The standardized subject exam prepared by the National Board of Medical Examiners is one measure of medical student accomplishment and acquisition of knowledge. Although other measures can be applied, the subject exam has the virtue of consistency and validity across institutions. These exams are also predictive of students’ ability to pass mandatory licensing exams. Finally, the exams may identify students with learning or testing disabilities. For these reasons, students will take these exams on designated core courses and clerkships and the exam results will serve as one component of the overall grade. A minimum level of competence on this exam must be achieved to pass the clerkship. 

NBME Exams in the Pre-clerkship Phase

If a pre-clerkship course director has determined that a minimum passing NBME performance threshold exists for their course, a student must meet the performance threshold to pass the course.

If the student does not meet the performance threshold and/or the NBME exam causes a student’s grade to fall below the passing threshold, then the student will get one opportunity to retake that NBME exam.

In the interim, such students will receive an Incomplete grade and must complete the repeat exam soon enough to have score results prior to when grades must be submitted (prior to six weeks after the course has been concluded).

If a student does not have a passing grade prior to taking the NBME exam, the student will not be allowed to retake the NBME exam to raise their final grade.

NBME Exams in the Clerkship Phase

Clerkship Directors will use the subject exam for their specialty as a component of the final grade for their rotation.

The exam may count for 10% to 50% of the final grade as designated by each clerkship director.

A minimum level of competence on this exam must be achieved to pass the clerkship. The standard passing score for the subject exam has been set for all clerkships at the 6th percentile. A score below the 6th percentile is considered a fail.

Students who are pending a subject exam retake will receive a grade of Incomplete for that clerkship. Students must retake the exam within the time period stipulated in the Grading Policy. Students who accumulate an initial clerkship subject exam failure or miss a subject exam in more than one clerkship will be placed on Personal Leave until all subject exam retakes have been successfully completed. 

If the student fails to achieve a passing threshold performance score on the exam retake, they will earn a failing grade for that course or clerkship.

RELATED POLICIES, FORMS AND LINKS

Last approved by SOM Committee on Curriculum and Educational Policy: May 19, 2025