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This article was migrated. The article was marked as recommended. IntroductionAn orthopaedic surgery clerkship is an important aspect of a medical student's application for residency, however, the process by which grades in these clerkships are determined is poorly understood. In this study, we sought to determine what grading systems are being used by orthopaedic residency programs and some of the factors taken into account when grading rotating medical students.MethodsA 24-question anonymous survey was distributed to residency coordinators at ACGME accredited civilian and military United States orthopaedic surgery residency programs. The survey included questions about the grading system, number of rotating students and factors considered when determining a student's grade. Standard descriptive statistics were used to evaluate survey responses.ResultsAt 57% (16/28) of programs that responded, more than 40% of current residents rotated as 4 th  year medical students. 50% of orthopaedic surgery programs who responded to the survey indicated that 80%-100% of away and home rotating students over the past 5 years received a grade of honors.DiscussionThe current process of grading orthopaedic surgery away rotations suggests that grades may be inflated, with more students receiving the highest designation than are truly deserving of that honor. Standardized grading of these rotations may benefits programs and students alike.

Grading Medical Students During their Fourth Year Orthopaedic Surgery Rotations