Marginal Performance Policy

Professionalism Reporting

Policy Statement:

A student will be designated a status of Marginal Performance based on academic performance metrics that indicate that the student could benefit from focused support in meeting the Keck MD program academic competencies. A Marginal Performance status alerts the student to concerns regarding their academic progress and their risk of failing subsequent course assessments and/or delaying or failing the USMLE Step 1 or Step 2 exam. The Marginal Performance designation is not included in the student’s MSPE or transcript.

Pre-Clerkship Phase Criteria

The academic metrics that are used to determine the designation of Marginal Performance status during the Pre-Clerkship phase are one or more of the following:

  1. Passing scores of 74 or less on the final end-of-course scored summative assessments for 2 or more pre-clerkship courses in a single semester. Note: for courses with a gross anatomy practical exam and/or other scored assessment (e.g., TBL), the final end-of-course scored summative assessment considered will be a composite of all the scored assessments.
  2. Failure of two Introduction to Clinical Medicine (ICM) OSCEs on the first attempt.

Clerkship Phase Criteria

The metrics that are used to determine the designation of Marginal Performance status during the Clerkship Phase are one or more of the following:

  1. Two subject exam scores that are below the 10th
  2. Summative CAT scores of less than 78 on 2 or more clerkships.

Process:

  • Students will be placed automatically on Marginal Performance status in the pre-clerkship or clerkship phase if they meet the criteria as defined.
  • Students will be notified by the Associate Dean for Student Affairs (or their designee) if placed on Marginal Performance status.
  • Students placed on Marginal Performance status are required to meet with the Associate Dean for Student Affairs within 10 business days after notification of Marginal Performance to establish an individualized plan of support which may include working with LEAD, ICM, or Clinical Skills Education and Evaluation Center faculty, or other supporting service as appropriate.
  • Marginal Performance status is monitored by the Student Performance Committee (SPC) and failure to comply with established learning or other plans may result in adverse actions as determined by the SPC.
  • A student on Marginal Performance status during the pre-clerkship phase will remain on that status for at least one semester and until their academic performance improves to Marginal Pass on fewer than 2 exams in a semester. Students on Marginal performance status in Semester 3 will remain on Marginal Performance status through at least Rotation 4 of the clerkship phase.
  • A student on Marginal Performance status during the clerkship phase will continue to receive support as appropriate and will remain on that status until they have successfully completed the clerkship phase.

Reviewed and Approved: January 21, 2026

Medical Education Curriculum Committee