Использовать CTE с RowNumber
create table #MARK_TABLE (ID int, STUDENT int, COURSE int, SCORE int)
insert into #MARK_TABLE
values
(1,1,1,60),
(3,1,2,81),
(4,1,3,81),
(9,2,1,80),
(10,1,1,60),
(11,2,1,80)
;with cteDeleteID as(
Select id, row_number() over (partition by student,course,score order by score) [row_number] from #MARK_TABLE
)
delete from #MARK_TABLE where id in
(
select id from cteDeleteID where [row_number] != 1
)
select * from #MARK_TABLE
drop table #MARK_TABLE