: December 12, 2018 to reflect F2 Assessment redesign (approved by CCEP on 11/13/18). This policy now incorporates Career Launch Assessment plans as well.