College of Medicine and Life Sciences - Office of Student Affairs (OSA)

MSPE (Medical Student Performance Evaluation)

Medical School Information Page: The University of Toledo College of Medicine and Life Sciences

Class of 2022

The mission of The University of Toledo is to improve the human condition; to advance knowledge through excellence in learning, discovery and engagement; and to serve as a diverse, student-centered public metropolitan research university. 

The mission of The University of Toledo College of Medicine and Life Sciences is to improve health in the communities and region we serve. We do this by educating excellent clinicians and scientists, by providing patient centered and high-quality care and by producing nationally recognized research in focused area. 

Special Characteristics of the UTCOMLS Education Program: 

Foundational Sciences Curriculum
The preclinical curriculum spans 19 months and is longitudinal and integrated in its design. The basic disciplines of anatomy, embryology, histology, physiology, pharmacology, and pathology are longitudinally delivered across 4 "threads" (common content areas). Within these threads, 13 systems cover the breadth of the preclinical curriculum which prepares students for the clinical rotations during the 3rd and 4th years of training. Additionally, the Principles of Clinical Medicine course is a longitudinal curriculum which is woven through each system and thread, and covers essential topics for clinical practice, including communication skills, physical examination skills, principles of evidence-based medicine, epidemiology and statistics, cultural competency, medical ethics, business of medicine, nutrition and clinical reasoning. Students begin their clinical experience during January of their first year during the "Integrated Clinical Experience." Basic Life Support (BLS) is required in Year 1 and Advanced Cardiac Life Support (ACLS) is required in Year 2.
Clinical Curriculum: Clerkship phase and Advanced Clinical Experience phase

The third-year clerkship phase consists of seven core clerkships: Medicine (10 weeks), Surgery (10 weeks), and 5 weeks each of Family Medicine, Neurology, Obstetrics & Gynecology, Pediatrics, and Psychiatry, as well as a 4-week elective. The fourth-year advanced clinical experience phase is a total of 37 weeks of elective time that includes a 4-week Acting Internship, a longitudinal 5-week transition to resident course, and a 2-week Emergency Medicine elective. A maximum of 16 weeks of electives can be taken in any ACGME core discipline. Students complete clinical rotations at The University of Toledo Medical Center, ProMedica Toledo Hospital (and other ProMedica affiliated hospitals in Toledo and northwest Ohio), and at our other affiliated hospitals and outpatient offices. A minimum of 8 weeks of clinical rotations must be completed in one of three rural or one urban Area Health Education Centers in northwest Ohio. Additionally, students have eight (8) weeks of flexible time that can be used for residency interviews or Step 2 preparation.

Enrollment Length:

The average length of enrollment for students in the 4-year M.D. program at UTCOM is 3 years and 10 months. 

Academic Transcript Compliance:

The University of Toledo College of Medicine and Life Sciences complies with the AAMC “Guidelines for Medical Schools Regarding Academic Transcripts.” 

Description of the Evaluation System: 

Final Grades in Preclinical Curriculum:
The required preclinical Threads are graded using a system of PASS (P, 70% or greater), and FAIL (F, less than 70%). The systems within each thread are graded using a system of SATISFACTORY (S, 70% or greater) and UNSATISFACTORY (U, less than 70%). An INCOMPLETE (I) is given when a student does not complete a thread or system within the specified time. Students may enroll in a variety of preclinical electives in the College of Medicine, which are graded on a CREDIT (CR)/NO CREDIT basis.
Final Grades for Core Clinical Clerkships:
Clinical clerkships are graded as: HONORS (H), HIGH PASS (HP), PASS (P), DEFER (DF), FAIL (F), OR INCOMPLETE (I). In the seven core clerkships, the final grade is based on a point system in three different components: 1) Clinical Performance (50 possible points); 2) the Departmental Educational Program, which may include didactics, quizzes, oral examinations, presentations, OSCEs, etc. (20 possible points); and 3) performance on the National Board of Medical Examiners (NBME) subject examination (30 possible points, calculated as the equated percent correct score as a decimal x 30). The specific grading scale is different for each clerkship, due to differences in national performance on the various subject tests and differences in the departmental programs. Additionally, the grading scales are adjusted on an annual basis based on NBME Subject Exam score standardization. 
  • FMMD: P=54-80%; HP=81-87%; H=88-96%
  • MEDI: P=52-83%; HP=84-87%; H=88-93%
  • NEUR: P=55-82%; HP=83-86%; H=87-97%
  • OBGY: P=54-82%; HP=83-87%; H=88-94%
  • PEDS: P=54-79%; HP=80-83%; H=84-93%
  • PSCH: P=56-88%; HP=89-92%; H=93-97%
  • SURG: P=52-81%; HP=82-87%; H=88-96%

Additionally, in order to pass students must post a score above the 5th percentile nationally on the NBME subject examination, earn ≥25 points in clinical performance, and earn ≥10 points in the Departmental Educational Program.

NBME cut-offs (5th percentile)



Family Medicine 


Emergency Medicine


Internal Medicine 












  • A grade of DEFER is a temporary grade for marginal performance until a deficiency is remedied. A Defer grade will be awarded for either of the following: 
    1. If the student does not post a passing score on the first attempt of a NBME subject examination.
    2. If the student scores <10 points on the Departmental Education Program component or fails any of the individual exercises. 

Students with a grade of Defer due to number 1 above will be given a second attempt to pass the NBME subject examination. If the student posts a passing score the second time they take the subject examination, their grade will be changed to PASS. If the student does not pass the second time they take the subject examination, their grade will be changed to FAIL. Students with a grade of Defer due to number 2 above are given one opportunity to repeat and pass the failed component of the Departmental Education Program and attain a total score of ≥10 points for the Departmental Education Program. If they are successful, the grade is changed to PASS; if not, the grade is changed to a FAIL. 

  • A grade of FAIL will be assigned for either of the following: 
    1. Failure to post a passing score after two attempts NBME subject examinations for the same clerkship.
    2. A score below 25 points in the clinical performance component. 

FAIL grades due to #1 and #2 above must be remediated by enrolling in a five-week Required Supplemental Clerkship in the failed discipline. Remediating students may also be required to repeat and successfully pass the departmental educational program and the NBME subject exam. In the Supplemental Required Clerkship, failure to attain a passing grade in any component of the clerkship will result in a grade of FAIL. 

An INCOMPLETE is given when a student does not complete a clerkship within the specified time. 

USMLE Step 1 & 2 Requirements: 

The University of Toledo College of Medicine and Life Sciences requires all students to pass Step 1 and Step 2 CK of the USMLE prior to graduation. If a student receives a failing grade on Step 1 after they have started a clerkship block, they are permitted to complete the block, but cannot take the NBME exam nor enroll in another required clerkship until they sit for the exam again; they are permitted to enroll in selected electives (generally pathology or clinical anatomy) during the time they are preparing to re-take the exam with permission from the Office of Student Affairs. Students who do not pass Step 1 or Step 2 CK after three attempts are subject to dismissal. 

OSCE Evaluation in Assessment of Medical Students 

In the preclinical years, summative Objective Structured Clinical Evaluations (OSCEs) are utilized in Clinical Decision Making I and II. In the clinical years, an OSCE or clinical skills assessment exercise is given as a formative or summative assessment in all seven third-year core clerkships. In addition, a comprehensive standardized patient clinical assessment is given as a formative assessment near the end of the third year. 

MSPE Narrative Comments: 

In accordance with the AAMC MSPE Guidelines, the narrative comments in the clinical clerkship section of the UTCOM MSPEs are summative narratives written by the clerkship director and based off clinical performance. 

Process for Composition of MSPE: 

  • The MSPEs are written by the Associate Dean for Student Affairs & Admissions and Assistant Deans for Student Affairs, all of whom hold faculty rank in the College of Medicine and Life Sciences in addition to their administrative appointments.
  • Each MSPE consists of a 4-6 page narrative document, including comparative graphs and a web address to the Medical School Information Page. The MSPE is generated as a Word document within a web-based MSPE platform developed by the Office of Academic Computing that pre-populates the MSPE template with such data as the student's matriculation date, expected graduation date, final grades, performance in the three sub-components of the core clerkships and summative narrative written by clerkship directors.
  • The Summary paragraph emphasizes the student's cumulative GPA and quartile compared to their peers in medical school. It also includes clinical competency score as well as a graph depicting this score.
  • The Noteworthy Characteristics paragraph is written by the student and reviewed by the MSPE author. 

Process for Student Review of MSPE: 

  • A draft of the MSPE is emailed in PDF format to the students for review and comment.
  • Students are given an opportunity to suggest specific corrections via email reply to an email mailbox designated specifically for ERAS-related correspondence.
  • A digitally signed release from the student via email is required before uploading the MSPE into ERAS, MODS or the San Francisco Match for ophthalmology applicants.
Last Updated: 6/27/22