Clerkship Grading, Promotion, and Remediation Information

Clerkship Grades

Clerkship course grades are generally comprised of clinical evaluation scores, OSCE/Oral exam scores, NBME shelf exam scores, and other assignments and assessments from the clerkship. Each clerkship discipline determines its overall course grading schema, which is approved by the Core Clinical Subcommittee and Curriculum Committee prior to the start of each academic year and will remain standard for the entire academic year from blocks 1 through 8. All clerkship grading methods will be clearly published in the clerkship-specific syllabus.  The Clerkship academic year will run from April to March (ex: April 2022 through March 2023). Students will follow the syllabus in the AY year in which the clerkship is taken.

A failing grade in any single component may result in failure of the clerkship, regardless of the overall clerkship grade calculation. The course director has the authority to determine if a student passes the clerkship, regardless of the final grade calculation.

A failure of a single component will be discussed by the clerkship director and course director to determine whether the failure should be remediated with a grade of incomplete (IP) until the student has successfully completed the remediation requirements, or result in a failure (F) for the clerkship.

Failure of two or more grade components (i.e. clinical grade, OSCE/Oral Exam, NBME, etc.) within the clerkship will result in failure of the clerkship.

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NBME SHELF EXAMS

The NBME provides both a percentage correct score and a percentile score for each exam. The percentage correct score is utilized for overall grade calculations. The percentile score is used to determine if the student passed.

Clerkships require the students score meet a minimum percentile score for passing. The percentile for passing is set by each clerkship and clearly published in the clerkship-specific syllabus.

Failure to pass the NBME exam will require a retake of the examination. If the student fails to pass the retake examination, a plan will be developed by the Clerkship Director in conjunction with Academic Support Services/Student Affairs that will be reviewed and discussed at the Student Promotions Committee (SPC). SPC will have the final determination on whether to approve this plan, make adjustments and/or if the student will need to repeat the clerkship in its entirety. A retake and/or failure may be mentioned in your final clerkship narrative.

Determining Quarters for Percentile Scores

NBME Academic Year Norms for AY 2023 (April 2023 through March 2024).

• Emergency Medicine
• Family Medicine
• Internal Medicine
• Obstetrics and Gynecology
• Pediatrics
• Psychiatry
• Surgery

Eligibility for Retake
Any student whose subject examination NBME score is below the percentile passing rate as set by the clerkship will be given the opportunity to retake the NBME. Prior to allowing a retake of the NBME, the overall clerkship grade will be calculated using the lowest passing numerical score to determine if the student has the ability to pass the clerkship. If the student does not have the ability to pass the clerkship with an NBME retake, they will fail the clerkship and be recommended to the Student Promotions Committee to repeat clerkship again in its entirety. Students will only be allowed to retake one NBME exam at scheduled break/exam retake time.

Notification for Retake
The clerkship director will inform the student that she/he is eligible for the retake exam. In addition, if the student does not retake the exam, an F will be recorded on the student's transcript for the clerkship.

Format for Retake
The retake exam will be a different form version than the original exam.

Timing for Retake
The retake exam will be scheduled during the next available curricular break or elective block. A student request for alternative or delayed exam must be made in writing to the Student Promotions Committee.  Due to holiday schedules, some curricular breaks may not allow for retake exams.

The retake exam cannot be scheduled during a current clerkship without approval. Students will be informed of the date of the retake exam by the respective clinical campus clerkship coordinator.

M4 students who need to retake an exam should be scheduled as soon as possible. The student will arrange the retake with the respective clinical campus clerkship coordinator based on room and proctor availability.

Location for Retake
Students will retake the exam on the clinical campus they are assigned. Legitimate requests for retaking the exam on a different clinical campus will be considered on a case-by-case basis by the Office of Academic Affairs. If approved, a minimum of two weeks lead time is required. Retake exams may be offered at limited locations due to holiday and staffing schedules. Students are expected to travel to the clinical campus where the retake NBME is being held. Travel arrangements to the clinical campus site for the retake are the sole responsibility of the student.

Grade on Retake
Students must achieve at or above the percentile passing rate as set by the clerkship. The percentile will be determined based on the original date of exam.  The student must meet the original passing score and the percentile mark from the block of the clerkship when the original NBME was taken.

^The numerical grade will be used in class ranks.

Clerkship Grade Calculation after an NBME retake
If a student successfully passes the NBME retake, the minimum percent correct score needed to pass the NBME will be used to calculate the final overall clerkship grade.

For example, if a student scores a 70 percent correct on the retake exam and the minimum score needed to reach the passing percentile is 65, a 65 is used for the final overall clerkship grade calculation.

The student cannot make higher than a Pass in the clerkship and will not be eligible for Honors.

OSCE/ORAL INTERVIEWS

Although OSCE/Oral Interview formatting and logistics will be similar across clerkships, each clerkship will determine the OSCE grading system that will remain standard for the entire academic year from Block 1 through Block 8 (April-March). This must be approved by the Core Clinical Subcommittee and Curriculum Committee as part of the overall clerkship course grading scheme.

No challenges to an OSCE grade will be reviewed unless the student has received an overall failing grade on the OSCE. Failure on a single OSCE case/component cannot be challenged.

OSCE exam materials will be available for review for up to five business days after the student receives the OSCE grade, by scheduling an appointment with the campus clerkship staff representative. When reviewing the exam, no cell phones, laptops, smartwatches or PDAs are permitted. Notebooks, textbooks and writing utensils are also not permitted.

Any challenge to the OSCE grade must be submitted in writing within five business days of the student receiving the OSCE grade. Any challenges submitted after this time period will not be accepted. A challenge to the OSCE grade allows for a total re-grading of the student's OSCE, which means the student(s) could lose points in other areas.

OSCE RETAKE INFORMATION

Failure to pass the OSCE exam will require a retake of the examination. If the student fails to pass the retake examination, a plan will be developed by the Clerkship Director in conjunction with Academic Support Services/Student Affairs that will be reviewed and discussed at the Student Promotions Committee (SPC). SPC will have the final determination on whether to approve this plan, make adjustments and/or if the student will need to repeat the clerkship in its entirety. A retake and/or failure may be mentioned in your final clerkship narrative.

Eligibility for Retake
Any student whose OSCE score does not fall within the individual clerkships guidelines for successful completion will be given the opportunity for OSCE retake. Prior to allowing a retake of the OSCE, the overall clerkship grade will be calculated using the lowest passing numerical score to determine if the student has the ability to pass the clerkship. If the student does not have the ability to pass the clerkship with an OSCE retake, they will fail the clerkship and be recommended to the Student Promotions Committee to repeat clerkship again in its entirety. Students will only be allowed to retake one OSCE exam at scheduled break/exam retake time.

Notification for Retake
The clerkship director will inform the student that she/he is eligible for the retake exam. In addition, if the student does not retake exam, an F will be recorded on the student's transcript for the clerkship.

Format for Retake
The format for the retake exam will be determined by the clerkship/course director(s).

Timing for Retake
The retake exam will be scheduled during the next available curricular break or elective block. In most cases, the retake will align with an already scheduled OSCE. A student request for alternative or delayed exam must be made in writing to the Student Promotions Committee.  Due to holiday schedules, some curricular breaks may not allow for retake exams. The retake exam cannot be scheduled during a current clerkship without approval. Students will be informed of the date of the retake exam by the respective clinical campus clerkship coordinator.

Location for Retake
The retake OSCE exam may be offered at limited campuses in order to be cost effective. The location will be determined no less than two weeks prior to the retake exam. Students are expected to travel to the clinical campus where the retake OSCE is being held. Travel arrangements to the clinical campus site for the retake are the sole responsibility of the student.

Grade on Retake
The student must meet the individual clerkships guidelines for successful completion of the OSCE.

^The numerical grade will be used in class ranks.

Clerkship Grade Calculation after an OSCE retake
If a student successfully passes the OSCE retake, the student will receive the minimum passing grade numerically for the OSCE (as set by the clerkship) to calculate the final grade.

For example, if a student scores an 85 on the retake OSCE and a minimum score of 70 is required, a 70 will be used to calculate the final overall clerkship grade.

The student cannot make higher than a Pass in the clerkship and will not be eligible for Honors.

Other Assignments & Assessments and Administrative Work

One of the competencies students must develop during their clinical training is the ability to accurately and appropriately document in a timely manner. Documentation is an essential and important feature of patient care and the professional workplace. Completing administrative work and keeping logs becomes a student training exercise in documentation. The seriousness and accuracy with which students maintain and update their log and complete other administrative work will be a part of their evaluation during the rotations. All of these features of documentation - seriousness, accuracy, conscientiousness, timeliness and honesty - are aspects of professionalism.

Failure to complete any component of the clerkship grade, including completing required patient logs and other assessments or administrative work/duties, will require remediation of that component. Failure to complete the required remediation will be considered an issue of professionalism and could result in failure of the clerkship.

Attendance Policy

Attendance is an integral part of the learning process and students must be present to engage in the education experience. Continued issues or concerns with attendance will be monitored by the clerkships and reported to Student Promotions Committee (SPC) and could negatively affect student's grades and ability to progress to fourth year.

A complete discussion of the Attendance Policy can be found in the Student Handbook.

Clerkship Failures and Remediation

• If a student fails any clerkship, the clerkship must be remediated successfully. Every component listed in the Clerkship Grading Schema must be passed in order to successfully pass the clerkship. This is to ensure students have demonstrated competency in all aspects of the curriculum.
• To pass a clerkship, all individual components and assessments within the clerkship must be successfully completed (initially or upon remediation).
• If a student fails more than one NBME shelf-exam, the student will be referred to the Academic Success Committee for discussion.
• If a student fails more than one OSCE, the student will be referred to the Academic Success Committee for discussion.
• If issues with professionalism, administrative work/duties or attendance arise on more than one clerkship, without correction, the student may be referred to Academic Success Committee and/or the SPC for professionalism issues.

NOTE: For purposes of student probation or advancement, remediating a failed 6 week or 8 week clerkship does not change the fact that it was failed. For example, if one student failed a clerkship and successfully remediates that clerkship, it is still considered that the student failed 6 or 8 weeks of coursework.

It is the responsibility of the course director and clerkship director to develop mechanisms for remediation for all non-examination failures and to administer the remediation of these components to students.

• Students will be notified by the clerkship director if there is a need to remediate any component of a clerkship.
• Failure to remediate a clerkship component will result in a recommendation to the SPC that the student repeat the entire clerkship course, regardless of the overall clerkship grade calculation. The course director has the authority to determine if a student passes the clerkship, regardless of the final grade calculation.

Student Promotions Committee

The progress of all students is closely monitored by the Student Promotions Committee (SPC). Students' final clerkship grades are reported to the SPC at the end of each clerkship for review. A complete outline of SPC policy can be found in the Student Handbook.

The following issues should be reported separately to Academic Affairs, even if the student successfully remediates the concern and passes the clerkship:

• Any failure in professionalism
• Failure of NBME Shelf Exam
• Failure of the OSCE
• Failure in overall clinical performance
• Any significant concern on a clinical evaluation
• Failure on an individual clinical evaluation
• Significant failure to complete administrative tasks
• Tardiness
• Significant concerns from patients, faculty, residents or staff