Clerkship Grading Policy

Clinical Grade Percentage 50%
Shelf/Exam Percentage 30%
“Other” Components Percentage 20%
Honors 88.5%-100% **
High Pass 79.6-88.4%   **
Pass 69.6-79.5      **
Fail <69.6% OR <5% on the shelf or <2 on Professionalism
Exam minimum passing (percentile/2 digit score) 63
What is “Other” and what percentage is it worth?
Student presentation 15%
FOCUS form, mid-clerkship form completion and professionalism 5%
Other components that need to be completed in order to pass
the clerkship
Patient log
FOCuS Forms
Duty Hour logs
Clerkship Specific Clinical Grade Procedures/Policies
Clerkship Specific Grade Procedures/Policies

Guiding Principles– We strive to provide a grading system that is:

o   Fairly applied- a system that we follow for all students.

o   Transparent – students can clearly see the process by which the grade is derived.

o   Discriminating- the HONORS grade represents a performance of true distinction.

o   Based on your absolute performance. There is no ‘curve’ or fixed percentage about who can/cannot get HONORS…

o   Performance –based- what the student does and is reported- not based on potential.

The CSEF score (a total of 52 points) will be converted to a score out of 100 to generate the clinical grade.  (Example CSEF score of 42 out of a total of 52 points correlates to 80.7 points out of 100, which would count towards 50% of the final grade).

The CSEF grade is complemented by narrative description on the EValue form and by other observations conveyed by instructors.

The Formal Evaluation of the Oral Patient Presentation is graded using standardized grading rubric.

If the student scores > 5th percentile nationally on the initial attempt at the NBME Shelf Exam, he/she is assigned points for the NBME Shelf Exam component of the final grade in proportion to the 2-digit score.

*** Integrating the Clinical Performance Score into the Final Grade

The student will request evaluations from residents and faculty with whom they had a meaningful encounter. A meaningful encounter would be at least a half day on the inpatient wards or in clinic. The evaluations will be weighed depending on the number of sessions a student spends with a preceptor/resident.

To achieve a final grade of HONORS, the student must achieve >88.5 Total Points, an average CSEF score of > 2.5 in “Management Planning Skills” and > 3 in each other CSEF category. In addition, the student must achieve a score on the shelf exam of 70 or above.

To achieve a final grade of HIGH PASS, the student must achieve 79.6 to < 88.4 Total Points, a CSEF score of > 2 in “Management Planning Skills” and > 3 in each other CSEF category. The student must pass the shelf exam.

To achieve a final grade of PASS, the student must achieve 69.6 to < 79.5 Total Points, and an average CSEF score of > 2 in each CSEF category, except for “Management Planning Skills”. The student must pass the shelf exam.

Deriving the Final Composite Grade from the input. An example:

  1. 50% —Clinical evaluation—CSEF score 42 out of 52 is converted to score of 80.7 out of 100. The student received a CSEF score of > 2 in “Management Planning Skills” and > 3 in each other CSEF category.
  2. 30 % —NBME shelf exam— 84 points x .30
  3. 15 % —Averaged score of the oral presentation, 100 x 0.15

5%-completion of passport: 100 x 0.5

(80.7) x 0.50 + (84) x 0.30 + (100) x .15 + 100 x 0.5= 85.5

This student’s final (composite) grade for the clerkship is HIGH PASS.

Evaluation of a medical student’s performance while on a clinical clerkship includes all expectations outlined in the syllabus and clerkship orientation as well as the student’s professional conduct, ethical behavior, academic integrity, and interpersonal relationships with medical colleagues, department administrators, patients, and patients’ families.  Any lapses in professionalism may result in a loss of up to 3% of the total possible clerkship points regardless of performance in other areas of the clerkship.  Any professionalism lapses resulting in a loss of clerkship points will require narrative comments by the clerkship director in the professionalism comment section of the final evaluation.
Clerkship-Specific Failure and Remediation Policies/Procedures
If a student scores <36.4/52 on the CSEF or if a student receives a score of 1-1.9 (averaged score across evaluators) in any CSEF domain (except for “Management Planning Skills”) , this may result in a failure.

Fail Clinical-If the student Fails the clinical portion of the clerkship, or does not meet the standards for professionalism, the student must retake the clerkship in its entirety

Fail Shelf only –For students who meet expectations for all grading elements except that they score < 5th percentile (63) on the subject exam, they may retake the subject exam one time. If the student fails to meet > 5th percentile on the retake shelf exam, the student must retake the entire clerkship, including the shelf exam.

BUSM Grade Review Policy
BUSM’s Grade Reconsideration Policy is located in section 2.2 of the Policies and Procedures for Evaluation, Grading and Promotion of Boston University School of

Medicine MD Students:

Primary teaching affiliate
of BU School of Medicine