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A student’s Medicine Inpatient Clerkship grade will be determined based on the following components:

Graded Components:

  1. Evaluation of clinical performance by attendings, residents and interns: 55%
  2. Observed H&P: 10%
  3. Graded H&P Write-up: 5%
  4. UNC Medicine Exam (clinical reasoning, CXR/EKG interpretation): 10%
  5. NBME/Shelf test: 20%

Pass/Fail Components:

  1. Students must submit five (5) signed and critiqued complete patient write-ups before the last day of the clerkship
  2. Students must submit a completed Admission Orders form
  3. Students must submit a Critical Incident Report and participate in the Humanities in Medicine seminar

Calculating Final Clerkship Grade

Final grades are reported as Honors, High Pass, Pass and Fail.

Students with a composite score in the top 35% of each clerkship cohort are candidates for a final grade of Honors. To receive an Honors grade, a student must also receive a score on the NBME/Shelf test above the mean for his/her clerkship cohort.

Students with a composite score in the next 35% will receive a final grade of High Pass.

Dr. Klipstein sets the minimum score needed to pass based on the performance of each clerkship cohort. Comments from attendings, residents and interns will be incorporated into a final written summary of each student’s performance.

Per UNC SOM policy, a student who satisfactorily completes all clerkship requirements but receives an NBME/Shelf test score that is below the 10th percentile (based on the appropriate national quarterly norms provided by the NBME) automatically earns a grade of Incomplete. The student will need to retake the Shelf test. If the student receives a sufficient score on the repeat exam, the clerkship grade will be converted to a Pass. Regardless of the improvement in the second Shelf test score, the final grade remains a Pass (i.e., the student is not eligible for a higher grade). If a student fails the exam a second time, the student’s final grade will be determined by the clerkship director based on the student’s overall performance. Repeating the clerkship may be required.

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 attending physician 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
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.

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