Medical schools have traditionally used letter grades for their students, but to decrease the competitive atmosphere between these prospective doctors, some of gone with a simple pass-fail system.
Does it matter?
A recent study suggests the answer is no. When comparing two groups, one who was graded “A-F” and the other pass-fail, there was no difference in absolute test scores, as well as no discrepancy in board scores or getting into competitive residency programs.
Additionally, those who were in the pass-fail system were less prone to anxiety and depression, which as we know, disproportionally afflicts medical students.
At Boston University, we had a pass-fail-honors system, which I think is a nice compromise between the two grading systems.
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- Is depression more prevalent in medical students?
- UMDNJ: Doctored grades
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- My take: ER naming rights, grading data, salary disparity
- Should health policy be mandatory for medical students?
{ 9 comments }
I’ll be starting at Baylor Med this July, and they recently announced a transition to pass-fail for the preclinical curriculum. I still don’t know if this will reduce the number of gunners competing for AOA, but either way, I’m sure a handful of students will enjoy “less anxiety and depression”, as you said.
Students should get used to being rated. In real life hospitals and accrediting agencies are are scoring adherance to core measures and other complications down to the tenth of a percent
I agree with it. Makes for less cutthroat behavior.
But, as we all know, the person who graduates at the bottom of their medical class is called…. Doctor.
When I was at BU we had Honors, High Pass, Pass, Deficiency and Fail. Grades by any other name.
I think the “gunners” who wanted the higher grades and put forth the extra effort earned those honor grades. If they mattered, who knows.
No one has ever asked me what grade I got in spleen…
I am at Tufts Med, and we have the same Honors-Pass-Fail. If it was graded, I think it would be terrible, but now, the gunners try to get honors, people try to honor things they like, and if you hate a class or are just swamped and stress, you take the pass and move on with life.
I can’t imagine what the stress level and the atmosphere would be like if it was graded. When looking at schools though, it seemed like everyone had some variant of P-F, I don’t recall anyone doing regular grades.
I just finished my first year at Columbia’s College of Physicians & Surgeons. We have a straight-up pass/fail system for the first 2 years (preclinical), and it is wonderful. There is negligible competition amongst classmates; instead, we are collaborative and collegial. We help each other learn, rather than gunning it alone. It hasn’t hindered how much we are learning – we still work hard and achieve high averages on exams. The biggest benefit beyond the class collaboration is that stress is minimized. With stress out of the picture and no need to be gunners (yet), we have the time to cultivate outside interests (music, art, athletics, policy, etc.) and contributing to our growth towards becoming humanistic physicians.
The truth that many students don’t realize though is that you are still being rated even in most Pass Fail systems, you just don’t know it. These schools still rank their students based on grades, they just do it by percentiles and then tell you whether you got a p or f. Have fun with that.
I am against dispensing with letter grades on principle. Students should have feedback about how they are doing. Competition is an unintended result but not the primary value. The negative aspects of competition are something the students will have to manage personally all their lives. The sooner that they learn to focus on their own professional goals and improvement, even while the world around them continues to give “grades”, the better.
Most students at my school did as I did: Decided getting into medical school was enough grade chasing for a lifetime and basically ignored our class standing. With only about 10% being an exception, we cooperated very well without “gunners”. Only about 2 of the eventual AOA members were hypercompetitive grade chasers. The others were just sort of pleasantly surprised that it turned out that way.
The grades should be given, and the student must decide what to do with them based on their values and goals. If they want to torture themselves over it, it is the role of their mentors to guide them in shaping a more livable set of values and use grades appropriately. That is a better preparation for managing the stress of the rest of professional life.
My school gave “Numerical” grades with 70% required to pass… They calculated Class Rank down to the 3rd decimal place, just like a Batting Average.
Erik my man…I FAILED “Spleen”
Frank
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