Grading System

The following grading system is used to report on the official transcript the performance of students in all courses and clerkships taken while an MD degree candidate:

• Pass (+) indicates that a student has demonstrated to the satisfaction of the responsible department or teaching group that they have mastered the material taught in the course.
• Incomplete (I) indicates that extenuating medical or personal circumstances beyond the student’s control have prevented completion of course requirements. An incomplete can be corrected in a manner specified by the department or teaching group and must be corrected within one year (unless the Committee on Performance, Professionalism and Promotion specifies an earlier date). When a student takes a final or makeup examination following an incomplete, it becomes a pass, marginal pass or fail. If the student does not attempt to correct the incomplete within the agreed-upon time, it becomes a fail.
• Continuing (N) indicates that the course has not concluded and that the student is continuing the course or that a minor component of a course (as defined by the course director) is pending.
• Grade Not Reported (GNR) indicates that a grade has not been reported by the instructor.

A student may not receive credit for repeating a course unless the content has changed significantly, as determined by the course director.

In addition to these transcript-related grades, additional designations are used internal to the School of Medicine to report on academic progress:

• Marginal Pass (MP) indicates that a student has fallen short of meeting minimal performance standards for a pass but has done better than a fail at the end of the academic quarter, and that additional work or remediation is necessary to achieve a pass. MP grades are tracked internally in the School of Medicine through the Medical Education Platform (MEP), and should be entered as an N grade in Axess.
  
• Fail (-) indicates that a student has not met the minimum performance standards for the course. A course in which a student has received a fail grade does not show up on the official transcript. A course in which a student has received a fail grade must be repeated, and the student must achieve a passing grade within one year of the failure or prior to beginning clerkships, whichever is sooner.

updated August 2022

All required pre-clerkship courses must provide students formal mid-quarter feedback of performance. Mid-quarter feedback must be provided early enough to allow a student the opportunity to improve their performance before the end of the course. Mid-quarter feedback should be provided by the mid-point of the course, and by the end of the 5^th week for standard 10-week courses. Mid-quarter feedback is recorded in the Medical Education Platform (MEP) student record system.

updated August 2022

Narrative assessment is provided to medical students in courses where the primary mode of instruction includes small group activities (typically up to 12 students per group), small clinical reasoning, clinical skills, and/or team-based learning where attendance is required and there is longitudinal direct contact with an individual faculty member for at least 10 hours during the course.   

In other pre-clerkship courses, where the primary mode of instruction takes place in lectures with occasional small group activities narrative assessments may be provided at the end of the course if attendance for the sessions is required and individual faculty have had at least 10 hours of direct contact time with the student during the course.  

In addition, faculty may provide narrative comments if they so choose when submitting mid-quarter feedback for each student via MEP (Medical Education Platform). 

updated August 2022

The End-Quarter Period is a time of reduced social and extracurricular activity preceding final examinations. Its purpose is to permit students to concentrate on academic work and to prepare for final examinations.

During the End-Quarter Period, classes are regularly scheduled and assignments made; this regular class time is used by instructors in whatever way seems best suited to the completion and summation of course material. Instructors should neither make extraordinary assignments nor announce additional course meetings in order to “catch up” on course presentations that have fallen behind. They are free, however, and even encouraged to conduct review sessions and to suggest other activities that might seem appropriate for students preparing for final examinations.

Students are expected to remain on campus during the end-quarter period and are advised to avoid planning activities that might conflict with course commitments and final exam preparation during this week.

No final examinations should be given during the End-Quarter Period except:

1. In classes where graded homework assignments or quizzes are routine parts of the instruction process.
2. In classes with laboratories where the final examination will not test the laboratory component. In such a case, the laboratory session(s) during the End- Quarter Period may be used to examine students on that aspect of the course.
3. In Practice of Medicine, in which previously scheduled standardized patient (SP) assessments are permitted during the End-Quarter Period.
4. In Science of Medicine, in which assessments may be maximally spread out in order to account for student wellness.

Major papers or projects about which the student has had reasonable notice may be called due in the End-Quarter Period. Take-home final examinations, given in place of the officially scheduled in-class examination, may be distributed in the End-Quarter Period. Although the instructor may ask students to return take-home examinations early in the final examination period, the instructor may not call them due until the end of the regularly scheduled examination time for that course. Such a policy respects the principle that students’ final examinations are to be scheduled over a period of several days.

Please note: In the COVID-era, there may be marked changes to the above policies. Our procedures will need to adapt to the changing landscape of county, state, and university regulations.

updated August 2022

Final examinations are scheduled by the Office of Medical Education, which posts tentative dates and times by the end of the previous quarter and final schedules by the end of the second week of the quarter. Students anticipating conflicts in examination schedules should seek to resolve them with course instructors.

Students are expected to remain on campus during the final exam period and should not book travel or other plans until they have confirmed the dates that they must sit for their final exams. Final exams should take priority over other commitments and students are advised to plan accordingly.

Final examinations are governed by the regulations below:

1. Students are expected to take the final examination unless at least 24 hours prior to the examination they have received formal written approval for either dropping the course from the course director or for obtaining an incomplete from an Advising Dean. Incompletes are given for significant personal or medical reasons beyond the student’s control. If a student does not appear for the examination and has not been granted a drop or an incomplete, the student will receive a fail.
2. Students are expected to report for their examinations at the time and place designated by the Office of Medical Education or the course director, unless the course director has made alternative arrangements. While examinations are not “proctored” as such, students must take the examination in the designated location within the prescribed examination time. Students are expected to adhere to the Honor Code at all times during examinations.
3. When the final examination or its appropriate substitute is not an in-class examination (e.g., when an instructor assigns a take-home examination, paper, or project in lieu of an in-class examination), the schedule and format of the final examination, or its substitute, will be determined no later than the end of the second week of the quarter and, if changed subsequently, may be only a modification approved by a majority of the students in the class.
4. Students with documented disabilities who have registered with and been determined by the Office of Accessible Education (OAE) to require special examination accommodations are responsible for notifying both the School of Medicine Learning Strategies Education Specialist and their course directors at the beginning of the quarter or when their accommodation letter is given that they will need accommodations. Unless students receive accommodations mid- quarter, they must let the School of Medicine Learning Strategies Education Specialist and their course directors know of their accommodations needs no later than the end of the second week of the quarter for which they are receiving accommodations. Reminder: students needing exam accommodations are to contact the OAE first, prior to notifying their course director(s).
5. Feedback on written examinations is to be as complete as practicable.

Please note: In the COVID-era, there may be marked changes to the above policies. Our procedures will need to adapt to the changing landscape of county, state, and university regulations.

Students receiving notification of a marginal pass should meet with the appropriate faculty and discuss the requirements for achieving an unqualified passing grade. Once a student achieves a “pass,” the performance will no longer be recorded as “marginal” in the student’s record. Students who receive a marginal pass in a course of five or more units (e.g. SOM or POM) must correct the marginal pass within 12 months of receipt of the marginal pass and prior to beginning any clinical clerkship and may be required to take USMLE Step 1 examination prior to beginning any clinical clerkship. Students with a marginal pass will be counseled by an Advising Dean and reviewed by the Committee on Performance, Professionalism and Promotion (CP3).

Students who fail a pre-clerkship course must achieve a passing grade within one year of the failure or prior to beginning clerkships, whichever is sooner. If this cannot be achieved through remediation (as determined by the Course Director) then the student must retake and pass the course when it is next offered. Only the CP3 has the authority to change this requirement. The requirements for achieving a passing grade are determined by the responsible faculty. Students with a failing grade will be counseled by an Advising Dean and reviewed by the Committee on Performance, Professionalism and Promotion.

Academic deficiencies in pre-clerkship courses must be rectified within 12 months of receipt and prior to the beginning of clerkships or by a date specified by the CP3 (which has the authority in an appropriate case to modify any of the requirements in this subsection).

Departments are encouraged to provide educational assistance to students failing required courses on the first-year grid, preferably during the first summer quarter following receipt of a failing grade, and to reexamine such students prior to autumn quarter registration.

Students failing courses on the autumn and winter quarter grids for the second year should, as a general proposition, be given the opportunity to correct these deficiencies prior to July 1 of that academic year. Students who receive an incomplete grade because of extenuating medical or personal circumstances should, once again as a general rule, be given the opportunity to correct the incomplete grade within 12 months of receipt or prior to entering clerkships, whichever comes first, in a manner specified by the department or responsible teaching group. Courses such as those in the Practice of Medicine sequence, where hands-on activities and small group interactions constitute a significant portion of the course, may require retaking of the course the following year.

Pre-clerkship deficiencies and corrections are recorded as internal “School of Medicine grades” in the Medical Education Platform (MEP) student record system, where students may view and track their academic progress. 

updated August 2022

Evaluation of performance in the Foundations of Medicine course are graded on a pass/fail basis. It is the prerogative of each course director to determine the best method for assessing student performance for their course. Each course will outline requirements, assessments, and passing scores in their syllabi and it is the student’s responsibility to familiarize themselves with these for each course.

updated August 2022

The POM Course is constantly adapting to changes presented by COVID.  Please note the general course policies below; however, the individual course Canvas pages and syllabi have the most up-to-date information on the grading and course policies.

Grading

Students receive a Pass (+), Continuing (N), Marginal Pass (MP), Fail (-), or Incomplete (I) grade after each quarter. The grade is based on completion of quarter course requirements, satisfactory performance on course assessments, and professional behavior. Following are the guidelines for each grade option in the course:

• Pass (+): Students have completed all course requirements, performed satisfactorily on all course assignments, and exhibited professional behavior in the course.
• Continuing (N): Students have not completed all course requirements and/or did not perform satisfactorily on any individual sections of course assessments. Continuing grades must be remediated within one (1) year, or prior to entering clerkships, whichever comes first.
• Marginal Pass (MP): Students have not achieved the passing criteria on course assessments; there may be moderate concerns about the student’s professional behavior in the course; and/or the student’s performance in in-class activities has raised moderate concerns about knowledge and competence. Marginal Pass grades must be remediated within one (1) year, or prior to entering clerkships, whichever comes first. MP grades are tracked internally in the School of Medicine through the Medical Education Platform (MEP), and should be entered as an N grade in Axess.
  
• Fail (-): Students had significant areas of concern on course assessments, (using the criteria above for N Grade or Marginal Pass); there may be significant concerns about the student’s professional behavior in the course; and/or the student’s performance in in-class activities has raised significant concerns about knowledge and competence.
• Incomplete (I): Student has satisfactorily completed a substantial part (but not all) of the course work. Students must request an incomplete grade by the last class meeting after meeting with their Advising Dean. Incomplete grades must be made up within one (1) year, or prior to entering clerkships, whichever comes first.

A grade of Continuing (N), Marginal Pass (MP), or Fail (-) will require notification to the CP3.

Students who do not perform satisfactorily on course assessments must complete a plan of remediation tailored to student needs and course resources, discussed with the student and the course director. Students who do not satisfactorily complete this plan of remediation will earn a “Fail” grade for the course.

Policy for Missed Assessments

Every student is expected to be present for each course assessment in the Practice of Medicine course.

A formal Course Director's permission is required to make-up any missed course examination. It is recommended that students meet with their Advising Deans prior to submitting a formal request for any missed course assessment.

A Course Director's permission may be issued before a regularly scheduled assessment or examination to accommodate some essential extracurricular event or after an examination for illness.

A score of zero will be credited towards a student’s final score if an assessment or examination is missed without an Advising Dean's permission and approval by the course director.

If a Course Director's permission is issued before a regularly scheduled assessment or examination to accommodate some essential extracurricular event, the student will be expected to take the scheduled makeup examination or assessment at Stanford. If the Course Director's permission extends beyond the second date because of some essential activity away from Stanford, then appropriate arrangements will be made within the resources of the course. Failure to make such an arrangement will result in a score of zero on that exam. A student who misses an assessment or examination with a Course Director's permission for illness should contact the POM course manager and appropriate arrangements will be made.

Policy for Remediation of a Continuing, Marginal Pass, Fail Grade in POM

A student who receives a Continuing (N) in any quarter of the POM series (INDE 201-206) must complete outstanding course requirements to correct the grade to a Pass (+). The student will be allowed to continue through the POM sequence. The Committee on Professionalism, Performance, and Promotion will be notified. Students who do not satisfactorily complete this plan of remediation within the prescribed time period will earn a Marginal Pass (MP) grade for the course.

A student who receives a Marginal Pass (MP) in any quarter of the POM series (INDE 201-206) must successfully complete a course of remediation tailored to student needs and course resources to correct the grade to a Pass (+). The student will not be allowed to continue through the POM sequence, unless provided special permission from the course director. The CP3 will be notified. Students who do not satisfactorily complete this plan of remediation will not be allowed to continue to clerkships.

A student who receives a Fail in any quarter of the POM series (INDE 201-206) will be required to re-take that quarter the following year, including all required exercises and examinations. The student will not be allowed to continue through the POM sequence, unless provided special permission from the course director (please see various five-year “split” schedules from the Office of Medical Education). The CP3 will be notified.

updated August 2022

Please note the general course policies below; however, the individual course Canvas pages and syllabi have the most up-to-date information on the grading and course policies.

Grading

Students receive a Pass or Fail assessment (reported in Axess) after each quarter. Your grade will be based on your scores in the assigned quizzes and the scheduled examinations. Each quarter has a different number of quizzes and examinations. Please see the individual syllabi for each quarter of SOM for specific details on the determination of grades and passing scores.

Policy for Missed Exams

Every student is expected to take each  midterm, end-quarter, and integrated examination in the Science of Medicine course at the time scheduled.

The integrated final exam for each quarter of SOM is usually scheduled for the last day of Exam Week. Failure to sit for any  midterm, end-quarter, or integrated examination in the SOM course will earn a grade of “fail” for the course.

Policy for Remediation of a Fail Grade in an SOM Course

A student who receives a Fail in any quarter of the SOM series (INDE 221, INDE 222 or INDE 223) will be required to take a special remedial examination after the inter-quarter break. This examination will be offered once. Vacation plans do not dictate when the exam will be taken. The course directors agree that a non-passing grade in SOM indicates a need for in-depth review of the entire quarter. The remedial examinations reflect material from the entire quarter and the timing of the exam is firm to allow for this additional study. Correction of a Fail grade in SOM requires a passing score (>65%) on the remedial examination.

A student who fails a quarter of SOM and who then fails the special remedial examination will be referred to the Committee on Performance, Professionalism and Promotion (CP3), which will make a final recommendation on a course of remediation. This recommendation may be a requirement to re-take that quarter the following year, including all required exercises and examinations.

updated August 2022