title: Grade inflation and the internal medicine subinternship: a national survey of clerkship directors.
abstract: BACKGROUND
  Grade inflation has been demonstrated in certain medical school clerkships but never studied in the internal medicine subinternship.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Internal Medicine, Greater Baltimore Medical Center, Baltimore, Maryland 21204, USA. scaccamese@gbmc.org
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Cacamese
authors.forename: Michael
authors.initials: M
authors.lastname: Elnicki
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Speer
mesh_terms: D002982:Clinical Clerkship / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D003625:Data Collection; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D004522:Educational Status; D005180:Faculty, Medical / Q000592:standards*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000592:standards*; D014481:United States