Grade Options

AMS courses and clerkships are graded on an Honors (H)/Satisfactory (S)/No Credit (NC) basis and are recorded as such on the student’s Official AMS Banner Transcript and on the Internal AMS Grade Card that is posted in EMSR (Electronic Medical Student Record). The Medical Curriculum Committee has permitted some courses (especially those in the first semester of the first year) to use a mandatory S/NC grading system in which no Honors grades are awarded. Passing grades for courses that have a mandatory S/NC grading policy are recorded on the official University transcript with an asterisk (S*) next to the grade indicating that the Honors designation is not an option for this course.

In consultation with the course leader(s), grades are assigned to the student by the Director of the Preclinical Curriculum (first year or second year) for basic science courses. Grades in the two-year Doctoring course are determined by the Doctoring course leaders.

Grades in preclinical courses are determined according to the following guidelines:

Honors (H or HNRS): This grade indicates that the student has performed at a level of distinction as determined by the course leader.

Satisfactory (S): The student has completed all requirements of the course at or above the minimum standard of performance in all components of the course.

No Credit (NC): The student's overall performance in a course is below the minimum standard of performance.

Additional (temporary) grading options for all courses and clerkships are as follows:

Existing Deficiency (ED): This temporary grade indicates that the student has performed below the minimum standard of performance in certain components of the course or clerkship, but that overall performance was deemed satisfactory. This grade option is used when a course or clerkship leader(s) believes that a reasonably limited amount of additional effort or study would remedy these deficiencies and result in satisfactory performance in all course components. When using the ED option, the course leader(s) should discuss the deficiencies with the student, develop a plan and timetable for correction, and communicate this to the Associate Dean for Medical Education and the student's Academy Director. The course leader(s) should decide, at the time of the meeting with the student, what means should be used to evaluate the student's performance at the end of the timetable. When the student successfully remedies the deficiencies, the clerkship director or Doctoring course leader(s) will change the course or clerkship grade to satisfactory (S), and the student will receive full credit for the course. If the student fails to remedy the deficiencies, then the course or clerkship grade will be changed to no credit (NC). An ED grade not remedied within one year of the beginning of the course or clerkship may become NC. This will require the student to repeat the entire course or clerkship.

Incomplete (I or INC): Under exceptional circumstances outside of the student’s control (such as illness or family emergency), a course may be left incomplete (except for a regularly scheduled final examination), with the director of the preclinical curriculum and the course leader or clerkship director’s consent. In such cases, a grade of "I" will be assigned, provided that the student has filed a request for extension of time to complete the work of the course or clerkship and the director of the preclinical curriculum and the course leader or the clerkship director had consented to such a request.  Course work not completed within one year will result in the grade being changed to no credit (NC).

Transcripts

The grades of H/S/NC (or S*) are entered onto the AMS Official Banner Transcript by the AMS Registrar’s office.  An Internal AMS Grade Card is also maintained by the AMS Registrar’s office.  This Internal Grade Card contains information about temporary grades and grade changes. 

When a student fails a course or clerkship and receives an NC, a remediation plan is put into place by the Director of the Preclinical Curriculum and the course leader(s) or the clerkship director(s).  [In the preclinical years, remediation typically entails mandatory tutoring sessions followed by a remediation exam, or a repeat of the entire course.] After a course or clerkship has been successfully remediated or repeated, the new grade of “S” replaces the original grade of “NC” on the Official AMS Banner Transcript.  A comment is inserted in the "Notes" section of the AMS Internal Grade Card that records the date that the grade change occurred.  The grade card is uploaded to the student's electronic record (EMSR) twice each year. The grade of Honors is not an option for a preclinical course that is passed by virtue of remediation or retake.  The grade of Honors is not available for a clinical clerkship when the original grade was NC.  The grade of Honors may be available under extraordinary circumstances, and at the discretion of the clerkship director(s), when the original grade was ED.

Temporary grades of ED or I are noted on the Internal AMS Grade Card, and are changed to an “S” on the Official Banner AMS Transcript and the Internal AMS Grade Card after appropriate course work has been completed.

Grade Determination/Appeal

The Director of the Preclinical Curriculum and the course leader(s) or the clerkship director(s) are responsible for determining how students will be evaluated and how grades will be assigned. Students who believe that an assigned grade is not an accurate reflection of their performance should discuss this with the Director of the Preclinical Curriculum and the course leader(s) or clerkship director(s). While there is no formal avenue of appeal of a grade within the medical school beyond the judgment of the Director of the Preclinical Curriculum and the course leader(s) or the clerkship director(s), the Associate Dean for Medical Education may be asked to provide input into particularly contentious discussions regarding grade assignments.

Grading Policy for Preclinical Courses: Overview

The preclinical courses are organized within each of the first four semesters of medical school as Integrated Medical Sciences I-IV and Doctoring I-IV. Each semester of IMS consists of 2-5 courses, each of which is assigned a course number and is under the direction of a separate course leader(s). The grading policies for each of these courses are described in this document.

Grading Policy Preclinical Courses: Semester I

There are four IMS-I courses (SFM, Histology, Human Anatomy, and General Pathology) and one Doctoring course (Doctoring I) in Year I Semester I. All IMS-I courses and the Doctoring I course have grade options of S/NC (Satisfactory/ No Credit).  No Honors will be awarded in Semester I.

Grading for Doctoring I

• BIOL3640 Doctoring I (2 credit course) Course Leaders: S. Warrier, K. Dodd – S/NC

Grading for Doctoring I will be based upon performance in Small Groups, OSCEs, Case Write-ups, Field Notes, and Community Mentor sessions. If a student’s performance is unsatisfactory in any component of the course, s/he will be required to remediate the deficiency before receiving a final grade. If a student’s performance is unsatisfactory in more than one component of the course, s/he may be required to repeat the course. This determination is made by the Doctoring course leaders.  All NC grades in courses or clerkships are brought to the attention of the Medical Committee on Academic Standing (MCAS).

Grading for IMS-I

• BIOL3642 IMS-I: Scientific Foundations of Medicine (1 credit), P. Gruppuso, T. Salazar-Mather – S/NC
• BIOL3643 IMS-I: Histology (1 credit), M. Thompson, J. Ou – S/NC
• BIOL3644 IMS-I: Human Anatomy (2 credits), D. Ritter – S/NC
• BIOL3645 IMS-I: General Pathology (1 credit), L. Dumenco – S/NC

Examinations: There will be six integrated examinations during Semester I. Each exam will contain questions from 2 to 3 of the IMS-I courses. Course scores will be cumulative throughout the semester. A grade of 70 % or above will normally be considered passing. A cutoff below 70% may be designated as passing at the discretion of the course leader and the Director of the Preclinical Curriculum. Students who do not achieve a passing grade will be assigned a grade of NC (No Credit).

Small Group Sessions: Small group sessions and labs are important components of the IMS-I Anatomy, Histology, and General Pathology courses. Small group performance assessment is based upon participation, quality of contribution to the discussions as well as leadership skills. Each small-group leader will assess student performance in the following Nine Abilities: Ability I: Effective Communication, Ability III: Using Basic Science in the Practice of Medicine, Ability V: Lifelong Learning, and Ability VI: Professionalism. Small group faculty evaluations are posted in Oasis, the internal registration and evaluation system for AMS.

Attendance and participation in all small group and laboratory sessions is mandatory.  Students need to communicate with their Academy Director for permission to miss a small group and, if given permission, students must alert their small group leader.  If a student misses more than two small-group sessions (even if excused) and/or does not perform satisfactorily in the small-group sessions, s/he may receive an ED or NC in the course and be required to remediate the deficiency by special accommodation or by retaking the course. This determination is made by the Director of the Preclinical Curriculum and the IMS course leader. See the Attendance Policy section of the Student Policy Handbook for more details.

Remediation, Progression to Semester II

If a student receives a single grade of NC or ED in any Semester I course (including any of the four IMS-I courses or Doctoring I), s/he will be brought to the attention of the Medical Committee on Academic Standing (MCAS). The Director of the Preclinical Curriculum and the IMS course leader(s) or the Doctoring course leader will determine the remediation plan (which may consist of summer remediation or retaking of the entire course).

If a student fails a special remediation examination, s/he will be required to repeat the course the following year, and this second NC will be brought to the attention of the MCAS.  The student may be placed on academic warning. Students will be permitted to take only one remediation exam. Exceptions will be considered by the Associate Dean for Medical Education in unusual circumstances.

Students failing two or more Semester I courses (including the four IMS-I courses and Doctoring I) will be required to repeat the entire semester and will be placed on academic warning or probation. Such determination is made by the MCAS. Students who return the following year and fail an additional course can be considered for probation and/or dismissal by MCAS. Students will not be allowed to return a third time to repeat Semester I.

Grading Policy Preclinical Courses: Semester II

There are three IMS-II courses (Brain Sciences, Microbiology/Infectious Diseases, and Endocrine Sciences) and one Doctoring course (Doctoring II) in Semester II.  Doctoring II is graded with S/NC options.  The Honors grade designation is available for all three IMS-II courses (H/S/NC).

Grading for Doctoring II

• BIOL3650 Doctoring II (2 credit course) S. Warrier, K. Dodd – S/NC

Grading follows the same policies as for Doctoring I.

Grading for IMS-II

Each IMS-II course is graded H/S/NC (Honors, Satisfactory, No Credit).  Grades are determined based on examination scores and small group attendance and participation

• BIOL3652  IMS-II: Brain Sciences  (2 credits),  J. Roth, N.S. Potter, J. Donahue, J. Donoghue, R. Boland, S. Salloway – H/S/NC 
• BIOL3653  IMS-II: Microbiology/Infectious Diseases (1 credit) T. Salazar-Mather, M. Gaitanis, J. Lonks – H/S/NC 
• BIOL3654 IMS-II: Endocrine Sciences (1 credit) G. Gopalakrishnan   – H/S/NC

Examinations: There will be three exams in the Brain Sciences course, two examinations in the Microbiology/Infectious Diseases course, and a single examination in the Endocrine Sciences course.  In courses with more than one exam, scores are cumulative and final grades are determined based upon the total number of possible points on all exams. Overall cumulative exam scores of 90 or above will be designated for Honors. This honor grade cut-off may be adjusted at the discretion of the director of the preclinical curriculum (first year) and the course leader(s). A grade of 70% or above will normally be considered passing. A cutoff below 70% may be designated as passing at the discretion of the course leader(s) in conjunction with the director of the preclinical curriculum (first year). Students who receive a failing grade in an IMS-II course will receive an NC and be brought to the attention of the MCAS. The Director of the Preclinical Curriculum and the course leader(s) will determine the remediation plan (which may consist of summer remediation or retaking of the entire course).

Small Group Sessions: Small group sessions and labs are important components of the IMS-II Brain Sciences, Micro/ID, Endocrine Sciences and Doctoring II courses. Epidemiology small groups are integrated into an IMS-II course as well.  Small group performance assessment is based upon participation, quality of contribution to the discussions as well as leadership skills. Each small-group leader will assess student performance in the following Nine Abilities: Ability I: Effective Communication, Ability III: Using Basic Science in the Practice of Medicine, Ability V: Lifelong Learning, and Ability VI: Professionalism. Small group faculty evaluations are posted in Oasis, the internal registration and evaluation system for AMS.

Attendance and participation in all small group and laboratory sessions is mandatory.  Students need to communicate with their Academy Director for permission to miss a small group and, if given permission, students must alert their small group leader.  If a student misses more than two small-group sessions (even if excused) and/or does not perform satisfactorily in the small-group sessions, s/he may receive an ED or an NC in the course and be required to remediate the deficiency by special accommodation or by retaking the course. This determination is made by the director of the preclinical curriculum and the IMS course leader. See the Attendance Policy section of the Student Policy Handbook for more details.

Remediation, Progression to Year II

If a student receives a single grade of NC or ED in any Semester II course (including the three IMS-II courses and Doctoring II), s/he will be brought to the attention of the Medical Committee on Academic Standing (MCAS). The director of the preclinical curriculum and the IMS course leader(s) or the Doctoring course leader will determine the remediation plan (which may consist of summer remediation or retaking of the entire course).  If a student is permitted to take and then fails a special remediation examination, s/he will be required to repeat the course the following year. Students will be permitted to take only one remediation exam. Exceptions will be considered by the Associate Dean for Medical Education in unusual circumstances.

Students failing two or more Semester II courses (including the three IMS-II courses and Doctoring II) will be required to repeat the semester.  Students will not be allowed to return a third time to repeat Semester II.  Note that students must successfully complete both Doctoring I and Doctoring II in order to proceed on to Year 2.

Grading Policy Preclinical Courses: Year II

There are five IMS-III courses (Cardiovascular, Renal, Human Reproduction, Pulmonary, Supporting Structures) and one Doctoring course (Doctoring III) in Semester III.  There are two IMS-IV courses (Hematology and Gastroenterology) and one Doctoring course (Doctoring IV) in Semester IV. 

Each IMS-III and IMS-IV course is graded H/S/NC (Honors, Satisfactory, No Credit). Grades are determined based on examination scores and upon small group attendance and participation.  Doctoring III is graded S/NC, while Doctoring IV is graded H/S/NC.

Grading for Doctoring III & IV

• BIOL3660 Doctoring III (2 credit course) Course Leader: M. Daniel – S/NC

Grading for Doctoring III will be based upon performance in Small Groups, OSCEs, Case Write- Ups, Field Notes, and Community Mentor sessions. If a student’s performance is unsatisfactory in any component of the course, s/he will be required to remediate the deficiency before receiving a final grade. If a student’s performance is unsatisfactory in more than one component of the course, s/he may be required to repeat the course. This determination is made by the Doctoring course leader.

• BIOL3670 Doctoring IV (2 credit course) Course Leader: M. Daniel – H/S/NC.

Students must pass each component of Doctoring (I, II, III) to move on to the subsequent Doctoring component.

Although the first three semesters of the Doctoring Course are graded S/NC, the Honors (H) grade option is offered in Doctoring IV. The components of students’ grades that are used to determine Honors include Small Group faculty evaluations, Final OSCEs, single best Case Write-up and Field Note from the year and the Community Mentor evaluation. If a student’s performance is unsatisfactory in any component of Doctoring IV, the same policies will be followed as those described for Doctoring III (see above).

Grading for IMS-III and IMS-IV

• BIOL3662 IMS-III: Cardiovascular (1 credit) D. Burtt, R. DeLellis, W. Bowen
• BIOL3664 IMS-III: Renal (1 credit) S.Hu, A. Cohen, R. DeLellis, W. Bowen
• BIOL3674 IMS-III: Human Reproduction (1 credit) T. Tejada Berges, R. DeLellis, W. Bowen
• BIOL3663 IMS-III: Pulmonary (1 credit) M. Jankowich, B. Kimble, R. DeLellis, W. Bowen
• BIOL3665  IMS-IV: Supporting Structures (1 credit) S. Schwartz, J. Katarincic, L Robinson-Bostom, R. DeLellis, W. Bowen
• BIOL3672 IMS-IV: Hematology (1 credit) E. Wittels, A. Taber, L. Dumenco, W. Bowen
• BIOL3673 IMS-IV: Gastroenterology (1 credit) H. Rich, M. LeGolvan, W. Bowen

Grades for each of the IMS-III and IMS-IV courses are determined based on examination scores and small group attendance and participation:

Examinations: Grades for each IMS-III and IMS-IV course (with the exception of IMS-III: Supporting Structures) are based upon a single examination and small group attendance and participation.  (A quiz also contributes to the final course grade in IMS-III: Renal). There are two examinations in the Supporting Structures course (the first, Orthopedics exam score, is carried over from Semester II; the second examination on Dermatology and Rheumatology occurs in Semester III).  These scores are cumulative, and the final grade for Supporting Structures is determined based upon the total number of possible points on the two exams.

For all IMS-III and IMS-IV courses, an overall cumulative exam score of 90 or above will be designated for Honors. This honor grade cut-off may be adjusted at the discretion of the course leaders and the director of the preclinical curriculum (second year). A grade of 70% or above will normally be considered passing. A cutoff below 70% may be designated as passing at the discretion of the course leader(s) in conjunction with the Director of the Preclinical Curriculum (second-year). Students who receive a single failing grade in an IMS-III or IMS-IV course will receive an NC and be brought to the attention of the MCAS.  The remediation plan is determined by the director of the preclinical curriculum (second-year) and the course leader(s).  This remediation most often consists of a period of tutoring and independent study followed by a remediation examination).

Small Group Sessions: Small group sessions and labs are important components of the IMS-III and IMS-IV courses (including Cardiovascular, Renal, Pulmonary, Human Reproduction, Hematology, Gastroenterology and Supporting Structures). Epidemiology small groups are integrated into several IMS courses as well. Small group performance assessment is based upon participation, quality of contribution to the discussions as well as leadership skills. Each small-group leader will assess student performance in the following Nine Abilities: Ability I: Effective Communication, Ability III: Using Basic Science in the Practice of Medicine, Ability V: Lifelong Learning, and Ability VI: Professionalism. Small group faculty evaluations are posted in Oasis, the internal registration and evaluation system for AMS.

Attendance and participation in all small group and laboratory sessions is mandatory.  Students need to communicate with their Academy Director for permission to miss a small group and, if given permission, students must alert their small group leader.  If a student misses more than two small-group sessions (even if excused) and/or does not perform satisfactorily in the small-group sessions, s/he may receive an ED or an NC in the course and be required to remediate the deficiency by special accommodation or by retaking the course. This determination is made by the Director of the Preclinical Curriculum (second-year) and the IMS course leader or the Doctoring course leader. See the Attendance Policy section of the Student Policy Handbook for more details.

Remediation, Progression

Students who receive a single failing grade in any Semester III course (including the five IMS-III courses and Doctoring III) will receive an NC and be brought to the attention of the MCAS. The MCAS will consider options for remediation based upon the recommendations of the director of the preclinical curriculum (second year) and the course leader(s) in consultation with the Associate Dean for Medical Education. If a student fails a special remediation examination, s/he will be required to repeat the course the following year. Students will be permitted to take only one remediation exam. Exceptions will be considered by the Associate Dean for Medical Education in unusual circumstances.

Students who fail two or more Semester III courses (any of the five IMS-III courses and Doctoring III) will be brought to the attention of the MCAS and will be required to repeat the entire semester. Students will not be allowed to return a third time to repeat Semester III.

Students who receive a single failing grade in any Semester IV course (including the two IMS-IV courses and Doctoring IV) will receive an NC and be brought to the attention of the MCAS. The director of the preclinical curriculum (second-year) and the IMS course leader(s) or the Doctoring course leader will determine the remediation plan (which may consist of required tutoring and independent study followed by a remediation or retaking of the entire course).  If a student is allowed to remediate this course via a special examination, it must be taken after completion of the semester before preparing for and taking Step 1. If a student is permitted to take and then fails a special remediation examination, s/he will be required to repeat the course the following year. Students will be permitted to take only one remediation exam. Exceptions will be considered by the Associate Dean for Medical Education in unusual circumstances.

Students failing two or more Semester IV courses (including the two IMS-IV courses and Doctoring IV) will be brought to the attention of the MCAS and will be required to repeat the entire semester. Students will not be allowed to return a third time to repeat Semester IV.

Students must successfully complete all preclinical courses before progressing to Year 3.

 

Timing of the USLME Step 1 Examination

The Office of Medical Education will provide information sessions on Step 1 preparation duing Year 2.  Students are provided with at least 6 weeks of Step 1 preparation time after completion of Year 2 courses at the end of February to prepare for taking the USMLE Step 1 Exam.  The medical school will not permit students to take the Step 1 exam before they successfully complete all preclinical coursework including IMS I-IV and Doctoring I-IV.

 

Grading Policies Years III and IV: Clinical Clerkship, Sub-Internships, and Electives

Clinical Skills Clerkship (CSC, BIOL 5885, J. Taylor, P. George, D. Zink): This first, non-specialty-specific clerkship will provide new third-year students with the transition from the preclinical to the clinical curriculum. Performance is based on participation in small groups and a six-station summative OSCE exam. Grading options for this three-week course that is offered annually each April/May are S/NC (Satisfactory/No Credit).

Subsequently, all required specialty-specific clinical clerkships (Internal Medicine, Pediatrics, Family Medicine, Surgery, Psychiatry, and Obstetrics & Gynecology), the Community Health Clerkship, sub-internships, and elective rotations are graded using a 3-tier system, the tiers being H/S/NC (Honors/Satisfactory/No Credit).

Grading for Clinical Clerkships:

• BIOL3001: Internal Medicine: M. Fagan, A. Charles, B. Gentilesco, J. Rabatin
• BIOL4500: Pediatrics: R. Rockney, B. Alverson
• BIOL5800: Family Medicine: D. Anthony
• BIOL4900: Obstetrics & Gynecology: B. Hampton, B. O’Brien
• BIOL5100: Psychiatry: R. Boland, T. Guthrie
• BIOL3900: Surgery: D. Roye, E. Ryder
• BIOL5400: Community Heath: E. Feller, P. Nolan, M. Mello

Specifics regarding the mechanisms for assigning grades for each course will be made available at the start of each clerkship. All clerkships aim to award Honors at a target level of 28% (< 30%) of students.

Students who require remediation in one clerkship may be allowed to progress to a different one.

Longitudinal Ambulatory Clerkship (LAC, various course numbers depending on the specialty, various faculty): Students are required to complete a longitudinal ambulatory clerkship in their last two years of medical school. The LAC is of six months duration and consists of one-half day per week at a single outpatient site.  A grade is determined by the one attending physician supervisor based on the student’s clinical performance.  Grading options for this required course are H/S/NC (Honors/Satisfactory/No Credit). 

Sub-internships:  During the fourth year, students must complete at least one sub-internship.  Grading options for this required course are H/S/NC (Honors/Satisfactory/No Credit).

The fourth-year Objective Structured Clinical Examination (P. George): After completing all of their core clinical clerkships, every senior medical student must take a summative Objective Structure Clinical Examination (OSCE) in the summer of Year 4. At AMS, the fourth-year OSCE assesses student competency in clinical skills using trained standardized patients. After completing this high-stakes Pass/Fail exam that is modeled after and prepares students for the USMLE Step II Clinical Skills exam, students receive detailed written feedback on their performance. At AMS, OSCE performance may be documented in students’ MSPE or “Dean’s Letter.”