A retrospective study was performed to evaluate a satisfactory/unsatisfactory (S/U) grading scheme in a didactic surgery laboratory during the first 3 years of implementation (2002-2004) and identify areas for improvement that might be adapted to this course or similar courses. Each instructor graded six students per session by assigning a descriptor of very good (G), acceptable (A), or unacceptable (U) in each of 11 assessment categories. A U in any category in one of the final two laboratories resulted in a failing grade for the course, unless the student performed acceptably in a make-up laboratory. A computerized course evaluation was used to solicit student feedback. Also, the numbers of G, A, and U grades were used to evaluate consistency of grading among instructors, to compare resident and faculty scores, and to track student progress. The return of course evaluations was low, but those available indicated favorable acceptance of S/U grading. There was little difference in assigned grades between faculty and residents, but some individual instructors seemingly graded more strictly than others. Student grades improved as the course progressed each year. No student received a final failing grade; however, two students required the make-up laboratory. Efforts to improve subjective grading should include planned acquisition of student feedback and establishment of more consistency of grading. While objective criteria may not be enough to adequately assess overall performance in didactic surgery laboratories, consistency of subjective evaluation requires adherence to well-defined assessment criteria. (Contains 7 tables and 1 figure.)