PS1 - 01: VARIATION OF SURGERY CLERKSHIP GRADES IN US MEDICAL SCHOOLS
Mary R Shen, MS, Michelle R Brownstein, MD, Michael O Meyers, MD; University of North Carolina at Chapel Hill

Purpose: Although many aspects of medical education have become standardized, evaluation and reporting of student clerkships has been highly variable.  We sought to review the spectrum of surgical clerkship grades reported for students in the current application cycle.     

Methods:  Applications to a single surgery program in the fall of 2017 were evaluated.  Surgical clerkship grading criteria, number of grading tiers and percentage of students assigned to each grade tier (when present) for surgical clerkships were categorized.  Data were analyzed by Student’s t-test and Fisher’s exact test.   

Results: 91 schools (37 private) were evaluated.  Geographic location was: 33 south, 20 midwest, 18 west and 20 northeast.  One school was pass/fail, all provided a description of how clerkship grades were calculated and 97% provided information about number of grading categories.  Mean number of grading categories was 3.8 ± 0.9; 68% had 3 or 4 tiers.  91% provided a reference range for student performance (96% public v 84% private; p=0.06) .  The mean percentage of students in the top grading tier was 31% ±15% (29% public v 34% private; p=0.11).  Northeast schools (37.8%) were slightly more likely to have students in the top tier than other regions (28.2-31%).  The median percentage was 27% which was slightly higher for private (32%) vs. public (25%).  Only 16% of schools had <20% of students in the top grading tier.  The mean percentage of students in the second grading tier was 45.2% ± 20% (47.3% public vs. 41.8% private; p=0.20).  Taken together, the mean number of students in the top two tiers was 68.9% ± 30.9% (72.6% public v 63.5% private; p=0.17) with 57% having >75% of students in the top two tiers.  There was no geographic difference in the top two tiers (range 65.6%-73.7%); p=NS.

Conclusions: There remains significant variation in surgical clerkship grading between medical schools with 80% of schools having >20% of students in the top grading tier.  Regardless of the number of grading tiers, 57% of schools had more than ¾ of students in the top two tiers.  Consideration should be given to standardizing grading schemes across medical schools.