Grade inflation and the internal medicine subinternship: A national survey of clerkship directors

Background: Grade inflation has been demonstrated in certain medical school clerkships but never studied in the internal medicine subinternship. Purposes: The purpose is to determine the existence, extent, and possible causes of subinternship grade inflation. Methods: We surveyed clerkship directors as part of the 2004 Clerkship Directors in Internal Medicine national member survey. Results: The majority of clerkship directors agree that subinternship grade inflation exists. Half of SI students receive Honors and one third receive High Pass. Eighteen percent admitted passing a student that they felt should have failed. Difficulty delivering negative feedback is the top explanation for grade inflation. Conclusion: Clerkship directors agree that grade inflation exists in the internal medicine subinternship. Faculty development and further analysis of our current subinternship evaluation and grading system may help to minimize this problem. Copyright (C) 2007 Lawrence Erlbaum Associates, Inc.