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Clerkship students will receive a letter grade of (H) Honors, (HP) High Pass, (P) Pass, or (F) Fail based on two components: (1) Clinical performance and (2) NBME Subject Examination performance based on the Equated Percent Correct score.

Eligibility for Pass, High Pass, and Honors assume a passing Subject Exam score on the first attempt. 

  • For overall grade Pass, student must pass both components on the first attempt. 
  • For overall grade High Pass, student must achieve Honors on one component on first attempt while passing the other on first attempt. 
  • For an overall grade of Honors, a student must achieve Honors in both components on the first attempt. 

Note that each clerkship has specific requirements that must be met to pass the clerkship. Observed Professional Activities and Required Clinical Encounter completion are prerequisites for clinical honors designations. The clerkship director may override a given grade due to student professionalism issues or failure to complete requirements. 

Family Medicine

CampusClinical HonorsNBME PassNBME Honors
Birmingham Honors Boxes checked by Faculty Preceptor plus Oral Exam of 90 or higher 63 80
Huntsville Committee decision plus Oral Exam of 90 or higher 63 80
Montgomery Honors Box checked by Faculty Preceptor plus Oral Exam of 90 or higher 63 80
Tuscaloosa Honors Boxes/Committee 63 80

 

Medicine

CampusClinical HonorsNBME PassNBME Honors
Birmingham 50% or more of Honors Boxes checked 60 77
Huntsville Honors Boxes/Committee 60 77
Montgomery Honors Boxes/Committee 60 77
Tuscaloosa Honors Boxes/Committee 60 77

 

Neurology

CampusClinical HonorsNBME PassNBME Honors
Birmingham 50% or more of Honors Boxes checked 67 82
Huntsville Honors Boxes/Committee 67 82
Montgomery Honors Boxes/Committee 67 82
Tuscaloosa Honors Boxes/Committee 67 82

 

Ob-Gyn

CampusClinical HonorsNBME PassNBME Honors
Birmingham Honors Boxes/Committee plus Oral Exam of 90 or higher 66 81
Huntsville Committee decision plus Oral Exam of 90 or higher 66 81
Montgomery Committee decision plus Oral Exam of 90 or higher 66 81
Tuscaloosa Committee decision plus Oral Exam of 90 or higher 66 81

 

Pediatrics

CampusClinical HonorsNBME PassNBME Honors
Birmingham Honors Boxes/Committee 65 81
Huntsville Honors Boxes/Committee 65 81
Montgomery Honors Boxes/Committee 65 81
Tuscaloosa Honors Boxes/Committee 65 81

 

Psychiatry

CampusClinical HonorsNBME PassNBME Honors
Birmingham 50% or more of Honors Boxes checked by faculty 74 87
Huntsville Honors Boxes/Committee 74 87
Montgomery 50% or more of Honors Boxes checked 74 87
Tuscaloosa Honors Boxes/Committee 74 87

 

Surgery

CampusClinical HonorsNBME PassNBME Honors
Birmingham 50% or more of Honors Boxes checked 60 76
Huntsville 50% or more of Honors Boxes checked by Faculty 60 76
Montgomery 50% or more of Honors Boxes checked 60 76
Tuscaloosa Honors Boxes/Committee 60 76

1. “Honors Box” refers to the clinical honors designation item on the clerkship student evaluation form. Note: Upper-level resident evaluations are included (Exception: Birmingham Psychiatry is faculty only). 
2. “Committee Decision” refers to a faculty-led committee grade review, which incorporates “Honors Box” data. 

Clerkship Raw Score

Each grading component also carries a numerical raw score. If a student fails the clerkship, the clerkship raw score is 69. Otherwise, the raw score is a weighted average of Clinical score and NBME Exam scaled score. The clinical score weight is .65 and the NBME score is weighted .35, with the exception of Ob/Gyn and Family Medicine which are .70 Clinical and .30 NBME. The Clinical score is 95 for a student who achieves Clinical honors and 85 for a student who passes but does not receive clinical honors. If a student fails and retakes the NBME Exam, the first (failing) score is still used in the raw score calculation.

These guidelines govern grading for the 2027 NRMP cohort at the time of the clerkship or clerkship students who take the clerkship prior to the 2028 criteria being published. Grades will not change based on a student’s subsequent change to another NRMP year.

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