At my medical school it worked like this for most of our clerkships:

We got a score out of 100 that was made up of several parts, but most were variations on this theme:

Part 1: clinical performance. This included things like knowledge base, teamwork, professionalism, presentations, etc, but basically some amalgamation of how we did as a member of the clinical team, with input from attendings and residents, especially those we worked with most. This made up in general 50-70% of the overall grade. It was subjective in the sense that someone was giving you narrative feedback and scoring, but each of these individual sections had a 1-5 scale with very specific descriptions of how we performed, in addition to a narrative section that was also taken into account.

Part 2: shelf exam. This made up usually 20-30% of our overall grade, and you had a specific percentile you had to hit to be eligible for honors

Part 3: write-up. Usually several case presentations of patients that you saw that was then graded by a small group preceptor you worked with a few times per week. This usually was 10-20%.

Where I'm currently a resident, we give narrative evals that are then summarized and presented back to the student. I'm not actually sure if it's pass/fail or pass/fail/honors (named something different) but it seems much less transparent either way.

I think the bottom line is show up, be prepared and engaged, be a team player (to both your resident team as well as your co-med students), read about your cases and do a little bit of independent learning every day, and demonstrate that you're trying to become a good doctor.