Medical Student Handbook

PROGRAM ANALYSIS: Assessment, Evaluation and Licensure

<< Back to Handbook Homepage

Assessment and Grading 

Formative Feedback 

Formative feedback, which is descriptive rather than evaluative involves sharing of information & giving advice; it does not provide a grade but rather provides guidance. Quizzes and low-stakes assessments (including individual readiness assessments tests, iRAT, within team-based learning, TBL) provide formative feedback in the preclinical setting. Formative feedback in the clinical setting must be provided to the student no later than the mid-point of the clerkship and must be of adequate detail to assure that the student can appreciate deficiencies in his/her performance and develop a plan to improve areas of deficiency. 

Preclinical Assessment Methods 

ASSIGNMENTS 
Exploration of assigned topics will be required within some systems; details of those assignments, including expectations will be clearly outlined early in the thread. 

ASSESSMENTS: QUIZZES AND EXAMS 
The University of Toledo College of Medicine and Life Sciences strives to assure fair assessment administration for each student in the MD program and uniform consequences for any breach of professionalism occurring during a proctored examination. All written/computer test administration proctored by the UToledo College of Medicine Academic Test Center proctors will be administered following the procedures outlined here. 

ASSESSMENT REVIEW 
In order to promote a balance between continued student learning and security of written assessment material, students will be given the opportunity to review items after the completion of quizzes within each system. Item review of questions at the End-of System Exams or NBME Comprehensive Exams will not be provided. Further details of the Quiz and Exam Review Policy can be found here. 

TEAM BASED LEARNING 
NBME Customized Assessment (CAS) 
At the conclusion of each THREAD, students are given the opportunity to complete a customized assessment of items form the National Board of Medical Examiners. These assessments constitute 20% of the thread grade, and encourage students to review and integrate all material presented throughout the thread. These assessments introduce students to the type of items they will experience on USMLE (United States Medical Licensure Examination), which are required for medical licensure in all states. 

INTEGRATED CLINICAL SKILLS EXAM (ICSE) 
This assessment will be administered at the end of each thread, constituting 10% of the thread grade, and will evaluate multiple components, including interpersonal skills, history taking, physical examination skills, documentation, and clinical reasoning. 

System Grades 

The University of Toledo College of Medicine & Life Sciences employs a P-F (Pass-Fail grade) grading system for all components of the preclinical curriculum. A grading system of SATISFACTORY/UNSATISFACTORY will be used for the individual systems that constitutes a Thread. A satisfactory grade requires that students meet the minimum level of 70% at the completion of each system within a thread. If students do not meet the minimum performance standards, they will be given a grade of unsatisfactory. The unsatisfactory can change to a satisfactory grade if the student demonstrates competence by passing (P) the overall thread, or if the student posts a passing score in the systems that earned an unsatisfactory grade once reexamination of a thread is completed. 

Thread Grades 

The University of Toledo College of Medicine & Life Sciences employs a P-F (Pass-Fail grade) grading system for all components of the preclinical curriculum. Grading on the P-F system may be postponed through use of a Conditional grade (DF-Defer). A defer grade assigned in any curricular component will be recorded on the 

student’s official transcript until all requirements of the course are completed, at which time it will be permanently changed to a Pass or a Fail grade, as appropriate. Students who fail to meet the minimum 70% in any system will have opportunities to retake that component if necessary, to attain a passing level in the overall thread grade. More information regarding retake, remediation, and promotion can be found here. 

The grading system, its requirement, components and their respective weights will be communicated in the syllabi for each of the threads and will be consistent across threads with respect to the weight of the NBME CAS and the ICSE. 

All final grades will be posted to the students’ record with the Office of the Registrar, and available to the students, no later than 6 weeks following the completion of the thread per COMLS policy. 

Clinical Assessment Methods 

CLERKSHIP GRADES
The seven required clerkships (Family Medicine, Internal Medicine, Neurology, Obstetrics & Gynecology,Pediatrics, Psychiatry, and Surgery) are graded in a standardized manner.  The components of the final score of each of these rotations includes three elements of a students overall clerkship performance (Clinical Competence Assessment, OSCE/Department points, and NBME (National Board of Medical Examiners) Subject Exam score. Evaluations are submitted via Rocket Med (MedEd). More details about clerkship grading.

All final grades will be posted to the students’ record with the Office of the Registrar, and available to the students, no later than 6 weeks following the completion of the rotation per COMLS policy. Students who do not complete the end of clerkship/ course evaluation may not be able to receive their grade, and may receive a PBR (professionalism and behavior report). 

SATISFACTORY PROGRESS 
Students will be removed from their required clerkship rotation schedule if they do not receive a passing grade in two required clerkships, or if they earn any combination of two grades of Incomplete, Defer, or Fail. 

Students who receive two or more grades of FAIL in the required clinical clerkships or a grade of FAIL in any previously failed clerkship are subject to mandatory review by the Medical Student Promotions Committee. 

ELECTIVE ROTATION GRADES 
Fourth year rotations include 2- and 4-week elective rotations, which are graded pass/fail, as well as a required Acting Internship (AI) and a minimum 2-week Emergency Medicine rotation (if not completed during the 3rd year), which receive grades of Honors/ High Pass/ Pass or Fail. 

Student Appeal of Grades

Students who wish to dispute a final thread/clerkship grade (including examination performance, clinical competency evaluation, OSCE performance (clinical skills exam) and/or narrative assessments) that they feel is unfairly or inaccurately assigned to them may do so by following this policy. The student must begin the process of grade appeal within 14 calendar days of the posting of the thread or clerkship final grade. 

---

Standards for Promotion and Graduation 

Promotional Decisions 

The College of Medicine and Life Sciences is vested in the academic success of its student body, including professionalism, performance in the classroom and in the clinical environment, as well as during all formative and summative experiences. The Academic Progress Committee is responsible for reviewing and discussing students' performance in all areas, identifying “as risk” students, and making recommendations for ensuring academic and professional success. 

Graduation Requirements 

In accordance with the Liaison Committee for Medical Education (LCME)’s standards for accreditation of the program leading to the M.D. degree, the University of Toledo College of Medicine and Life Sciences has established a specific set of requirements that students must meet in order to graduate from with the Doctor of Medicine (M.D.) degree. 

---

Evaluation 

The COMLS medical school relies upon medical student feedback to improve its curriculum and processes. Medical student feedback is also a required element by the Liaison Committee on Medical Education for accreditation. Students are expected to provide feedback on a regular basis. To offer the most helpful critique, focus on specific details and provide examples. For instance, what helped you learn? What could be changed to be more effective? Suggest ideas for improvement. It is important to avoid name-calling and emotionally- driven or unprofessional comments (e.g., "What were you thinking? That was horrible!"). 

Both positive and negative feedback can be helpful. When offering positive feedback, remember to provide examples and the why/how. For example, instead of simply writing "In-class discussions were awesome," tell why this was positive: "In-class discussions were awesome because she created a classroom where students were comfortable sharing different perspectives." Similarly, when offering negative feedback, be sure to give details and why/how. As another example, "He just talks at the students" is more helpful if suggestions for improvement are given: "He just talks the entire lecture, but it would be better if he implemented activities to engage the students. We also need time to ask questions." (Adapted from the CRLT at the University of Michigan) 

M1 and M2 students are required to provide weekly reflections on faculty sessions and complete each End of System evaluation during the foundational sciences phase of the curriculum. These surveys are administered through Qualtrics. All medical students (M1-M4) are expected to complete the annual Learning Environment survey as well as the Career, Financial & Wellness Services survey, which are administered in late fall. During the clinical phase, M3 students are required to complete Preceptor, Site, and End of Clerkship evaluations, while M4 students are required to submit Preceptor and Common Elective evaluations, all through the RocketMed system. 

In addition to the evaluations above, the medical school has two additional opportunities for students to provide feedback that are optional: Monthly evaluations disseminated at the middle of each month, and the Learning Environment portal that is accessible 24/7 (https://utmc.utoledo.edu/learningenvironment). All 

COMLS surveys (required and optional) are anonymous and provide a safe place to report issues without fear of retaliation. 

Questions about medical student feedback can be directed to: 

• Brandy Brown, Database Specialist, brandy.brown@utoledo.edu 
• Lori DeShetler, Ph.D., Assistant Dean for Assessment & Accreditation, lori.deshetler@utoledo.edu 

---

Licensure 

Licensing Examinations 

The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. It is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). The USMLE program supports medical licensing authorities and physicians in the United States through development, delivery, and continual improvement of high-quality assessments across the continuum of physicians’ preparation for practice. 

The USMLE assesses an examinee's ability to apply knowledge, concepts, and principles and to demonstrate fundamental patient-centered skills. These skills constitute the basis of safe and effective patient care. 

Healthcare consumers throughout the nation enjoy a high degree of confidence that doctors who have passed all three Steps of the USMLE have met a common standard. 

Required Licensing Examinations 

University of Toledo College of Medicine are required to successfully complete Step 1, Step 2 CK, and Step 2 CS* of the United States Medical Licensing Exam (USMLE) in order to fulfill graduation requirements for the Doctor of Medicine (MD) program. Current fee information can be accessed at here. 

*Please note: for students graduating in 2021, Step 2 CS will not be administered nationally, so will not be required for graduation. An alternative evaluation of clinical skills may be required in lieu of this exam in order to qualify for graduation. 

USMLE Step 1 

Successful completion of the USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical 

Skills (CS) examinations are requirements for graduation from the school of medicine. USMLE Step 1 Students must take the USMLE Step 1 prior to enrolling in clinical clerkships. If students receive notification that they did not pass USMLE Step 1 during clinical experience, they may be allowed to complete their current didactic or clinical experience. After one unsuccessful attempt, a remediation plan must be developed. After three unsuccessful attempts to pass any one Step exam, students will be considered for dismissal. 

NBME USMLE Step 1 Certification Authorization 

Students must successfully complete the entire preclerkship curriculum prior to taking the USMLE Step 1 exam.  Once a rising 3rd year medical student has registered to take their USLME Step 1 exam, they will print the certification authorization form and take the form to the Student Service Center. Staff will verify identity, affix a photo of the student to the form, emboss the form with the official University seal, sign and date the form and return it to the student for mailing to NBME.* 

*Note: the process may change with the ongoing COVID 19 pandemic as it has temporarily shifted to an electronic process. 

USMLE Step 2 CK

Students must successfully complete the USMLE Step 2 CK prior to graduation. After one unsuccessful attempt, a remediation plan must be developed. After three unsuccessful attempts to pass Step 1 or Step 2 CK, a student will be considered for dismissal.

---

Licensure Requirements 

Graduates of this program are eligible to participate in accredited postgraduate training programs across the United States. Specific requirements for initial medical licensure for all 50 states and U.S. territories can be found on the Federation of State Medical Boards website.