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Proceed with Caution: A review of grading criteria and MSPE ratings across medical schools

To examine the variability in obstetrics and gynecology (OBGYN) clerkship gradings and the Medical Student Performance Evaluations (MSPE) in all applications received at one residency program.

Clinical grading and the MSPE are important components of the application for residency training. Little is known about grading consistency or adherence to the Association of American Medical Colleges guidelines (AAMC) for the MSPE across medical schools.

All applicants’ OBGYN clerkship grading and MSPE’s submitted to one academic OBGYN program in the Midwest during 2021-2022 residency application cycle were reviewed. Clerkship grade descriptors, grade distribution, MSPE ratings, and MSPE ratings’ distributions were analyzed.


Results: Of the 916 applications, there were 237 unique schools with 43 unique grading tiers and 217 rubrics for grading. Clerkship grading criteria was not available for 49 applicants (5.3%). 25 different MSPE ranking criteria were used for summary rating with 107 different MSPE ranking percentiles. MSPE ranking was not available for 362 applications (39.5%) including 45 from schools that suspended MSPE ranking due to the COVID-19 pandemic.


Very little consistency was found with clerkship grading criteria and MSPE overall student ranking across medical schools.  Grades and MSPEs had a wide variety of descriptors and wide percent distribution for each tier. With educators encouraging holistic review of residency applications to decrease reliance on board scores as screening tools, it is increasingly important to be able to compare applicants across and within medical schools. Improvement in transparency and the development of a unified and holistic standardized way of grading and MSPE ranking are needed to seek a more reliable and valid application review process.  

Topics: CREOG & APGO Annual Meeting, 2023, Student, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Patient Care, Medical Knowledge, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, UME, Assessment,

General Information

Student,Resident,Faculty,Clerkship Director,Osteopathic Faculty,Residency Director,
Patient Care,Medical Knowledge,Professionalism,Systems-Based Practice & Improvement,Interpersonal & Communication Skills,Practice-Based Learning & Improvement,
Clinical Focus

Author Information

Hannah Makki, BA; Association of Professors of Gynecology and Obstetrics; John Dalrymple, MD; Maya Hammoud, MD, MBA; David Marzano, MD; Abigail Winkel, MD, MHPE; Karen George, MD, MPH

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