Texas Tech Shelf Percentiles

Introduction

Medical school is full of challenges, and one of the biggest hurdles students face during their clinical years is the shelf exam. These subject exams, officially created by the NBME (National Board of Medical Examiners), serve as standardized assessments across the United States. At Texas Tech University Health Sciences Center School of Medicine, performance on these exams is not just about passing—it directly influences a student’s clerkship grade and future residency applications.

The term “Texas Tech shelf percentiles” refers to how student exam performance is measured relative to national data. Rather than relying only on raw scores, Texas Tech assigns clerkship grades by placing scores into percentile ranks. This ensures that grades reflect both a student’s knowledge and how their performance compares to peers nationwide.

In this guide, we’ll explore what these percentiles mean, how they are calculated, what cutoffs exist for passing or honors, and strategies for students to succeed.

Understanding Shelf Exams and Percentiles

Shelf exams are subject-specific tests given at the end of each core clerkship, such as Internal Medicine, Pediatrics, Surgery, Psychiatry, Obstetrics/Gynecology, and Family Medicine. The exams are standardized, meaning that whether you are in Texas, California, or New York, the same national test is used.

Percentiles are statistical measures that compare your score with other examinees. For example:

A 50th percentile score means you performed better than half of the students taking the exam.
A 10th percentile score, often used as the passing threshold at Texas Tech, indicates a minimum acceptable level of knowledge.
An 80th percentile score is typically required for honors designation in many clerkships.

This system allows Texas Tech to fairly compare students’ performance across different clerkships and rotations.

Texas Tech Clerkship Grading Policy

Texas Tech uses a composite grading system for clerkships that includes:

NBME Shelf Exam (percentile-based grading)
Clinical evaluations from faculty and residents
Clinical Competency Exam (CCE) or practical assessments
Professionalism and participation

The shelf exam, however, is often the single most weighted component. Students who excel on the shelf tend to secure higher clerkship grades, which makes understanding Texas Tech shelf percentiles crucial.

How Percentiles Are Calculated

Percentiles at Texas Tech are determined using NBME data from the past three years. This rolling average ensures fairness across different exam versions and testing cohorts. Each student’s raw score is converted into an equated percent correct score, which then translates into a national percentile.

Texas Tech then applies its own quarter-based tables to determine where a student’s score falls for that academic year.

For example:

Clerkship periods 1–3 may use different percentile tables than periods 4–6, because test cohorts vary across the year.
Off-cycle students are also assigned percentiles according to the most comparable data available.

This process minimizes grade inflation or deflation and aligns student performance with national standards.

Cutoff Percentiles and Score Ranges

One of the most important aspects of the Texas Tech grading system is the cutoff percentile system. These percentiles dictate whether a student passes, fails, or earns honors in a clerkship.

Here is a simplified overview of common thresholds:

Grade Level	Percentile Cutoff	Meaning
Fail	Below 10th	Insufficient performance; must retake or remediate exam
Pass	10th and above	Meets minimum national standard
High Pass	~70th percentile	Strong performance above average
Honors	~80th percentile	Exceptional performance compared to national peers

It is important to note that exact cutoffs may vary slightly by clerkship and academic year, but the 10th percentile minimum passing rule is consistently applied.

Grading Formula and Weighting

While the NBME shelf exam is significant, it is not the only factor. A simplified breakdown might look like this:

NBME Shelf Exam – 35–40% of grade
Clinical Evaluations – 40–50%
Clinical Competency Exam (CCE) – 10–15%
Professionalism / Participation – 5–10%

Texas Tech applies “correction factors” to ensure balance between clerkships. For example, if a clerkship exam is particularly difficult in a given year, percentiles smooth out the differences by comparing students to a national pool rather than only within the school.

Retakes and Remediation

Students who score below the 10th percentile must retake the NBME shelf exam. While passing on the retake allows progression, the score may be capped at the minimum passing percentile when calculating the final grade.

This means that while a student can still graduate, they may not qualify for honors in that clerkship. Off-cycle students, or those who delay their shelf exam, are assigned percentiles from the most relevant national cohort.

Interpreting Texas Tech Shelf Percentiles

For students, understanding percentiles is key to setting realistic goals:

Passing Goal: Always aim to be above the 10th percentile to avoid remediation.
Strong Goal: The 70th percentile is often a marker for “High Pass.”
Competitive Goal: To be in contention for honors and to stand out on residency applications, aim for the 80th percentile or higher.

Residency program directors frequently view clerkship grades as indicators of clinical ability. Since the shelf exam influences these grades heavily, Texas Tech shelf percentiles directly affect residency competitiveness.

Challenges and Critiques

While percentile-based grading has many strengths, there are also challenges:

Small score differences can mean big percentile jumps. For example, a 2–3% change in raw score could move a student from the 60th to the 75th percentile.
Different clerkship schedules may affect preparation time. A student taking Surgery as their first clerkship may face a disadvantage compared to one who takes it later after more experience.
Stress factor: The pressure of knowing one exam largely determines a clerkship grade can increase anxiety.

Despite these challenges, the percentile system is considered one of the fairest ways to evaluate performance across institutions.

Strategies for Success

Students can improve their percentile outcomes with a focused approach:

Early Preparation – Begin studying for shelf exams from the start of the clerkship, not just in the last weeks.
Use NBME Practice Exams – These provide the most accurate prediction of percentile performance.
Leverage Question Banks – Resources like UWorld and AMBOSS align closely with NBME exam style.
Time Management – Balancing clinical duties with study is essential; aim for daily review sessions.
Peer Study Groups – Discussing cases and questions can solidify understanding.

By consistently preparing, students can aim not only to pass but to excel into higher percentile ranks.

Conclusion

The system of Texas Tech shelf percentiles is a crucial part of medical education at the School of Medicine. By converting raw exam scores into percentile rankings, Texas Tech ensures fair comparison with national peers, balances grading across clerkships, and maintains high academic standards.

For students, this means more than just passing an exam—it directly shapes clerkship grades, residency applications, and future opportunities. Understanding the percentile system, preparing strategically, and aiming for higher performance can make a significant difference in medical school success.