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Final Examination

Students will take the NBME subject exam on the last Friday of the clerkship. The SOM webpage on NBME subject exams provides specific information about testing logistics. Testing information will be sent by the UWSOM Testing Service during the first week of each rotation. If you have any questions about testing logistics, please email

We have a few recommended studying resources for the NBME exam:

Certain sites have different patient populations, we recommend extra studying in areas where you may have seen fewer patient presentations.

For the HMC/UWMC site, extra focus on the pediatric EM components of the above resources as well as the supplemental lecture and readings on our website are recommended.

The NBME exam score will count for 7% of the final grade (equivalent to 1 shift). In order to pass the exam, students must receive a final score of 64 or above. 

PLEASE NOTE: Per the Clerkship Grading Policy all required clerkships require a passing grade on the final exam in order to graduate.

Students needing to delay a clerkship exam (in the event of a personal or family illness, emergency, or death) must complete an attestation form. Please see the UW SOM Exam Postponement Policy for details. 


A formal structure for feedback to occur in real-time during the clerkship is in place for the core objectives. Mid-clerkship feedback will occur about halfway through the course based on daily observations collected at that point. This will be via a formal email at HMC/UW. In WWAMI, this will be in person or via email.


The final evaluation will be based on a compilation of attending and senior resident evaluations of clinical performance and the final exam score on the Emergency Medicine NBME subject exam. The grading scale for the 2024-2025 academic year is as follows.

Clinical Grade:

  • 3.5-4.0 (87.5%-100%): Honors
  • 3.0-3.49 (75%-87.3%): High Pass
  • 2.0-2.99 (50%-74.8%): Pass
  • 1.99 and below (less than 50%): Fail

This summative clinical evaluation will be taken directly from your overall performance average on the following clinical assessment tool that aligns with our overall intended learning outcomes for you: EM Clinical Assessment Tool

Final Grade (Clinical Grade + Exam):

  • 86.6%-100%: Honors
  • 74.6%-86.5%: High Pass
  • 50.9%-74.5%: Pass
  • 50.8% and below: Fail

This final grade scale is adjusted from the clinical grade scale to incorporate the Emergency Medicine NBME subject exam score.

Grade Challenge

If you wish to dispute your final grade, the Grade Challenge form must be completed and received by our office within 4 weeks after the grade was posted. 

Circumstances in which a challenge is appropriate include:

  • An apparent mathematical error in computing your final grade.
  • A technical problem with the evaluation process.

Circumstances in which a challenge will not be entertained include:

  • Discrepancy between the feedback you received and the evaluation that was submitted. 
  • Disagreement with our grading process (e.g. how the clinical grade is calculated and weighted)
  • Disagreement with an evaluator's assessment of your performance. 
  • Performance on the exam.

If you have questions about your grade or our evaluation process, please contact Megan Mast and not the individual educator or site director. Please visit the Clinical Grade Review, Challenge, and Appeal Process website for more information on the School of Medicine process.