Variation of surgery clerkship grades in US medical schools

Abstract Background Despite efforts at standardization, evaluation and reporting of clerkships remains highly variable. This study reviews the current spectrum of surgical clerkship grading. Methods Data were reviewed for every medical school from which an application was received to a single surgery residency program in 2017 and were evaluated for core surgical clerkship grading systems, distributions, and components. Fischer's exact tests and Wilcoxon-Mann-Whitney tests were used for analysis. Results 133 (49 private) schools were evaluated. Geographic distribution:34 Northeast, 50 South, 31 Midwest and 18 West. 120 reported grading tiers, with public schools (95%) more likely than private (80%) to report this (p = 0.02). The number of grading categories ranged from 2 to 11; 90% with 3–5. Over 25% of the schools gave ≥40% of students the highest grade; median of 30% in the highest tier. Conclusions Significant variation exists in core surgery clerkship grading between schools. Similarly, a sizeable difference exists in how grades are calculated and the reporting systems used. Standardizing grading schemes across medical schools would be beneficial.