End medical school grades

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There should be no grades in medical school. Forty-something percent of applicants get accepted to one or more medical schools. To even apply to medical school, one needs to have not only graduated or be on track to graduate college, but also needs to have passed the MCAT and have the support of a pre-medical application committee. I am no mathematician, but I do not think that it is a stretch to say that less than 10 percent of those who wanted to go to medical school on their first day of college do, in fact, end up matriculating into medical school.

From Day 1 of medical school, students must be made to feel that their classmates and professors are on their side. For the cynical folks who doubt they’d be able to approach medical school as anything other than a zero-sum game, a Hunger Games-esque fight for the top residency program, these people should either not be admitted in the first place, or at least should get help. Grades feed competition which feeds students’ lack of self-worth, which threatens future doctors’ compassion for patients, and so on.

Most importantly, the patients get hurt. I do not consider myself a competitive person by medical school standards, but when I was a third-year student completing core clerkships, I found myself approaching each of my patients as a determinant in “how I would do” (i.e., what grade I would receive) in a given clerkship. Imagine you are a patient, and your medical student front-line provider is sticking you with a butterfly needle three, maybe four times in desperate search for a flash because they want their resident to know how “competent” they are. This example may only cause a minor inconvenience to the patient, but imagine this medical student graduating AOA, going to their first choice surgical residency, and carrying the same mindset into the OR. Patient safety always must come first, and an environment where asking for help must be encouraged, not viewed as a sign of incompetence or weakness. Because the current environment we are currently in fosters nervousness, which leads to medical errors.

Over the last year, we have experienced the deadliest pandemic in recent memory, a president who refused to admit wrongdoing, and a violent event in the Capitol. When I was texted about the loss of a family member, I was on rounds with my medicine team. Afraid to show weakness, I stayed the entire day, only mentioning that I was not okay when it was time to sign out to the night team. I was overly concerned with how I would be perceived if I left in the middle of rounds. Medical school hardened me significantly, in some ways good, but if 2020 has taught us anything, it is that we must remember that we and our patients are all just imperfect people doing our best. We must end the endless competition in what should be a collaborative field, and that starts with doing away with grades in medical school.

Adam Lieber is a medical student.

Image credit: Shutterstock.com

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