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Clerkships are a difficult time, to say the least. One of the most frustrating aspects is that medical students are graded on a daily basis in a highly subjective fashion on their overall performance, and students will get grades that may not be commensurate with what they deserve (or think they deserve). Because of how important clerkship grades are to residency applications and beyond, it is important to realize there are opportunities for students to appeal their grades through formal or informal avenues. However, appealing a clerkship grade or grade from an attending can be challenging, and most schools rarely change grades at the behest of a student’s request without overwhelming evidence. Almost like a court case, the student asking for a grade change needs to prove beyond a reasonable doubt that the grade they received was unjust and that they deserved a better one. If you feel like that is you, then the following advice will help you throughout the appeal process:

1. Be sure you have really earned the clerkship grade you are asking for.

By calling your clerkship grade into question, you are calling into question the entire evaluation and grading committee as well as the judgment of all the medical residents and attendings who have evaluated you. While you think this can only help you, you always run the risk of burning a few bridges. Thus, you need to really ask yourself if what you stand to gain (a better grade) is worth the trouble you might put others through and that it might rub them the wrong way. Thus, you shouldn’t appeal a grade on a whim with your fingers crossed hoping that the stars align, just for a chance at a better grade. Unless you can make a strong case, this is often not worth it.

2. Have your allies readied.

Take some time to reflect on who would actually advocate for your excellent performance on the clerkship. Which residents or attendings actually liked you? If you were good about feedback during your clerkship, then this should be an easy question. Be prepared to bring up all of these people to whoever you are appealing your grade to, as they will be asked to potentially evaluate you again or provide more detail into your performance.

3. Be prepared for a long and drawn-out process.

Changing a grade in medical school is not easy. Even an informal request can become hugely formal, and the back and forth between you, the grading committees, and your evaluators could take months with the schedules of residents and attendings. Be prepared to have this on your mind during your next clerkships, board studying, residency interviews, and the like.

4. Be your own strongest advocate.

Getting through the appeal process means you will need to stand up for yourself. Your attendings and residents will try their best to support their own evaluations of you and do not like to equivocate. It is also less work for the school to change your grade. Thus, unless you are in the driver’s seat the whole time, you will find that most of the folks you encounter through the appeal process will be telling you that it may not be worth moving forward. Be that as it may, if you have reached a point in the appeal process where you have already invested some effort, it is in your interest to see it through.

5. Appeal to the human side of your superiors.

To do this, the easiest way is to maintain how hard you worked and how important performing at a high level on this clerkship was to you. To this end, showing there was struggle may help others empathize on a more personal level. There may be other approaches here, but the key is to make others like you and want to advocate for you.

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