INTRODUCTION: Predictors of student performance on clerkship rotations are limited. In this study, we aim to identify predictors of success on the surgery clerkship. METHODS: 62 third-year medical students completed an institution-specific clerkship survey. Students were grouped according to clerkship grade of honors (HG) versus high-pass or pass (PG). Statistical analyses were performed using Student's t-test, Pearson's Chi-square/Fisher's exact test, and linear regression analysis. Multivariate logistic regression was performed to identify predictors of achieving an honors on the clerkship. RESULTS: HG students were more likely to be individual-based learners with higher grit and USMLE Step 1 scores compared with PG students. Moreover, USMLE Step 1 score was associated with quiz, shelf examination, and final clerkship grades, but not clinical evaluations. There were few differences with regard to preferred learning modalities, but overall, medical students favored active learning activities. CONCLUSIONS: We found that higher USMLE Step 1 score, higher grit score, and an individual-based learning style were associated with a higher grade on the surgery clerkship. However, these factors may not fully capture the less objective components of high performance. Additional methods by which educators can measure students' clinical competency are needed.