Clerkship Grading

The preceptors may use the RIME framework (Reporter, Interpreter, Manager, Educator) to help describe a student's progress while giving feedback.

Midclerkship and Final evaluations will be completed by the preceptor on ONE45.  All preceptors will use the Common Assessment Form to evaluate a student’s performance.  The Common Assessment Form is based on the UNC competencies as enumerated in the clerkship learning objectives.

A final grade of Honors for the clerkship means that the student performed in a superior fashion in all areas. A High Pass means the student performed in an excellent fashion in many areas. A Pass means the student performed satisfactorily in all areas. A Fail means that the student had serious deficiencies in performance of skills enumerated in the clerkship learning objectives section or had serious professionalism issues.

Since the preceptors do not grade uniformly, we may adjust a preceptor's marks upward or downward based on our experience with the specific preceptor.

Graded Components

Your final grade is determined by the following components:

  1. Evaluation of clinical performance by preceptor on Common Assessment Form: 40%
  2. Ambulatory Medicine Web-based Shelf Exam: 20%
  3. Multiple choice knowledge questions at the dayback: 10%
  4. Performance with standardized patients (OSCE): 10%
  5. Team based learning group assessment test: 6%
  6. Team based learning individual assessment test: 6%
  7. Reflective Essay: 5%
  8. Peer evaluations:  3%

The National mean for the Web-based Shelf exam is 70. The mean for UNC students is usually higher and often reaches 80. No student who performs under the mean +/- the standard deviation will be eligible for honors. Your final grade will be determined by comparing your performance to your peers in your block.

We normalize preceptor grades by reviewing the average scores for each preceptor and comparing you to that average. If you score greater than 2 standard deviations below that preceptor’s average, you will be in danger of failing the clerkship.

If you earn lower than the 10th percentile on the Ambulatory Online Shelf exam, you will receive a grade of Incomplete. You will need to score above the 10th percentile to pass the course.  You will need to retake the shelf exam, score above the 10th percentile at which time your grade will be change to a Pass with a notation of the initial grade and then the final grade.  A CDSP will automatically be generated.

Grade Distribution

There is no predetermined percent of students who will receive a given grade during each clerkship cohort.

Grade Appeals

Students must submit to the Clerkship Director in writing the reasons for the appeal and must provide objective documentation to support a change in a grade. The appeal will be presented to the Department of Medicine Education Committee. The decision of this committee is final. Students may not approach an individual preceptor unless directed to do so by the Clerkship Director.

The University’s Policy on Prohibited Harassment and Discrimination ( prohibits discrimination or harassment on the basis of an individual’s race, color, gender, national origin, age, religion, creed, disability, veteran’s status, sexual orientation, gender identity or gender expression.  Appendix B of this Policy provides specific information for students who believe that they have been discriminated against or harassed on the basis of one or more of these protected classifications.

Students who want additional information regarding the University’s process for investigating allegations of discrimination or harassment should contact the Equal Opportunity/ADA Office for assistance:


Equal Opportunity/ADA Office

The University of North Carolina at Chapel Hill

100 E. Franklin Street, Unit 110

Campus Box 9160

Chapel Hill, North Carolina 27599

Telephone: (919) 966-3576

Fax: (919) 962-2562



Any administrator or supervisor, including a department chair, associate dean or other administrator, who receives a student’s complaint about prohibited harassment or discrimination must notify the Equal Opportunity/ADA Office within five (5) calendar days of receiving the complaint.  If a student raises a claim of prohibited harassment or discrimination during an academic appeal, an investigation of the student’s claim must be performed under the direction of the Equal Opportunity/ADA Office.  The school or department must await the results of the harassment or discrimination investigation before deciding the student’s academic appeal.