Grading: Clerkship Level


Policy 540.40


Policy Statement  


All University of Vermont clerkship rotations, other than the Bridge Clerkship, use the same grading policy.

Grading:

  1. Student achievement of University of Vermont and clerkship specific competencies will determine whether a student passes a clerkship.
  2. Each clerkship will assess student medical knowledge. Medical knowledge can be assessed by a standardized written or oral examination and/or other assessment tools.
    1. For clerkship rotations using a National Board of Medical Examiners (NBME) subject exam to assess medical knowledge, a passing score is defined as a score equal to or greater than the 5th percentile nationally. In the case where the 5th percentile does not directly correspond to an NBME two-digit score, the score closest to, but not exceeding the 5th percentile will be used. The 5th percentile is determined each quarter by the NBME, and the percentile rank is adjusted to account for the difference between the start of the clerkship year of the VIC and the national cohort.
    2. For clerkship rotations using other cognitive assessment tools, e.g., a locally produced multiple choice examination, a passing score is defined as a score of 70% or greater. The Robert Larner, M.D. College of Medicine at The University of Vermont does not round scores.
  3. Each clerkship will assess student clinical performance. Clinical performance can be assessed by preceptor observation, written notes, oral presentations, simulation exercises, and other means. All clerkship rotations will use the Uniform Clerkship Assessment form to assess clinical performance.
  4. At the conclusion of a clerkship, students will be assigned a grade of Honors, Pass, Fail, or Incomplete.
  5. Clerkship grades are posted to the grade portal of the Office of Medical Student Education within 35 days of the end of the clerkship.

Assignment of grades:

  1. Both clinical performance and medical knowledge assessments will be used to determine student grades. Approximately 70% of the total course grade will be derived from clinical performance and approximately 30% from assessment of medical knowledge.
  2. Performance on a clinical skills exam will be graded on a pass/fail basis.
  3. Passing grades will be assigned to students who meet all the following criteria:
    1. Complete all clerkship assignments.
    2. Pass all graded components of the clerkship (including a clinical skills examination if a clinical skills examination is part of the clerkship).
  4. Honors grades will be assigned to students who meet the criteria for passing the course and meet all of the following criteria:
    1. Pass all graded components of the clerkship on the first attempt;
    2. Score in the upper 50th percentile of the clerkship for the clinical performance assessment;
    3. Score in the upper 50th percentile of the clerkship for medical knowledge assessment. If an NBME subject examination is used for knowledge assessment, students must score in the upper 50th percentile nationally, adjusted by quarter.
    4. Score in the top 30-35% of the clerkship for the final grade.
  5. Failing grades will be assigned to students who meet any of the following criteria:
    1. An average score of less than 2 in any domain on the Universal Clerkship Evaluation form.
    2. Narrative comments on the universal clerkship evaluation form indicative of a failing performance.
    3. A failing score on a remediation examination of medical knowledge.
    4.  A failing score on a remediation of a clinical skills examination.
  6. A failing grade may be assigned to a student who meets any of the following criteria:
    1. Failure to complete all clerkship assignments within the time frame established by the clerkship director.
    2. A score of 1 anywhere on the universal clerkship evaluation form.
  7. A grade of incomplete will be assigned to students who meet any of the following criteria.
    1. Complete all clerkship assignments and pass all graded components of the clerkship but fail the assessment of medical knowledge.
    2. Complete all clerkship assignments and pass all graded components of the clerkship but fail the clinical skills examination. 
    3. A grade of incomplete must be entered at the end of 35 days for students who have not completed the requirements of the clerkship, or who have been granted an exam delay or excused absence.

Remediation

  1. A grade of incomplete can be removed by successful retake of either the cognitive exam or the assessment of clinical skills examination (whichever applies). Two failures of either assessment results in a grade of failure.
    1. A student shall not remediate a failed clerkship cognitive assessment during a subsequent clerkship. A student who has failed a clerkship cognitive assessment shall remediate that exam on designated days/times determined by the Clerkship Team.
    2. The Office of Medical Student Education Course Coordinator will contact the student, proctor, course director, COMET, and COMTS as needed to reschedule the assessment.
    3. Students failing a clinical skills examination will perform remedial activities at the discretion of the Clerkship Director and the Director of Simulation Education of the Clinical Simulation Laboratory. Following completion of these activities (if any), students must schedule a remedial clinical skills examination during the times designated by the Director of Simulation Education of the Clinical Simulation Laboratory.

End of Clerkship Clinical Skills Examination

Students must pass the End of Clerkship Clinical Skills Examination (CSE) in order to graduate. To be eligible to take the CSE, all required work of the Clerkship year must be completed successfully. A student failing the CSE after one attempt must retake the exam and will receive a grade of “incomplete.” Upon successful retake of the exam, the grade will be changed to “pass”. Students failing the End of Clerkship CSE a second time will receive a transcript grade of fail and will meet with the Associate/Assistant Dean for Students for the opportunity to discuss further remediation to be approved by the Committee on Advancement.

Applicability of the Policy


Clerkship Level Students

Related Larner College of Medicine Policies


Related University of Vermont Policies


Related Liaison Committee on Medical Education (LCME) Standard(s)


9.6 Setting Standards of Achievement

History


  • 7/25/2012 Policy Adopted/Affirmed [Medical Curriculum Committee]
  • 5/23/2016 Policy Revised [Medical Curriculum Committee]
  • 8/16/2016 Policy Revised [Medical Curriculum Committee]
  • 3/21/2017 Policy Revised [Medical Curriculum Committee]
  • 12/17/2019 Policy Revised [Medical Curriculum Committee]

Policy Oversight


Associate Dean for Clinical Education

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