## Calculation of Course/Clerkship Raw Score, T-Score, T-Score Average, and Ranking Statistics

### Course/clerkship raw score

A raw score is the numerical grade awarded in a pre-clinical course or a clerkship.  Raw scores are not awarded for junior selectives, Special Topics, co-enrolled electives, Scholarly Activity, senior courses and Medical Scientist Training Program courses.  Raw scores are on a scale of 0-100 with 70=passing.  The method for calculating a raw score is determined by the course/clerkship director, with the following restrictions:
• Raw scores are reported as integers.  Scores less than 70 are truncated (e.g., 69.889=69), and scores 70 or higher are rounded up for decimal values of .5 or greater (e.g., 70.513=71, 71.488=71).
• If a student fails a pre-clinical course and is allowed to take a makeup test in order to pass, the raw score reported is the original (failing) score.
• If a clerkship student has to repeat the NBME Subject Exam, the score from the first attempt is used in calculating the clerkship raw score.  If the student passes the second attempt, the calculated raw score based on the first NBME score is reported, even if it is below 70.  If the student fails the second attempt, he/she fails the clerkship, and the clerkship raw score must be less than 70.  Thus, if the student fails the second attempt and the computed clerkship raw score is still 70 or greater, the reported raw score is set to 69.

### Course/clerkship T-score

Course and clerkship raw scores are converted to T-scores to maintain comparability of scores across courses, years and curriculum changes.  A T-score is a commonly used standard score that indicates the position of a raw score relative to the mean of a group, expressed in standard deviation (SD) units.  A T-score of 50 corresponds to the group mean; a T-score of 60 is one SD above the group mean; a T-score of 40 is one SD below the mean, and so on.  A T-score distribution always has a mean of 50 and a SD of 10, regardless of the underlying mean and SD for raw scores, so each pre-clinical course and clerkship has a mean T-score of 50 and an SD of 10.  The formula for calculating a T-score is:

T-score = 50 + [10 x ((raw score – mean)/SD)]

The mean and SD for a pre-clinical course are based on students taking the course during the same offering (time period).  For clerkships, the mean and SD are based on active students applying for residency in the same year.

### T-score Average (TSA)

A TSA is a weighted average of course/clerkship T-scores for a student during a given training phase.  Separate TSA’s are calculated for pre-clinical courses, clerkships, and overall.  The overall TSA is used for AOA nominations, honors, and for class rank reported in a student’s residency application.  If a student repeats a course or clerkship, both T-scores are included in the TSA.  Course/clerkship weights are determined by the Medical Education Committee.

The following example illustrates the calculations:

 Training Phase Course or Clerkship T-score Weight Weight x T-score TSA Pre-clinical Course 1 50 8 400 Course 2 65 4 260 Pre-clinical Sum = 12 660 55.0 Clerkship Clerkship 1 50 4 200 Clerkship 2 60 8 480 Clerkship Sum = 12 680 56.7 Overall Sum = 24 1340 55.8

The formula for TSA is [Sum of (Weight x T-score)] divided by [Sum of Weights].  Thus, Pre-clinical TSA = 660 / 12 = 55.0, Clerkship TSA = 680 / 12 = 56.7, and Overall TSA = 1340 / 24 = 55.8.  TSA’s are rounded to one decimal place.

### Ranking statistics (percentiles and quartiles)

A percentile rank is calculated for T-scores in pre-clinical courses and clerkships and for each type of TSA.  For pre-clinical course T-scores, the “ranking population” consists of students taking the course during the same offering (time period).  For clerkship T-scores and for all TSA’s, the ranking population consists of active students applying for residency in the same year.

Percentile rank can be interpreted as the percent of students in the ranking population falling below a given T-score or TSA.  A T-score is considered to be the midpoint of a continuous score interval from 0.5 below to 0.5 above the score.  For example, a T-score of 55 represents the midpoint of an interval from 54.5 to 55.5.  Since TSA is reported to one decimal place, its interval is from .05 below to .05 above the TSA; e.g., a TSA of 57.5 represents the midpoint of an interval from 57.45 to 57.55.

To determine the percentile rank, we assume that one-half the scores (or TSA’s) in the interval fall below the midpoint and calculate the overall percent of students that fall below the midpoint of the interval.  Thus, the percentile rank for a T-score is the percent of students below the score plus one-half the percent of students at the score. For example, if 120 of 180 students scored below 55 and 11 of the 180 scored at 55, the percentile rank for 55 would be (120/180) + 0.5 x (11/180) = 66.6% + 3.1% = 69.7%.  Percentiles are reported as integers, rounding up for decimal values of .5 or greater, so 69.7 would be rounded up to 70.

Percentiles are converted to quartiles for reporting to students on the Academic Summary as follows:

 Quartile Description Percentile Ranks P1 Top 25% 75 - 99 P2 50 - 74 P3 25 – 49 P4 Lowest 25% 1 - 24

T-scores and quartile ranks for each course and clerkship, along with the raw score ranges for each quartile, are reported in a student’s residency application on the Medical Student Performance Evaluation (MSPE) Course Ranking Report.

The Technical Standards Advisory Committee (TSAC) will be charged with reviewing requests for accommodations by students at the UASOM. The TSAC will use the published technical standards as the basis for determining if accommodations requested are consistent with these standards.

The TSAC will consist of nine voting members and four non-voting ad hoc members. The Associate Dean for Students will serve as the chair and vote only in the case of a tie vote. Voting members will be faculty members and medical students from each of the following areas of expertise: Physical/Rehabilitation Medicine Neuropsychology Psychiatry Surgical Specialty Primary Care Specialty 2 Basic Science (e.g. anatomy, pathology, microbiology, radiology) Medical Students: MS3 and MS4 Ad hoc members will be the Associate Dean for Students, the Assistant Dean for Admissions, and representatives from the UAB Office of Counsel and the UAB Office of Disability Support Services. Members will be appointed by the Dean of the UASOM for two-year appointments that can be renewed indefinitely. The appointments will be staggered to avoid a large turnover in the committee in any one year.

The committee will meet a minimum of once a year to be updated on legal issues and standards proposed by the American Association of Medical Colleges. Other meetings will be called by the chair within four weeks of a request for review by the Associate Dean for Students or the Assistant Dean for Admissions. A quorum will consist of 60% of the voting membership. A simple majority will be decisive.

This policy adopted by the Executive Faculty of the University of Alabama School of Medicine and approved by the Dean on October 2007.

Reasonable accommodations will be made for qualified individuals with limitations due to a documented disability. Applicants for admission and current students, with or without reasonable accommodations, must be able to satisfy the technical standards for acceptance into, progression through and graduation from the School of Medicine.

Accommodations must be requested through the UAB Office of Disability Support Services and recommendations for accommodations must come from this office.

### Applicants

Once admitted, students will contact the UAB Office of Disability Support Services, who will work with the Technical Standards Advisory Committee to establish accommodations. Throughout a student's career, we will work to make sure that a disability is reasonably accommodated.

### Current Students

A student who seeks accommodations will be referred to the UAB Office of Disability Support Services for assessment. The financial cost for documentation, assessment or evaluation will be the sole responsibility of the student. Personnel in the disability office will obtain appropriate documentation and assist students with any necessary testing. If they determine that accommodations are necessary to allow a medical student to meet the School of Medicine technical standards, then they will forward those recommendations to the Technical Standards Advisory Committee. The committee will review the request to see if the accommodations are feasible.

The Associate Dean for Students will be notified in writing of the committee's decision. If the accommodations are deemed appropriate and feasible, the Associate Dean for Students will be given the responsibility for implementing them. If the accommodations cannot be made, the student will be informed by letter. If the student is unable to meet the technical standards, the student will be dismissed. A medical student who is dismissed on the basis of inability to meet the technical standards of the School of Medicine will have the right of appeal to the dean through the established appeal process used in academic dismissals.

### Purpose

The national Veterans Affairs (VA) Hospital system has mandated that all medical students who participate in activities in one of their facilities undergo fingerprinting. Because all SOM students potentially spend time in the VA health care facility, either during their clinical rotations or during their Introduction to Clinical Medicine course, the SOM requires that all medical students be fingerprinted.

### Policy

All medical students are required to undergo Veterans Affairs fingerprinting.

### Procedure

Working with Medical Student Services, the VA will fingerprint all medical students. The VA will send medical student fingerprints to an FBI database for review. If criminal convictions are revealed, they will be reviewed by the VA for relevance to working in the VA setting. If the VA determines that the convictions are inappropriate for working in their setting, they will not allow the student to work there and will notify Medical Student Services that that student has failed their fingerprinting check.

Upon receiving notification from the VA that a student has failed the fingerprinting check, MSS will contact the student and require the student to undergo a criminal background check at the student's expense. A faculty review committee will be convened by the Associate Dean for Students to review the results of the criminal background check and determine if the student will be allowed to continue in medical school.

Students dismissed by the faculty review committee have the right to appeal the decision to the Dean of the School of Medicine.