Assessment and Grading
The Icahn School of Medicine at Mount Sinai will maintain and provide an accurate grading history for all courses taken by students in the School.The School’s grading policies in this section address how students are graded, grade submissions, appeals, and potential conflicts of interests.
Please note:
Students who matriculated in 2024 and thereafter are subject to ASCEND policies.
Students who matriculated in 2023 or earlier and who are graduating in 2027 or earlier are subject to the LEGACY curriculum policies.
Students who matriculated in 2023 or earlier who are graduating in 2028 or thereafter will be subject to a mix of policies depending on when their progression was delayed or temporarily halted. These students will be subject to ASCEND policies when they resume or continue their studies.
Legacy Policies
Grading Policy Years 1 and 2 This policy includes information about grading in the Legacy Curriculum for Years 1 and 2.
Applicable for: Graduating Classes of 2025, 2026, 2027
Approved by: Executive Oversight Committee
Relevant LCME Standards: 9.6 Setting Standards of Achievement
Approval Dates: 7/8/22 5/5/23 4/19/24
RELATED POLICIES
Remediation Policy - Years 1 and 2
Grade Submission Policy
Absence Policy
Yearly Progression Policy
POLICY
Course grading in Years 1 and 2 is on a Pass/Fail basis. The criterion for passing each course is provided to students in the Course Information Sheet at the start of each course.
For longitudinal courses across Years 1 and 2, (i.e., The Art & Science of Medicine), the final course grade is determined at the end of Year 2. The final course grade of Pass or Fail is reflected on the student’s transcript.
Grading Policy Years 3 and 4 This policy includes information about grading in the Legacy Curriculum for Years 3 and 4.
Applicable for: Graduating Classes of 2025, 2026, 2027
Approved by: Executive Oversight Committee
Relevant LCME Standards: 9.6 Setting Standards of Achievement
Approval Dates: 7/8/22 6/2/23 4/19/24
RELATED POLICIES
Academic Integrity
Remediation - Years 3 & 4
Technical Standards
THIRD YEAR REQUIRED CLERKSHIPS GRADING POLICY
All Clerkships are graded Honors, Pass, and Fail, using a criterion-based rubric, outlined in the clerkship’s Clerkship Information Sheet (CIS). Each required clerkship has criteria for each of these grades linked to every clerkship learning objective. These criteria vary by clerkship.
For Year 3 clerkships, each Clerkship Director submits a final grade that includes narrative feedback. The final grade for the third-year clerkships is included in a student's Medical Student Performance Evaluation (MSPE) for residency applications.
Criteria for Grade of PASS
To Pass the required clerkships, the student must fulfill ALL of the criteria stated below:
Meet the ‘Pass’ level of criteria for EVERY learning objective as listed in the Clerkship Information Sheet (CIS).
Complete and log all Required Clinical Experiences prior to last day of the clerkship
Complete and submit all clerkship-specific requirements.
Accrue no more than three “marks” on the Behavioral Grading Criteria listed in the CIS
Criteria for Grade of HONORS
To receive a grade of HONORS, the student must fulfill ALL of the criteria stated below:
Achieve the ‘Honors’ level of criteria for a set number of learning objectives (defined per clerkship in the CIS).
Accrue no more than one “mark” on the Behavioral Grading Criteria listed in the CIS
Criteria for Grade of FAIL
A student who does not complete ALL requirements to PASS the clerkship will receive a grade of FAIL
Additionally, students who are suspected of violating the Academic Integrity Policy will be referred to the Senior Associate Dean for Student Affairs and the Senior Associate Dean for Curricular Affairs. If the Deans determine that the student violated the Academic Integrity Policy as part of a clerkship activity or assessment, the Deans may assign a grade of Fail (in addition to other disciplinary action as delineated in the Academic Integrity Policy).
A student who receives a failing grade for a clerkship must remediate the clerkship as explained in the ISMMS Remediation Policy - Years 3 and 4.
Incomplete
A student who cannot complete a clerkship or its requirements, will receive an Incomplete. An Incomplete will change to Honors, Pass or Fail once the student has completed all requirements of the clerkship.
NBME Subject Exam
A student who fails the NBME subject exam on the first attempt will receive a temporary grade of Conditional, provided other assessments and clinical evaluations are satisfactory. Upon successful completion of the failed exam at retake, the grade is revised to a Pass or Honors depending on the clerkship grading criteria. If the student fails the exam on the retake, they will receive a failing grade for the clerkship.
FOURTH YEAR REQUIRED CLERKSHIPS GRADING POLICY
All Year 4 Clerkships and Acting Internships (AI) are graded Honors, Pass, and Fail, using a criterion-based rubric outlined in the clerkship’s Clerkship Information Sheet (CIS).
Criteria for Grade of PASS
Each required clerkship and AI has specific Pass criteria linked to each learning objective. These criteria may vary by clerkship/acting internship. All criteria are stated in the CIS. To Pass the required clerkships, the student must fulfill ALL of the criteria stated below:
Meet the ‘Pass’ level of criteria for EVERY learning objective as listed in the Clerkship Information Sheet (CIS).
Complete and submit all clerkship-specific requirements.
Accrue no more than three “marks” on the Behavioral Grading Criteria listed in the CIS
Criteria for Grade of HONORS
To receive a grade of HONORS, the student must fulfill ALL of the criteria stated below:
Fulfill ALL of the criteria for passing outlined above
Achieve the ‘Honors’ level of criteria for a set number of learning objectives (defined per clerkship in the CIS).
Accrue no more than one “mark” on the Behavioral Grading Criteria listed in the CIS
Criteria for Grade of FAIL
A student who does not complete ALL requirements to PASS the clerkship will receive a grade of FAIL
Additionally, students who are suspected of violating the Academic Integrity Policy will be referred to the Senior Associate Dean for Student Affairs and the Senior Associate Dean for Curricular Affairs. If the Deans determine that the student violated the Academic Integrity Policy as part of a clerkship activity or assessment, the Deans may assign a grade of Fail (in addition to other disciplinary action as delineated in the Academic Integrity Policy).
A student who receives a failing grade for a clerkship/acting internship cannot graduate and must remediate the clerkship prior to May of the academic year as explained in the ISMMS Remediation Policy - Years 3 and 4.
Other
A student who cannot complete a clerkship or its requirements, will receive an Incomplete. An Incomplete will change to Honors, Pass or Fail once the student has completed the clerkship and its assessments.
COURSES
Courses in Years 3 and 4 are graded as Pass and Fail.
ELECTIVES
Clinical electives are graded Honors, Pass, and Fail. Non-clinical electives are graded as Pass or Fail.
Clinical Electives
Students must receive at least three (3) of five (5) criteria in the ‘Honors’ category to receive HONORS. A student who does not complete ALL requirements to PASS the elective will receive a grade of FAIL.
Non-clinical Electives
Student must PASS all criteria to pass the elective.
ASCEND Policies
Grading Policy - Phase 1 This policy includes information about grading in Phase 1 of the ASCEND Curriculum
Curricular Structure: ASCEND
Approved by: Executive Education Committee
Relevant LCME Standards: 9.6 Setting Standards of Achievement
Last Approved: 5/17/24
RELATED POLICIES
Remediation Policy Phase 1
Grade Submission Policy
Absence Policy
Progression Policy
Retake Policy Phase 1
POLICY
Grading for Phase 1 is on a Pass/Fail basis. The criterion for passing each module is provided to students in the Module Information Sheet. The final module grade of Pass or Fail is reflected on the student’s transcript.
PROCESS
The criterion for passing each module and the passing cutoff are provided to students in the Module Information Sheet at the start of each module.
Grades are reported by the Office of Curricular Affairs to the Registrar.
Upon successful remediation of a failed module, a separate Pass grade is reported to the Registrar
Retake Policy - Phase 1 This policy includes information about retakes in Phase 1 of the ASCEND Curriculum
Curricular Structure: ASCEND
Approved by: Executive Education Committee
Relevant LCME Standards: 9.6 Setting Standards of Achievement
9.9 Student Advancement and Appeal Process
Last Approved: 6/6/25
RELATED POLICIES
Grade Submission Policy
Absence Policy
Progression Policy
Remediation policy – Phase 1
POLICY
If a student’s module grade is below the passing cutoff prior to final grade determination, they can retake one assessment to improve their grade. The retake assessment will relate to the content competency that is most deficient for the student. The assessment is selected by the Module Director.
Upon completion of the retake, the student’s module grade is then recalculated. If the retake assessment leads to a module grade above the pass cutoff, the student will receive a Pass grade for the module. If the retake assessment does not lead to a module grade above the Pass cutoff, the student will receive a Fail grade.
Scheduling of the retake is dependent on the assessment and is coordinated with the student. Students may retake assessments for two modules in Phase 1. Regardless of outcome, students who do not meet the pass cutoff for a module after having used two retakes will automatically receive a Fail grade for the third or more module. A student has the right to decline taking a retake if they do not want to use one of their allotted retakes.
Until the student retakes the necessary assessment, they will receive a grade of Conditional on their transcript. This will be changed to Pass or Fail based upon the retake.
PROCESS
The Office of Assessment and Evaluation (OAE) notifies the module director of any students at risk of failing based upon preliminary grade calculations. Together they identify the content and assessment(s) leading to the current grade and identify the assessment for retake.
Students will be notified by the Office of Assessment and Evaluation if their grade does not meet the pass cutoff and the identified assessment for retake. Students may retake failed assessments on alternate exam dates as identified on BlackBoard or on listed proctored exam dates during Winter break 1, Summer break, and Winter break 2.
Scheduling of the retake is coordinated between the student (with input from Student Affairs) and the OAE. If the retake requires a proctored assessment, these can only be scheduled on alternative testing dates identified in the academic calendar.
If a student fails the exam retake, the student must remediate the module.
Students must have an approved retake plan in place for all modules and complete the plan prior to the beginning of Phase 2.
ASCEND and LEGACY Policies
These policies are applicable to students in the Legacy Curriculum and the ASCEND Curriculum.
Addressing Conflicts of Interest in Student Assessment Policy This policy seeks to mitigate the impact that dual relationships and conflicts of interest (COI) between students and faculty, non-faculty instructors, and residents may have on the assessment and evaluation of students.
Curricular Structure: All Medical Students in Legacy and ASCEND
Approved by: Executive Oversight Committee
Relevant LCME Standards: 1.2 Conflict of Interest 11.1 Academic Advising and Academic Counseling 12.5 Non-Involvement of Providers of Student Health Services in Student Assessment/Location of Student Health Records
Approval Dates: 8/4/2023 7/12/2024
RELATED POLICIES
Remediation Policy - Phase 1
Grade Submission Policy
Absence Policy
Progression Policy
Retake Policy Phase 1
POLICY
This policy seeks to mitigate the impact that dual relationships or adverse actions between students and faculty, non-faculty instructors, and residents who directly play a role in assessment, remediation, or promotion of students. The goal of this policy is to ensure that those who directly assess students do so without conflict of interest that may compromise the objectivity and integrity of the student assessment or promotion process. This policy defines dual relationships or adverse actions involving a student that constitute a conflict of interest (COI) to include, but are not limited to current or prior:
Significant personal or social relationships
Familial relationships
Provider-patient (health/mental health care) relationships
Assigned role as academic or career and professional advisor
Direct financial or business relationship (e.g. start-up company)
Faculty role in adverse action against a student, including filing a professionalism concern
Student filing of mistreatment report involving faculty, non-faculty instructors, or residents
If a relationship or history of adverse action is known, faculty, non-faculty instructors, and residents will make arrangements with the course, module, or clerkship director to avoid any conflict of interest during teaching and evaluation periods. At a minimum, they will not complete an evaluation or provide summative assessment of any student with whom a conflict of interest is known. At any point in time, a student assigned to a course, module, clerkship, elective, or other educational activity with an evaluator who has a conflict of interest (or conversely the educator) may request and will be granted an alternative assignment. Should uncertainty arise regarding COI with a student, it is he expectation that the instructor will take responsibility to disclose the COI to the relevant course, module, clerkship director or appropriate administrative leader (e.g. committee lead, assistant or associate dean).
PROCEDURE
Pre-clerkship Courses
Faculty, Non-Faculty Instructors, Residents:
In advance of each course in Year 1 and 2, the Office of Curricular Affairs notifies each educator of this policy and provides the roster of students assigned.
It is the responsibility of the faculty to review the roster and disclose a conflict of interest (COI) through the COI in Assessment Reportable Form. The specific type of relationship/COI does not need to be disclosed. Once this form is submitted, the Office of Curricular Affairs is notified. The team then reports the COI to the course or module director and coordinator who will reassign the student to a different educator.
Students:
Prior to each course in Years 1 and 2, the Office of Curricular Affairs notifies students of the roster of faculty who may assess students in a small group and/or have a clinical role.
Students can “opt out” of that faculty member’s small group through the COI in Assessment Reportable Form. The Office of Curricular Affairs is notified of the form.
The student will be reassigned without disclosing the reason for reassignment to the faculty.
Clinical Rotations
Faculty, Non-Faculty Instructors, Residents:
Faculty and residents are made aware of all clerkship students and notified four weeks prior to the start of each module by the clerkship coordinator. The clerkship coordinator will send the standardized COI communication to the faculty.
Faculty will be provided with a roster of students. If a faculty realizes that they have a conflict of interest with a student who may be assigned to them, that faculty member is responsible for notifying the course or clerkship director and coordinator about the potential conflict via email.
The clerkship coordinator will then ensure that the faculty member or resident is not in a preceptor or evaluation role.
The specific type of relationship/COI does not need to be disclosed. If there are any reported COI, the Coordinator or Clerkship Director will complete the COI in Assessment Reportable Form. The Office of Curricular Affairs is notified of the form.
All clerkship evaluation forms have an item that asks the evaluator if a potential conflict of interest may exist. If the evaluator checks “yes” then the clerkship director will nullify the evaluation and it will not be included in any assessment or grade.
Students:
Medical students in clinical rotations are made aware of faculty and other educators assigned to teach in the clerkships four weeks prior to the start of the module by the clerkship coordinator. The clerkship coordinator will send the standardized COI communication to the clerkship students.
Students will be provided with a roster of all educators who will teach in the clerkship for the academic year. If a student is assigned a role with an individual faculty member that is prohibited by a current or prior clinical or familial/intimate relationship with that faculty member, it is the responsibility of the student to notify the course or clerkship director via email.
The clerkship coordinator will then ensure that the student is not placed with the faculty member or resident in a preceptor or evaluation role.
The reason given for the reassignment is duality of interest; the nature of the specific duality of interest circumstance need not be identified.
If there are any reported COI, the Coordinator or Clerkship Director will complete the COI in Assessment Reportable Form. Once this form is submitted, an email is curricular.affairs@mssm.edu.
Grades and Transcripts Policy This policy outlines how grades appear on a student’s official transcript.
Curricular Structure: All Medical Students in Legacy and ASCEND
Approved by: Executive Oversight Committee
Relevant LCME Standards:
Approval Dates: 4/19/24
RELATED POLICIES
Grading Policy
POLICY
This policy outlines how grades appear on a student’s official transcript.
PROCESS
Official transcripts will identify a grade for each module, course, clerkship, and elective taken at the Icahn School of Medicine at Mount Sinai toward fulfillment of the MD degree requirements.
Written narrative evaluations are not part of the transcript and will not be duplicated or mailed with transcripts; however, all clinical narratives for clinical courses and clerkships completed by the end of Year 3 are included in the MSPE.
Grades Appeals Policy This policy includes information about how to appeal a final grade or narrative grade.
Curricular Structure: All Medical Students in Legacy and ASCEND
Approved by: Executive Oversight Committee
Relevant LCME Standards: 9.9 Student Advancement and Appeal Process 11.6 Student Access to Educational Records
Approval Dates: 5/3/24
RELATED POLICIES
Remediation Policy Phase 1
Grade Submission Policy
Absence Policy
Progression Policy
POLICY
A student may appeal a final grade earned in the MD program and issued by the ISMMS faculty
PROCESS
Within thirty (30) calendar days of the grade being released, the student must submit an appeal request using the Grade Appeal Form and identify the basis for the appeal:
computation dispute about the final grade;
unequal application of grading standards or applying grading criteria to one student or some students in a manner that treats them differently;
unfair or unannounced alterations of assignments, grading criteria, or computational process from what was stated in the syllabus;
and/or other (to be specified).
The appeal will be reviewed by the Grade Appeal ad hoc committee (ad hoc committee). The ad hoc committee will include, at the minimum, representatives from the Offices of Curricular Affairs, Student Affairs, and Assessment and Evaluation.
The ad hoc committee will notify the module/course/clerkship director that an appeal has been filed, review the applicable student and module/course/clerkship performance data, and meet with the student and course/clerkship director if necessary.
Within ten (10) calendar days of the meeting(s), the ad hoc committee will provide a final decision by email to the student and the module/clerkship director. The decision will include the basis on which the decision was made to the extent possible based on the information available.
The Office of Curricular Affairs will inform the Registrar in the Office of Enrollment Services of a grade change, if applicable. The student’s record and official school transcript will be amended to reflect the changed grade if applicable.
The decision made by the ad hoc committee is final and not subject to further appeal
Final Grade Submission Policy This policy includes information about the timely submission of final grades.
Curricular Structure: All Medical Students in Legacy and ASCEND
Approved by: Executive Oversight Committee
Relevant LCME Standards: 9.8 Fair and Timely Summative Assessment
Approval Dates: 4/19/24
POLICY
Final grades for all modules, courses, clerkships, acting internships, and electives must be reported to the Registrar in the Office of Enrollment Services within six (6) weeks of the end of the course/rotation.
PROCESS
Final grades are released to students through the student information system (Empower).
Formative Feedback Policy This policy includes information about formative feedback requirements for students throughout the four-year MD curriculum.
Curricular Structure: All Medical Students in Legacy and ASCEND
Approved by: Executive Oversight Committee
Relevant LCME Standards: 8.6 Completion of Core Experiences 9.7 Formative Assessment and Feedback
Approval Dates: 4/19/24
RELATED POLICIES
Required Clinical Experiences
Academic Integrity
POLICY
Each medical student is assessed and provided with formal formative feedback by at least the midpoint of each module/course or clerkship. A module/course or clerkship less than four weeks in length provides alternate means by which medical students can measure their progress in learning.
PROCESS
Modules/Courses
Students will receive formative feedback by at least the midpoint of each required course. Course directors determine the timing, frequency, and methods of formative feedback. Methods of formative feedback include, but are not limited to, quizzes, exams, OSCEs, skills practice, individual assignments, group activities, and in-person feedback discussions.
Clerkships
Midway through a clerkship, a clinical supervisor provides feedback to the medical student. Progress in completing the required clinical experience (RCE) log will be reviewed during this mid-clerkship feedback. To monitor compliance with this policy, students report that they have received mid-clerkship feedback on the clerkship evaluation form at the end of each clerkship.
During the annual review of each course and clerkship, the Executive Oversight Committee (EOC) confirms that each course provides formative feedback to all students. The EOC also confirms that all students received their mid-clerkship feedback for each clerkship annually. Mid-clerkship feedback is further verified through review of student responses to internal and external evaluations (e.g., end of clerkship evaluations, AAMC Graduate Questionnaire).
REVISION HISTORY
5/5/23
Last updated