Radiology Clerkship Qualitative Grade Descriptors

An "expected level" of performance should be based on a reasonable combination of internal Harvard Medical School criteria, and a more general level seen at most medical schools.


Student has shown significant deficits in any one of the major areas of assessment including:

  • attendance at the majority of tutorials
  • obtaining clinical information
  • choosing the appropriate radiologic study for a clinical problem
  • describing radiologic findings in a clear logical manner using appropriate radiologic terminology
  • generating adequate differential diagnoses and plans for further work-up
  • exhibiting an adequate fund of knowledge of anatomy and pathophysiology of disease
  • communicating and interacting appropriately with staff and faculty
  • demonstrating reliability, integrity, collegiality, and cultural sensitivity
  • showing motivation to learn and to improve

The deficit(s) observed cause serious concern about the student’s ability to deliver appropriate radiologic work-up of patients, provide correct interpretation of key critical radiologic images, and/or to conduct themselves with the professionalism expected of third year medical students.

And/Or  persistent failure to pass the Final Exam or other assessments determined by the Clerkship Director and Director of Medical Student Education in Radiology; Or a failing grade on the Oral Radiology presentation as well as  on the Final Exam.(<62). 


The student is overall in the lower quartile of the group.  The student has generally demonstrated adequate but limited proficiency with the basic material and skills expected of a student at this level of training or has shown limited motivation to learn during the rotation and has demonstrated one or two areas which (though not frankly deficient) would benefit from continued improvement.  Examples include inappropriate selection of radiologic exam for a given clinical problem, occasional failure of timely attendance at radiology tutorials, occasional superficial or disorganized oral radiology presentations, occasional notable omissions or errors in oral radiologic image analysis, some gaps in knowledge of basic anatomy and pathophysiology, and occasional difficulty in interactions with faculty or staff.  Any significant deficits that raise serious concern about the student’s ability to function appropriately in a clinical setting warrant a grade of Unsatisfactory rather than Pass.  On the other hand, reliable, motivated students who have demonstrated more than adequate proficiency in most areas of assessment and notably superior performance in some areas of assessment should generally receive Honors.

It is expected that 15-25% of the students will fall in this category over a given calendar year.


The student’s work is consistently solid in all respects; in at least several areas, the student’s work has been very good to outstanding, in particular anatomy and pathophysiology.  Although not truly exceptional, the student is consistently motivated, reliable, and organized, and works well with staff and faculty.  By the end of the rotation, s/he can be trusted to select the appropriate imaging exam for a given clinical problem, to perform and present a thorough, reasonably efficient evaluation of most key radiologic images and generate an appropriate differential diagnosis and treatment plan, as well as deliver a coherent oral presentation on a selected radiologic topic.  S/he has completed all expected tasks during the rotation and has sometimes sought out additional opportunities for learning and contributing during the rotation.

It is expected that the majority of students (45-65%) will fall in this category over a given calendar year.

Honors with Distinction

More often than not, the student has performed at levels that exceed the expected level for training.  While not necessarily unique, s/he has consistently demonstrated excellent to outstanding clinical skills, presentations and oral radiologic case analysis, and fund of knowledge, in particular anatomy and pathophysiology; is highly motivated, reliable, and well-attuned to faculty and staff; reads widely and shows a consistent interest in seeking out and incorporating feedback, extending skills and knowledge, and contributing to the team.  High scores (particularly above 85) on the Final Exam, while not required, are a plus that may be considered when other areas of performance are in the range between Honors and Honors with Distinction.  The student has demonstrated performance that would typically merit enthusiastic recommendation to a leading residency training program.

It is expected no more that 30% of students will fall into this category over a given calendar year.

Components of student evaluation and relative weighting for final clerkship grade
  1. Final exam (40%) – images (60) with similar format to entrance survey, multiple choice questions (65-70) derived from the course texts, tutorials, and student PowerPoint questions
  2. Oral Radiology PowerPoint presentation, with submitted handout and sample questions (20%)
  3. Student participation (40%) – Mini-CEXmorning report, chest/abdomen wrap up session, performance in combined radiology-clinical conferences, and faculty/mentor feedback

**Not included: entrance survey, RadLab pre and post-tests


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