Clerkship Grading

Clerkship grades are primarily determined by your clinical evaluations and final exam score. However, your entire performance, including evaluator’s comments, acceptable completion of all requirements, participation during didactics and completion of e-learning activities, are reviewed and can contribute to your final grade.

2021-2022 Grading (effective 3/29/21)

Accounts for ~2/3rds of your final grade.

Your Clinical Grade is based on the UWSoM ESPCC (Evaluation of Student Performance in Clinical Curriculum) from each of your supervisors. Faculty, resident and other staff evaluations all contribute, and these scores are weighted by the amount of time an evaluator spent with you. The 12 ESPCC evaluative areas are averaged and combined with the “recommended overall level of evaluation” in a 2/3 to 1/3 proportion to determine overall Clinical Score. Guidelines for converting clinical scores into clinical grades are below, but these are only guidelines and are impacted by comments and requirements:

Clinical Score*                                                      Clinical Grade

≥ 4.7                                                                        “Honors”

Less than 4.7 and ≥ 4.2                                          “High Pass”

Less than 4.2 and ≥ 3.0                                          “Pass”

Less than 3.0                                                          Reviewed for possible final grade of “Fail”

A failing Clinical Grade (Clinical score of < 3.0) may result in failing the clerkship regardless of your Exam Score. Not completing clerkship requirements will negatively impact your Clinical Grade. Historically, the average Clinical Score in psychiatry is ~4.5±0.4 representing a mix of 4’s and 5’s on the ESPCC.

*You cannot calculate your Clinical Score from your E*Value report, as E*Value requires us to enter rounded, whole numbers, and not the actual average ESPCC scores with decimal accuracy. However, we will report your calculated clinical score on your evaluation. 

Accounts for ~1/3rd of your Final Grade

We use the NBME clinical science exam in psychiatry as our final exam. The percent correct you achieve on the NBME will be reported on your evaluation.

You must get 81% correct (~29th percentile nationally) or above to receive a Final Grade of Honors. Please note, scoring above 81% correct on the NBME does not mean your Clinical Grade of Honors will always translate to a Final Grade of Honors as lower exam scores continue to impact your Final Score/Grade even if you are above the 81% cutoff.

You must get 71% correct (~4th percentile nationally) or above to pass the exam. Scoring 70% or below will require you to retake the NBME in accordance with Patient Care Phase policies. If you fail the NBME exam on your first try (e.g., getting 70% or less correct) the maximum Final Grade you can receive for the clerkship will be a Pass and may result in failure of the clerkship and need to retake the clerkship in its entirety. Historically, the UWSOM average NBME score is ~84±6% correct, virtually equivalent to the national average.

Your Clinical Score (accounting for ~66.7%) and Exam Score (accounting for ~33.3%) will be combined to determine your Final Score using standard statistical methods (i.e., converted to Z-scores, combined and compared to historical averages). Of note, your final score cannot be calculated by you from your overall evaluation. Your Final Score will be translated into the Final Grade using the chart below as a guide:

Final Score                                                            Final Grade

≥ 4.7                                                                        “Honors”

Less than 4.7 and ≥ 4.3                                          “High Pass”

Less than 4.3 and ≥ 3.0                                          “Pass”

Less than 3.0                                                          Reviewed for possible final grade of “Fail”

These cutoffs were chosen by analysis of yearly UWSoM trends and set such that our Final Grade distribution is roughly 30% Honors, 45% High Pass and 25% Pass. The exact distribution of grades is not fixed will vary slightly each year.

If you disagree with the grade you have received for you psychiatry clerkship, there is a an official process you need to follow.


1. Ask for a Grade Review with the Admin

To initiate a grade review, request a grade review with the course administrator for a guided review of evaluations (if any), exam scores, and/or final examination score. If after the grade review, students are unsatisfied, they may initiate the grade challenge process.

Margie Trenary 


If you are not satisfied after the discussion with the department admin, the next step is:

2. Submit a Grade Challenge form to the director (Dr. Borghesani or Dr. Anne Thomas for WRITE students)

Submit a written grade challenge request to the course director by week four of the following quarter. This allows a minimum of three weeks to meet with the student and process the challenge.

After meeting, the director will contact the student within three weeks in writing with the grade challenge decision, allowing the student one week to decide whether an appeal is necessary.



If after your discussion with Dr. Borghesani or Dr. Thomas, your grade challenge has not been resolved, the final step is:

3. Submit a Grade Appeal form (send to SoM Grade Appeal Committee)

Following an unsatisfactory grade review and grade challenge, students may submit a grade appeal by week eight of the following quarter by completing the form and submitting to The Foundations Grade Appeal Committee will meet to review all materials related to the appeal and make the final determination to retain or revise the grade by a minimum of four weeks after receipt. Grade appeal must be completed by the end of the following quarter.


School of Medicin Page for Grade Disputes