I'm copy pasting a helpful description that @boneitis posted in last year's thread:
"First Year
During M1, the grading scale is pass/fail. There is no pre-determined pass threshold. They told us that if we were getting at or above 70% cumulative for a block that we would be fine. If for whatever reason, we had a lower grade, they would take into consideration other things such as attendance, participation, subjective evals by faculty. In reality, I had friends who scored around 50% in some blocks but never needed to remediate. If remediation is required, you are offered an opportunity to retake an exam rather than remediate the entire block or year, like other schools. There is, allegedly, no mention of remediation on your transcript, unlike other schools. There are also OSCEs that take place throughout all four years, with an emphasis during first-year. At other schools, the OSCEs are part of your overall grade. At HMS, they are not graded. And most importantly, there is no internal ranking. I have friends who went to pass/fail schools only to find out that they were still ranked, completely defeating the purpose of a pass/fail curriculum.
Second Year
The bulk of the second-year is the "principle clinical experience." This consists of our core rotations in medicine (12 weeks), surgery (12 weeks), peds (6 weeks), ob/gyn (6 weeks), psychiatry (4 weeks), neurology (4 weeks), radiology (4 weeks), and a year-long primary care rotation that takes place one afternoon every 2 weeks. At many other schools, these clerkships are graded on an "honors/high pass/pass/fail" scale. Other schools also have AOA (HMS doesn't), which requires you to reach around the 90th percentile on shelf exams to honor a rotation. At HMS, we are only required to get above the bottom 5th percentile (or 10th percentile for medicine and surgery) on the shelf exams to pass (this translates to around a 60% raw score). The shelf scores are not part of our grade and they are not reported on our transcripts. If for whatever, you fail a shelf, you have multiple opportunities to retake it without failing the rotation.
Third/Fourth Year
At the beginning of third-year, we sit for Step 1. We are allowed to take upwards of 3 months off for dedicated, yet it seems that most of my classmates took less than 10 weeks. After that, we do a mix of clinical electives, advanced science courses, and dedicated research time for a scholarly project. We are required to do a mandatory 4-week sub-i in medicine at a different hospital than your medicine rotation. We are required to do two 4-week AISC classes, which are just advanced basic science courses, most have a clinical component to them. We have a 4-week global health/social medicine course that is an extension from a first-year class. We do a 4-week clinical capstone class and then we are given around 3 months of dedicated research time for our mandatory scholarly project. During these years, the grading scale moves to "honors with distinction/honors/pass/fail." What is great about this is that we don't have AOA, so there really is no "honors." At other schools, only the top percentiles of students are eligible for honors. At HMS, literally every student could get an "honors with distinction" on a rotation. The best part out of all of this: grades aren't reported to residency programs. Hated your neurology rotation? Unless you are applying to neurology, the grade and evals won't be given to programs. When we apply, we get something called a DSA, which only includes the grades and evals for the specialties that are relevant to what we are applying to. For example, if I wanted to apply to neurosurgery, the only grades that are reported are medicine (reported for everyone), general surgery, and any neurosurgery elective I did. I can't tell you how much stress this grading system removes from the process."