MEDICAL STUDENT PERFORMANCE EVALUATION

For
(Student’s Name)
(Date)

IDENTIFYING INFORMATION
(Student’s Name) is a fourth year student at The George Washington University School of Medicine and Health
Sciences in Washington, D.C.
UNIQUE CHARACTERISTICS
(Student’s Name) was not your typical pre-medical student. While many medical school applicants have performed
research using techniques such as PCR, knock-out mice, and various forms of radioactive labeling, (Student’s Name) studied
Buddhist Monks. Indeed, His/her functional neurobiological studies of the meditative state in these unique research subjects is
one of the more interesting projects that you will hear about.
(Student’s Name) has been, and continues to be, unique in his/her approach to his/her medical studies bringing a wide
array of interests and talents to His/her academic preparation for the field. He/she was born and raised in Spokane, Washington,
which he/she still considers home.
He/she moved East to attend Georgetown University, graduating in (date) with a Bachelor of Arts degree in Theology and a
minor degree in Biology. He/she then matriculated at The George Washington University School of Medicine and Health
Sciences in the Fall of (date). During his/her first year, (Student’s Name) joined our Medical Education Leadership Track
Program. Students enrolled in a Track Program complete a two year series of seminars and workshops related to their chosen
discipline and a summer experiential project between the first and second years of medical school. (Student’s Name) was the
recipient of a summer scholarship from George Washington to pursue a research project with Eastern Maine Healthcare Systems.
While there, he/she was involved in the research and development of patient education interventions addressing the treatment
and management of pain syndromes. Students in the Track Program also complete a scholarly project related to their discipline
and a senior capstone experience. Students in the Medical Education Leadership Track serve as co-course directors for our
Students as Educators Program. In this Program, students gain advanced preparation and teaching skills and serve as facilitators
for physical diagnosis education for the first and second year medical students. (Student’s Name) has also served admirably over
the past four years as a curriculum representative for his/her class. He/she has served on a number of important curriculum
committees, most recently the Curriculum Management Group, the central committee for the coordination and integration of
education at the Medical School. (Student’s Name) maturity, reliability, and grasp of medical education theory and practice have
been admirable for someone at his/her level of training.

ACADEMIC HISTORY
Elected to Alpha Omega Alpha Medical Honors Society Date
Date of Graduation from Medical School: Date
Date of Initial Matriculation in Medical School: Date

For Transfer Students:

Date of Initial Matriculation in Prior Medical School:
Date of Transfer from Prior Medical School:

For Dual/Joint/Combined Degree Students:

Date of Initial Matriculation in Other Degree Program:
Date of Expected Graduation from Other Degree Program:
Type of Other Degree Program:
Was this student required to repeat or otherwise remediate any
coursework during his/her medical education?

Did this student's educational program contain any leave(s)

of absence, extension(s), or other gap(s) or break(s), either
required or voluntary?

Was this student the recipient of any adverse action(s) by the

medical school or its parent institution?

ACADEMIC PROGRESS
Pre-Clinical / Basic Science Curriculum:
(Student’s Name) performed very well in the first two pre-clinical years, passing all courses and achieving Honors
grades in many courses.

The Practice of Medicine course extends for one and one-half days per week throughout the first two years. This course
contains three main components; a "Doctor-Patient-Society" small group format for learning and practicing interviewing and
physical diagnosis skills; the Primary Care Apprenticeship wherein students spend one half day every other week in the office of a
faculty or community physician in pediatrics, family medicine, or internal medicine; and the Problem-Based Learning tutorials during
which they work on clinical cases in small groups with a faculty facilitator.

Doctor-Patient-Society:
Year 1: "It has been a pleasure to work with (Student’s Name). He/she works hard to master the required skills. He/she
needs to improve a little in the area of participation. I am hopeful he/she will continue his/her good attitude an enthusiasm into next
year."
Year 2: "(Student’s Name) has done an outstanding job over the past two years. He/she will do quite well during his/her
clinical rotations. Good interviewing skills."

Problem-Oriented Case-Based Learning:

Year 1: "(Student’s Name) performance in PBL I was excellent. (Student’s Name) was a valued group member; He/she
displayed a clear grasp of complex issues. Further, (Student’s Name) insightful discussion of patient suffering in his/her report on
anorexia and bulimia nervosa was quite poignant."
Year 2: "(Student’s Name) performance in the final semester of PCL II was excellent!"

Clinical Apprenticeship:
Year 1: "Very polite and respectful towards the patients. Shows great promise to continue improving with more clinical
exposure. Assimilates and organizes knowledge quickly in an experience-appropriate manner (He/she is still a first year
medical student)."
Year 2: (passing grade, no comments)

Individual Clerkship Evaluations Year III:

Surgery:
General Surgery: "His/her fund of knowledge was adequate but with areas of weakness. He/she should read regularly and
in-depth to broaden his knowledge base. He/she did fairly well in using information to solve clinical problems. He/she was able to
formulate basic plans of evaluation and suggested therapy. His/her oral presentations demonstrated regular improvement and
became more organized, clearly presented, and comprehensive. He/she was able to do thorough and accurate histories and
physicals despite time constraints. He/she had good recognition of the surgical problems. He/she was above average in his basic
surgical skills. He/she demonstrated good interest in being part of the operative team. He/she had a professional attitude and
behavior. He/she learned to cope with the demands of a busy service. He/she was always pleasant and related very well to other
students, residents, and hospital staff. He/she was respectful of others. He/she related extremely well to patients and
demonstrated compassion and concern for their welfare."
Pediatric Plastic Surgery: "He/she was helpful in the operating room and clinical setting. He/she was inquisitive and
thorough. He/she was energetic and engaged."
Anesthesiology: "He/she had a solid knowledge of physiology. He/she was inquisitive and took initiative."
Clinical Grade: High Pass/Honors Exam Grade: High Pass Overall Grade: High Pass
 Medicine: "He/she did a lot of research on his own and then educated the team. He/she did complete histories and He/
she was good with procedures. He/she had very good clinical skills. He/she could work on developing independent assessments
and plans. He/she had superb professional behavior and work habits. He/she was motivated and self-directed. He/she treated
all patients with respect. He/she was a very motivated and driven individual yet humble and willing to learn. Overall, his/her
strengths were his/her professionalism, interpersonal skills, and attention to detail. Areas for improvement include becoming
more confident in his/her own independent assessments and plans."
Clinical Grade: Honors Exam Grade: Pass Overall Grade: Honors

Primary Care: "He/she had an excellent fund of knowledge and demonstrated continuous reading. He/she did an
outstanding job of gathering information and was always able to develop a logical assessment and plan for care. He/she had
outstanding communication skills. He/she had excellent history taking skills. His/her physical exams were done with very good
technique, logical progression, and with great proficiency. His/her oral and written presentations were well organized, clear,
concise, and included all the pertinent positives and negatives. He/she had an outstanding work ethic. He/she was extremely hard
working and very self-directed. He/she was extremely professional towards the staff and patients and had a very pleasant
personality. He/she was a team player who worked well others."
Clinical Grade: Honors Exam Grade: Honors Overall Grade: Honors

Psychiatry: "He/she was almost immediately at ease with his/her patients and had a strong knowledge base in
addition to his/her clinical skills. He/she was able to use academic resources and apply them to his/her clinical
presentations. He/she was dependable, hard working, and stayed late when the clinical load was large. He/she knew his/her
patients and was a reliable source of information for the entire treatment team."
Clinical Grade: Honors Exam Grade: Honors Overall Grade: Honors

Pediatrics:
Ambulatory Pediatrics: " He/she demonstrated an outstanding fund of knowledge and continuous use of the medical literature.
He/she showed excellent organizational skills and was always able to develop a logical assessment and treatment plan. He/she
had outstanding history taking skills. He/she was very proficient at physical exams. He/she demonstrated steady improvement in
the efficiency of his/her exams. His/her oral and written presentations were always clear, concise, and included all pertinent
positives and negatives. He/she demonstrated organizational skills when presenting cases. He/she had a superb work ethic. He/
she was extremely pleasant and very professional. He/she was a true team player. He/she was punctual and willing to take on
extra responsibilities. He/she was enthusiastic and hard working."
Inpatient Pediatrics: "He/she demonstrated a solid fund of knowledge, above what is often seen in the third year. He/she
also had a strong ability to research his/her patients and accurately present what he/she learned about the clinical situation. He/
she worked diligently on organizing his/her data and did so quickly resulting in well organized instructive presentations. He/she
was able to identify pertinent positive and negative data and interpret its relevance to the case rather than simply reporting data.
He/she was able to formulate an accurate assessment of his/her patient and explain on rounds what were his/her leading
diagnoses and how they would be investigated or evaluated. His/her history and physical exam skills were excellent and through.
He/she worked diligently. He/she presented confidently and included the family on family centered rounds. His/her write-ups were
well organized and thorough. They demonstrated his in-depth understanding of his/her patients and also common pediatric
problems and how they are evaluated. The attendings and residents found (Student's Name) to be consistently enthusiastic,
interested, and a team player. He/she was always very professional and respectful towards team members and families. He/she
was appreciated by all as a helpful, motivated team member who was reliable and took responsibility for his/her patients."
Clinical Grade: High Pass/Honors Exam Grade: Honors Overall Grade: Honors

Obstetrics and Gynecology: "He/she had an above average knowledge base. He/she demonstrated well organized
clinical thinking and was able to synthesize data into reasonable plans. He/she was a great help in the operating room. He/she
was willing to take part in surgery. He/she was very perceptive on subsequent steps in the surgical procedure. He/she was able to
assist above a student level. He/she had thorough interviews and was able to identify pertinent findings. He/she was very
comfortable at the patient's bedside. He/she prepared concise and well organized histories and post-operative notes. He/she gave
a presentation on ectopic pregnancy that was thorough and a handout that was well organized. He/she worked hard and did his
work in a timely fashion. He/she was compassionate and very enthusiastic. He/she showed outstanding initiative on labor and
delivery. He/she was a very helpful member of the team who was always professional with staff, patients and colleagues. Areas of
strength were his diligence, enthusiasm, careful and thorough physical exams, and clearly written notes. Areas for improvement
included his/her differential diagnoses and his/her focused history and physical presentations."
Clinical Grade: Honors Exam Grade: Honors Overall Grade: Honors

Individual Clerkship Evaluations Year IV:

 Acting Internship in Internal Medicine: "He/she has an outstanding knowledge of disease, pathophysiology, diagnosis
and treatment. He/she has superior organization skills and was always able to logically formulate a description of the clinical
information.
He/she had an outstanding ability to reach a logical assessment of the patient and their problems. He/she had an excellent ability
to develop a comprehensive differential diagnosis and was astute at organizing considerations in a logical order. He/she had an
outstanding ability to develop a logical plan of care which included sophisticated plans for treatment and diagnosis. (Student’s
Name) was spot-on in terms of his critical reasoning skills and applying his/her superior fund of knowledge to a clinical setting. His/
her oral presentations were very clear and exceptionally well organized. All pertinent information was presented concisely and
pertinent positives and negatives were included. His/her written presentations had outstanding clarity and superior organization
with an excellent summary of history, physical, assessment and plan. He/she was punctual, respects authority and works well with
others. Overall, (Student’s Name) is an excellent teacher. I had the opportunity to observe him/her on several occasions give
short talks to the team and not only did the team learn but I did as well. He/she is engaging, caring, thoughtful and a modest and
mature young man."
Final Grade: Honors

Anesthesiology: Completed all course requirements.

Final Grade: Honors

************************************ADDENDUM ADDED (Date)********************************************

Individual Clerkship Evaluations Year IV:

Neurology: Completed all course requirements.

Final Grade: High Pass
Pain Management*: Completed all course requirement.
Final Grade: High Pass
Electrocardiography: "He/she has an excellent fund of knowledge and clinical skills. His/her presentations are
outstanding." Final Grade: High Pass
Emergency Medicine: Completed all course requirements.
Final Grade: High Pass
Extramural Emergency Medicine: "He/she is open and honest and says what He/she intends to do and does it. Sets
deadlines and delivers them. He/she sets high expectations of self and others. He/she is smart, hardworking and ethical."
Final Grade: High Pass
Extramural Anesthesiology " He/she has an excellent mind for anesthesia and sees the big picture. He/she has good skills
and picks up techniques quickly. He/she has excellent communication skills. He/she is very professional. Residents love working
with him/her. He/she shows excellent commitment."
Final Grade: Honors

*Indicates a 2 week course

*****************************************************************************************************************************

SUMMARY
(Student's Name) has put together an outstanding academic performance at George Washington marked by superior
academic achievement in both the pre-clinical and clinical curriculum. This is complemented by his/her excellent work in the
Medical Education Leadership Track and his/her important service to the institution as a Senior Curriculum Representative. He/
she should develop into an outstanding member of his/her residency training program where both his/her advanced educational
skills as well as his/her strong academic preparation should help him/her develop into a leader.

W. Scott Schroth M.D., M.P.H.

Associate Dean for Administration
Associate Professor for Medicine and Prevention and Community
Health
Student Name: Appendix A: First Year Courses
(Student's Name) ▪ = Student's Performace

Gross Anatomy Microscopic Anatomy Practice of Medicine A Neurobiology

ANAT210 ANAT 213 IDIS 210 IDIS212

100% 100%
100% 100%
90% 90%
90% 90%
80% 80%
80% 80%
70% 70%
70% 70%
60% 60%
60% 60%
50% 50%
50% 50%
40% 40% 40% 40%

30% 30% 30% 30%

20% 20% 20% 20%

10% 10% 10% 10%

0% 0% 0% 0%
HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL

Medical Biochemistry Practice of Medicine B Immunology Physiology

BIOC201 IDIS211 MICR202 PHYL201

100%
100% 100% 100%
90%
90% 90% 90%
80%
80% 80% 80%
70%
70% 70% 70%
60%
60% 60% 60%
50% 50%
50% 50%
40% 40% 40% 40%
30% 30% 30% 30%
20% 20% 20% 20%
10% 10% 10% 10%
0% 0% 0% 0%
HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL
Student Name: Appendix A: Second Year Courses
(Student's Name) ▪ = Student's Performace

Practice of Medicine II-A Microbiology Pathology Psychiatry

IDIS220 MICRO201 PATH201 PCHI301

100%
100% 100% 100%
90%
90% 90% 90%
80% 80%
80% 80%
70% 70% 70% 70%
60% 60% 60% 60%
50% 50% 50% 50%
40% 40% 40% 40%
30% 30% 30% 30%
20% 20% 20% 20%
10% 10% 10% 10%
0% 0% 0% 0%
HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL

Pharmacology Practice of Medicine II-B Intro Clinical Medicine Pharmacology

PHAR201 IDIS221 IDIS301 PHAR202

100% 100% 100% 100%

90% 90% 90% 90%
80% 80% 80% 80%
70% 70% 70% 70%
60% 60% 60% 60%
50% 50% 50% 50%
40% 40% 40% 40%
30% 30% 30% 30%
20% 20% 20% 20%
10% 10% 10% 10%
0% 0% 0% 0%
HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL HON PASS CN FAIL
Student Name: Appendix B: Third Year Clerkships
(Student's Name) ▪ = Student's Performace

Pediatrics Obstetrics & Gynecology Psychiatry

PED303 OB&G303 PCHI302

100% 100%
100%
90% 90%
90%
80% 80%
80%
70% 70%
70%
60% 60%
60%
50% 50%
50%
40% 40%
40%
30% 30%
30%

20% 20% 20%

10% 10% 10%

0% 0% 0%
HON HIGHPASS PASS CN FAIL HON HIGHPASS PASS CN FAIL HON HIGHPASS PASS CN FAIL

Medicine Primary Care Surgery

MED305 MED301 SURG303

100% 100% 100%

90% 90% 90%
80% 80% 80%
70% 70% 70%
60% 60% 60%
50% 50% 50%
40% 40% 40%
30% 30% 30%
20% 20% 20%
10% 10% 10%
0% 0% 0%
HON HIGHPASS PASS CN FAIL HON HIGHPASS PASS CN FAIL HON HIGHPASS PASS CN FAIL
 APPENDIX C
ASSESSMENT OF PROFESSIONAL ATTRIBUTES AND BEHAVIORS

The professional attributes and behaviors of all students at The George

Washington University School of Medicine and Health Sciences are assessed
systematically during their clinical clerkships. The Committee on the Undergraduate
Medical Curriculum and the Medical Student Evaluation Committee have adopted a
modified version of the AAMC-recommended professionalism evaluation form (see
www.aamc.org/members/gsa/professionalism_%20assessment_form.pdf )

Our complete evaluation form can be viewed at:

www.gwumc.edu/smhs/students/pdf_files/clerkship_eval.pdf

Our assessment instrument evaluates the following attributes and behaviors on a 5

point scale. “5” indicates satisfactory evidence of professionalism in the relevant
domain. Students given a rating of “1-4” are considered to have demonstrated less than
satisfactory professionalism in the relevant domain. If less than satisfactory evaluations
are received, the reason for the unsatisfactory evaluation MUST be described in the
clerkship narrative.

• Truthfulness
• Adherence to Ethical Principles
• Responsibility
• Teamwork
• Compassion/Empathy
• Commitment to Competence and Excellence: Motivation and Drive
• Respect for Patients: Relationships, Autonomy, and Confidentiality

The following summarizes the results of the professionalism evaluations for:

(Student's Name)

X All professionalism evaluations were satisfactory.

Unsatisfactory evaluations were identified in the following clerkships (see clerkship

narratives for details):

________________________
________________________
________________________
 APPENDIX D:
SUMMARY COMPARATIVE
DATA CLASS OF (Date)

The George Washington University School of Medicine and

Health Sciences: Class of (Date)

Chart: Total Number of Honors Grades for Class of (Date) in Major Courses through
year 3 (17 Possible Honors) indicates student's standing

35

30
Number of Students

25

20

15

10

0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Number of Honors Grades

* Honors grades were tabulated for GW Medical School Course s with at le ast three
credit hours.
Appendix E
Medical School Information Page

The George Washington University School of Medicine and Health Sciences

Washington, DC

Special programmatic emphases, strengths, mission/goal(s) of the medical school:

The George Washington University School of Medicine and Health Sciences has as its goal the
preparation of humanistic physicians with strong clinical skills. The unique situation of the
school’s location in the nation’s capitol permits students many opportunities to pursue interests in
research, community service, and leadership. We admit a highly diverse group of students with
wide-ranging interests and accomplishments.

Special characteristics of the medical school's educational program:

In addition to the standard four year MD program, GW sponsors dual BA/MD and MD/MPH
programs in which up to 15% of each class is enrolled. We also sponsor a decelerated program for
the first year in which selected students with unique or non-traditional academic preparation but
high promise for the practice of medicine are offered enrollment

Average length of enrollment (initial matriculation to graduation) at the medical school:

Approximately 90-95% of each entering class completes their medical education within four years
of admission.

Description of the evaluation system used at the medical school: .

George Washington utilizes an Honors/Pass/Conditional/ Fail (High Pass for Clinical Years)
grading system. A conditional grade indicates isolated areas of weakness that can be remedied
without repetition of the entire course. Clinical skills assessment is carried out repeatedly through
the first three years utilizing standardized patients. These evaluations are incorporated into course
grades in the Practice of Medicine course or the relevant clinical clerkship. GW does not
maintain a class ranking system nor do we ‘rank’ students by the use of single summative
adjectives. Indeed, we believe that it is impossible to distill a student’s many characteristics
and skills into a single adjective. Nevertheless, we strive to use adjectives carefully and
accurately, reflecting the relative performance of a student compared to their peers. We are
reluctant to use superlatives in describing most students. Clinical evaluations are edited for
grammar and length. Specific comments regarding strengths and areas for improvement are
always incorporated.

Medical school requirements for successful completion of USMLE Step 1, 2 (check all that apply):
USMLE Step 1: USMLE Step 2
Required for promotion Required for promotion
Required for graduation Required for graduation
Required, but not for promotion/graduation Required, but not for promotion/graduation
Not required Not required

Medical school requirements for successful completion of Objective/Observed Structured Clinical

Evaluation (OSCE) at medical school. OSCEs are used for (check all that apply):
Completion of course
Completion of clerkship
Completion of third year
Graduation
Other: ___________________________
Utilization of the course, clerkship, or elective director’s narrative comments in composition of the MSPE.
The narrative comments contained in the attached MSPE can best be described as (check one):
Reported exactly as written
Edited for length or grammar, but not for content
Edited for content or included selectively

Utilization by the medical school of the AAMC “Guidelines for Medical Schools Regarding Academic
Transcript.” This medical school is:
Completely in compliance with Guidelines’ recommendations
Partially in compliance with Guidelines’ recommendations
Exceptions:
Not in compliance with Guidelines’ recommendations

Description of the process by which the MSPE is composed at the medical school (including number of
school personnel involved in the composition of the MSPE).
Each MSPE is written by one of two physician deans at the Associate or Assistant level. All
letters are reviewed for consistency by the Senior Associate Dean for Academic Affairs.

Students are permitted to review the MSPE prior to its transmission:

Yes
No