FEC Student and Faculty ForumShould We Change the Medical Student

Grading System?

How we arrived here…and

Where we are going…

Revisiting Lauren Wolchok’s Data (c/o 2013)

October 22 & 29, 20136:00-7:00pCHS 63-105

Current System: Pass/FailPass/Fail System: “The UCLA SOM has a pure Pass/Fail grading system for all four years.”

During the 3rd year…• Each required clerkship has a (1) clinical evaluation and (2) final exam.

1. Clinical: evaluations submitted by the residents/faculty to Course Chair• 5-part criteria

2. Exam: National shelf or exam of the clerkship’s choosing• Have set passing rates you must get above to pass

• If a student passes both the clinical and final exam component the first time, the student will receive a “Pass.”

• If a student fails the clinical portion of a clerkship and/or the exam, the student will receive a grade of “Fail” and must remediate.

DGSOM Website Policies and Forms Policies General Guidelines on Pass/Fail Grading (modified)http://www.medstudent.ucla.edu/offices/sao/clinical/GradingStudentEvaluations.cfm

Letter Of Distinction: An opportunity for faculty members to recognize a student who has distinguished himself/herself by demonstrating extraordinary performance…

“Only truly remarkable performance will be recognized…”

• LODs are cited in the Dean’s Letter accompanying internship and residency applications…

• No LOD maximum or minimum per clerkship (i.e., either several letters or none may be awarded)

• Exam Score Minimums: While not required, most clerkships have minimum Shelf Scores cut off the be eligible (normally ~80-85%)

• Evaluation Score Minimums: While not required, most clerkships have minimum 5-point evaluation scores required to obtain an LOD (i.e. must have more 5s than 4s)

Current System: LOD

DGSOM Website Policies and Forms Policies General Guidelines on Pass/Fail Grading (modified)http://www.medstudent.ucla.edu/offices/sao/clinical/GradingStudentEvaluations.cfm

Background*

The elected representative body of the Faculty of the School of Medicine

Key Responsibility: • Oversee the design and conduct of the academic program of courses and curriculum

A standing subcommittee of the FEC

Key Responsibilities: • Formulate and periodically review the mission statement for

undergraduate medical education• To evaluate existing courses and clerkships• To review and recommend revisions of the Medical School curricula

*http://www.medsch.ucla.edu/public/faculty/fec/fec.htm

Survey of the entire student body covering varous aspects of student education and wellbeing that was independently created, distributed and analyzed by the Medical Student Council

92% satisfaction with P/F in preclinical years68% satisfaction with P/F in clinical years39% believe P/F helpful in applying to residency26% think LOD awards are transparent59% do NOT think LOD awards are transparent22% think LOD awards are fair42% do NOT think LOD awards are fair

Research: LCME Student Survey

http://mscdgsom.weebly.com/lcme-student-surveys.html

--> Students are generally displeased with the Fail/Pass/LOD system of the 3rd year

LODs in Pediatrics by Site(20% Overall)

Research: LOD Consistency

TEXTReference

COMMUN.KA

CS

HARBOR

KAISER.SUN

RIVER/RED

UCLA/OVH

25%

27%

17%

50%

13% !!

0% !!

LODs in Internal Medicine by Site (23% Overall)

Research: LOD Consistency

TEXTReference

25%

27%

17%

50%

13% !!

0% !!

CS/HARBOR

CS/WVA

HARB/SMMC

HARBOR/KA

HARBOR/WVA

KA/OVH

KAISER/WVAOVH/SMMCWVA/OVH

OVH

UCLA

30%

20%

57%

14%8%

42%

15%

18%

CONCLUSIONS

Research: LOD Consistency

LOD distribution varied by Site

Range: 0% to 54%

LOD distribution varied by Clerkship

Range: 13-25%

Comparison: Top 30 Schools

TEXTReference

77% used 4+ tiers for evaluating 3rd and 4th year medical students

Grading Task Force Recommendations:

1. Move to 4-point grading system in 3rd & 4th years(Honors, High Pass, Pass, and Fail)

2. Final clerkship evaluation grade will be comprised of (1) clinical and (2) exam performance

3. There should be a clear spell out in the MSPE of clinical and exam performance separately

Note: These changes would only come into affect for the next incoming class of students (starting with c/o 2018).

Proposed Changes

FEC WebsiteMEC PageMinuteshttp://www.medsch.ucla.edu/public/faculty/MEC/Minutes.htm#