Understanding UCLA's Basic Competency Evaluation and Performance Standards

The David Geffen School of Medicine (DGSOM) at UCLA has implemented a comprehensive system to evaluate the competency of its medical students. This article delves into the grading policies, evaluation methods, and consequences of not meeting the required standards, as well as general information about applying to DGSOM.

Grading System for Core Clinical Clerkships

In March 2022, a significant shift occurred when the Medical Education Committee decided that core clerkships would be graded on a Pass/Fail basis, starting in the 2022-2023 academic year. This change affected clerkships in Emergency Medicine, Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery. However, grading for 4th-year electives remains unchanged.

The possible grades for each Core Clinical Clerkship are Pass, Fail, or Incomplete, and these grades are typically available for student review within six weeks of clerkship completion. An Incomplete grade may be assigned by the Clerkship Chair if clinical work is of passing quality but incomplete or if the final examination has not been taken. Until resolved, the Incomplete grade remains on the transcript, and all Incomplete Clerkships must be passed before moving on to 4th-year coursework.

To receive a grade of Pass, students must complete all clerkship requirements and achieve the minimum passing standard for both clinical performance and the National Board of Medical Examiners (NBME) Shelf Exam.

Clinical Grade Contribution

The Clinical Grade is meticulously calculated and reviewed by each Core Clerkship Chair in collaboration with the Clerkship Grading Committee. This committee uses a rubric tallying 13 possible evaluations of clinical skills for the Core Clerkships.

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These clinical skills include:

History Taking
Physical Examination
Fund of Knowledge
Differential Diagnosis Development
Treatment Plan Generation
Medical Record Documentation
Oral Presentations
Communication with Patients and Families
Communication with the Interprofessional Team
Humanism
Integrity and Work Ethic
Commitment to Learning
System-Based Practice

Each clinical skill is rated using criterion-based anchors along four levels of performance. Evaluators select the descriptor that best describes the student’s performance. If an evaluation is not possible due to a lack of observation, the evaluator selects "Unable to Evaluate/Insufficient Contact.” Each student is evaluated by descriptive anchors, which are assigned a value on a scale of 1-4. A null value is assigned for designations of "insufficient contact or unable to comment" for any of the clinical skills.

The Clerkship Chair(s) and Site Director(s) produce a summative evaluation and a composite narrative for each Core Clerkship. The Clerkship Chair, in collaboration with the Clerkship Grading Committee, assigns a Clinical Performance Grade by calculating a Total Evaluation Score from a compilation of the individual evaluations of clinical skills received. The Total Evaluation Score is a percentage value of the total score possible.

Calculating the Clinical Performance Grade

The Total Evaluation Score is calculated as a ratio against the highest score possible. For example, if 9 items are submitted, the maximum score is 36 (4 X 9); for all 13 clinical skills, 52 (4 X 13). A total evaluation score > 48% will result in a clinical performance grade of Pass. A total evaluation score of <48% will result in a clinical performance grade of Fail.

ACGME Competencies

In addition to earning a Total Evaluation Score of at least 48%, students must meet a minimum performance standard in all 6 ACGME Competencies to pass the clinical course. These competencies and the required percentage of total available points to PASS are:

Patient Care (Clinical Skills 1 and 2) - 50%
Clinical Knowledge (Clinical Skills 3, 4 and 5) - 33%
Interpersonal Skills (Clinical Skills 6, 7, 8 and 9) - 50%
Professionalism (Clinical Skills 10 and 11) - 50%
Practice-Based Learning (Clinical Skill 12) - 50%
Systems-Based Practice (Clinical Skill 13) - 25%

Student evaluation forms are assigned to residents, fellows, attendings, and, at times, other licensed health professional faculty. Site Coordinators obtain lists of these individuals with whom students have worked. Supervising physicians who have had sufficient contact to fairly evaluate student performance on at least one clinical skill are expected to complete individual evaluations.

A composite of all individual evaluations submitted is utilized in assessing student performance, with collaboration between Site Directors and Clerkship Chair(s) in assigning the final clinical performance grade. A narrative assessment of each student’s performance is compiled utilizing the individual comments provided by evaluators. The most representative descriptions from the “comments” section will be incorporated into the Medical Student Performance Evaluation (MSPE) letter for residency applications at the discretion of clerkship leadership.

Students who feel there is an error in their evaluation may request a review with the Clerkship Chair(s) within 14 days of grade submission. Edits to the summative evaluations will be limited to errors such as incorrect names or pronouns, grammar, etc. Clerkship Chairs do not add or delete comments from the MSPE section of the summative evaluation once submitted to the Dean’s Office. Evaluations may not be revised by completing additional work with the exception of an incomplete.

Final Examination (NBME) Grade

The NBME Shelf Exam minimum passing standard is based on annual national percentile exam reports for each required clerkship. The percentile score is Pass >5th percentile and Fail: < 5th percentile. Percentile data is obtained from annual reports from the NBME for each of the eight clinical subject (shelf) exams. The scores corresponding to the percentile nearest (but above or equal) to the 5th percentile are identified at the beginning of each academic year, based on the last academic year.

The National Board of Medical Examiners (NBME) ensures that each reported subject examination score is an accurate reflection of the responses for an examinee. Given this, DGSOM does not submit requests to the NBME for score re-checks on behalf of students.

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Required Clerkship Radiology Course

Students also complete asynchronous radiology modules relevant to each clerkship and take and pass a written radiology examination during each core clerkship. A minimum cumulative score of 70% is required to pass the course. This grade does not appear on the transcript.

Course Failure Policy in the Core Clinical Clerkships

Failing one clerkship exam (NBME shelf exam) will result in an Incomplete grade. The student is permitted to retake the exam for a second attempt on a designated exam date following two weeks of study with no required clerkships.

If a student fails the retest of a clerkship exam (second attempt of NBME shelf exam), the student’s grade for that clerkship will remain Incomplete, and their standing is changed to Experiencing Academic/Professional Difficulty. The student is permitted to retake the exam for a third attempt on a designated exam date following two weeks of study with no required clerkships.

Three exam failures on the same clerkship will result in a grade of Fail/No Credit, and the student’s standing is changed to Academic/Professional Probation. The student is required to repeat the clerkship in its entirety. If the student repeats the clerkship and passes the clerkship examination on the fourth attempt, the grade will appear on the transcript with an asterisk designating that the course was repeated. Failing the exam after repeating the clerkship (now a total of four failures on a single exam) may result in a referral to CASPP for consideration of dismissal.

Consequences of Multiple Incomplete Clerkships

If a student fails exams in two different clerkships, the student does not need to suspend future clerkship activity and is permitted to retake both failed exams on two different designated exam dates following two weeks of study for each exam with no required clerkships. Students with two or fewer incomplete grades due to exam failures or missed exams will be permitted to remain in the curriculum but will need to retake the failed exam(s) at a later date.

If a student fails or does not sit for exams in three different clerkships (three incomplete clerkships when adding exams either not taken or failed), the student will not be permitted to move forward in the curriculum. The student's academic professional standing will be changed to Experiencing Academic/Professional Difficulty, and the student must drop their next clerkship(s) and enroll in an Independent Study course until at least one clerkship shelf exam has been taken and passed.

General Information About Applying to DGSOM

Application Requirements and Deadlines

To apply to DGSOM, successful applicants will have obtained a Bachelor’s degree from a US or Canadian institution by completing at minimum 3 years of undergraduate coursework or have obtained a graduate degree from a US or Canadian institution. DGSOM considers applications from U.S. citizens, permanent residents, DACA recipients, or California residents.

The AAMC PREview exam is required for Traditional MD Program Track applicants. The Secondary application fee is $100.00.

Important dates to consider:

Final deadline for MCAT score submission: October 31, 2025, 8:59pm (Pacific Time)
Primary application submission deadline: October 1, 2025, 8:59pm (Pacific Time)

Applications are reviewed on a rolling basis and receive equal consideration regardless of the month in which they are received.

Application Submission and Updates

Recommendations and transcripts are submitted through the AMCAS application portal. Updates to your application will only be accepted when you submit your Secondary Application.

Program Tracks

Traditional: Select "University of California, Los Angeles David Geffen School of Medicine".
PRIME: Select "University of California, Los Angeles David Geffen School of Medicine". On the Secondary Application, you may choose to select the "Dual Consideration Option" to also be considered for the Traditional MD Track.
MSTP: Select "University of California, Los Angeles David Geffen School of Medicine".

Following a comprehensive holistic review of both the application and secondary application, select applicants are then invited to interview.

Competencies and Technical Standards

The David Geffen School of Medicine at UCLA does not evaluate specific prerequisite coursework. Instead, medical school applicants are given the flexibility to demonstrate mastery of competency areas throughout their unique academic history.

The School of Medicine requires that students meet all requirements necessary to obtain a medical license. Essential abilities and characteristics are required for the completion of the MD degree.

Residency Performance and Deficiencies

A study examining resident performance at four academic anesthesiology residencies over a 10-year period revealed that residents who received actions from their Clinical Competency Committee (CCC) had lower graduation and board certification rates.

The study included 865 residents, with 215 receiving a total of 405 actions from their respective Clinical Competency Committee. The proportion graduating differed (93% versus 99%, respectively, P<0.001), as did the proportion achieving board certification (89% versus 99%, respectively, P<0.001). When a single deficiency in an Essential Attribute (e.g., ethical, honest, respectful behavior; absence of impairment) was identified, the proportion graduating dropped to 55%.

Deficient ACGME Core Competencies varied among residents who were placed on probation, with the most common performance gaps noted in Patient Care, Professionalism, Interpersonal and Communication Skills, Medical Knowledge, Practice-Based Learning, and Systems-Based Practice.

Medical Knowledge was the most commonly deficient competency (128 residents), followed by Patient Care (n = 78), Professionalism (n = 75), and Communication & Interpersonal Skills (n = 74).

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