Medical students need to fail more often. Here’s why.

We need to fail more tests in medical school. I’m serious.

In first year, our class had two of the most memorable weeks of our schooling: A crash course on biochemistry taught by a professor who is widely accepted as one of the best teachers in our medical school. His in-class lecture style kept students engaged and entertained; I, and many of my classmates, learned tremendous amounts of his material and still retain it today.

However, most of our class failed his test. Many of us didn’t even come close to a 70 percent. But why? Why do I still remember so much about his material, and yet I failed his test, when I remember almost nothing about other tests which I passed with flying colors?

Simply speaking, because his questions were not designed to pad our grade. They were each designed to make us think. And that’s what the first two years of medical school need to focus on.

In our second year, even in the systems-based courses, the administration is so concerned with passing grades and class rank that they overlook how much knowledge is actually retained. Metrics of competitiveness mean that our tests have only a scant handful of challenging questions designed to “set us apart” atop a sludge of rote memorization questions to ensure most students will pass. Class rank, therefore, is an assessment of how quickly you memorized the material for the exam, and actually promotes cramming and lower-quality learning strategies (i.e., the so-called “brain dump”).

But here’s my point. The only metric, the only result, of the first two years that really matters is how well we medical students know medicine for Step 1, third year, and beyond. Whether or not someone memorized more material in a week than someone else is relatively inconsequential compared to how well that person will remember that material when it matters. Our system of medical education promotes short-term retention; I have friends in my class who focus on long-term retention when studying and actually do worse than those who cram!

The focus of medical school should be on long-term knowledge, but it seems that the real focus is on competitiveness. Forget the grades. Forget the ranks for the first two years. Give us the most challenging questions you can, and let our failures teach us valuable lessons. I am absolutely certain this approach would make us into better third-year students (and doctors!) in the long run.

Tyler Scaff is a medical student.

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