Disadvantages to Pass/fail system

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I have not started med school yet, but I will be going into a completely pass/fail course system (not high pass honors or whatever).

I thought this makes it easIER on the students, but my friend saids he is still struggling. I dont know if he is struggling to score a high test score (although it doesnt matter) or if he is struggling to pass. Or maybe hes just tripping balls. And also, how do they differentiate the students when they pick students for residency? Im guessing that if the classes were graded, then they have more data to rank the students, but for a completely pass/fail system, how do they say who is better and what not? Is it mainly the board scores? Or do the 3rd year grades have a lot of weight? Or is it the extracurricular stuff? Research?

Hypothetically, can someone just enjoy their life in medical school and still get into a competitive residency? (study as much as they need to to do fairly well while enjoying the perks of being a student)? My friends are being a bit too negative about med schools and I wanted to hear some of your opinions. Is it also easier to get a residency spot in your school affiliated hospital or is it tougher?

Originally Posted by Sekiray

I have not started med school yet, but I will be going into a completely pass/fail course system (not high pass honors or whatever).

I thought this makes it easIER on the students, but my friend saids he is still struggling. I dont know if he is struggling to score a high test score (although it doesnt matter) or if he is struggling to pass. Or maybe hes just tripping balls. And also, how do they differentiate the students when they pick students for residency? Im guessing that if the classes were graded, then they have more data to rank the students, but for a completely pass/fail system, how do they say who is better and what not? Is it mainly the board scores? Or do the 3rd year grades have a lot of weight? Or is it the extracurricular stuff? Research?

Hypothetically, can someone just enjoy their life in medical school and still get into a competitive residency? (study as much as they need to to do fairly well while enjoying the perks of being a student)? My friends are being a bit too negative about med schools and I wanted to hear some of your opinions. Is it also easier to get a residency spot in your school affiliated hospital or is it tougher?

There are no disadvantages. P/F is awesome. Yes you can enjoy life and get in to a competative residency.

Originally Posted by soeagerun2or

There are no disadvantages. P/F is awesome. Yes you can enjoy life and get in to a competative residency.

If you work hard, you will be rewarded at any school you go to. Grades don't matter. The boards will judge us all in the long run.

Patience, young one. Just do your best and don't stress over the details.

I'm fairly sure this has been dissected fully in previous threads because I remember being in the same situation as you before I started at my school. A thread search will probably help you, but I'll tell you how it works where I am.

We're completely P/F for the first two years and then we go into a (newly renovated) system of Honors, high pass, etc. for our clinical rotations. We don't have a class ranking system so it's our third year performance which counts the most for things such as AOA. I've been told that the first 2 years are taken into consideration but we actually have classes where they literally do not give us a grade for exams, just a bunch of x marks and we're supposed to do the math ourselves and see a professor if we have too many. However, all this is moot because we don't find out who made AOA until after The Match, so it's really for our personal edification. With all that background, this is how I've come to feel about the P/F system:

-It really does promote cooperation. People at my school frequently share study guides and links to helpful websites

-You have to be a self-motivator if you want to REALLY learn the information. It's easy to fall into the trap of doing the minimum work necessary to pass a class. This, however, could backfire on you when Step 1 roles around

-I find our school to be very relaxed as far as medical schools go. We even had a professor who e-mailed the class reminding us to embrace P/F when she thought we were freaking out too much about an anatomy exam

-I've had plenty of spare time to pursue outside interests so far this year. Granted I'm only an MS1, but I've been able to mostly maintain my old hobbies, a spare-time job, and do some leisure-reading without having to worry about how it might affect my GPA like I had to in undergrad.

All that said, students at my school consistently score above the mean on their boards and match into competitive residencies. Ok, this is far too long and I have a physio book begging to be highlighted.

Hope this helped.

Originally Posted by Tony326

I'm fairly sure this has been dissected fully in previous threads because I remember being in the same situation as you before I started at my school. A thread search will probably help you, but I'll tell you how it works where I am.

We're completely P/F for the first two years and then we go into a (newly renovated) system of Honors, high pass, etc. for our clinical rotations. We don't have a class ranking system so it's our third year performance which counts the most for things such as AOA. I've been told that the first 2 years are taken into consideration but we actually have classes where they literally do not give us a grade for exams, just a bunch of x marks and we're supposed to do the math ourselves and see a professor if we have too many. However, all this is moot because we don't find out who made AOA until after The Match, so it's really for our personal edification. With all that background, this is how I've come to feel about the P/F system:

-It really does promote cooperation. People at my school frequently share study guides and links to helpful websites

-You have to be a self-motivator if you want to REALLY learn the information. It's easy to fall into the trap of doing the minimum work necessary to pass a class. This, however, could backfire on you when Step 1 roles around

-I find our school to be very relaxed as far as medical schools go. We even had a professor who e-mailed the class reminding us to embrace P/F when she thought we were freaking out too much about an anatomy exam

-I've had plenty of spare time to pursue outside interests so far this year. Granted I'm only an MS1, but I've been able to mostly maintain my old hobbies, a spare-time job, and do some leisure-reading without having to worry about how it might affect my GPA like I had to in undergrad.

All that said, students at my school consistently score above the mean on their boards and match into competitive residencies. Ok, this is far too long and I have a physio book begging to be highlighted.

Hope this helped.

I really appreciate your long response. Thanks for clarifying and making things seem better than what my neurotic friends are saying. That part about pursuing outside interests really helped me feel better about my choice of going to a P/F school. Thanks alot once again.

At my school, we are officially "Pass/Fail", however, we are still ranked. How, you ask? Because they still keep track of all our raw scores! While on our transcript it will only say P or F, there is a "second sheet" (yes, this is what the administration actually calls it) that lists our class rank based on raw scores in individual classes. What does this mean for us? Well, we will still be judged by relative performance when applying for residency, that information will still be provided to them automatically, we just have no way of knowing ourselves how we're doing relative to the class. Decrease stress? YEAH RIGHT!

The fact remains that nobody else has any say over your board scores than you.

If you are the type of person who wants to be stressed about how other people are doing, I'm sure that there are many schools that can accommodate. My vote, however, is for P/F.

I go to a true P/F school (no rankings at all) and I have to say that I agree with everything that Tony said. I love my school and the biggest part of that it the P/F system. It just makes for a much chiller environment - I am always amazed when I talk to my friends in schools with rankings how much more stressed and neurotic they have become. As for motivation - I really don't think that the majority of the people in my class study less just because its pass fail. First of all - it is very difficult to be certain that you will pass, even if you studied your a@@ off so you still try to do your best and not rest on the laurels of your past performance. In fact, ever since our school has adopted the P/F curriculum five years ago, the exam scores AND the average board scores have been going up consistently every year - people are actually doing better on exams than they were when the grades mattered. Maybe the decreased stress actually helps. The point is, I don't think P/F means you'll learn less or be less motivated - it just means that when you're having a tough time once in a while you don't have to give yourself an ulcer thinking about how you're not going to get that honors after all. I don't think you'll regret doing the p/f program, but the couple of negatives that are associated with it are worth mentioning; namely that board scored do tend to matter a bit more for us since it's the only way of evaluating our preclinical performance (but hey, you're going to try to do the best you can on boards anyways) and also this system might bother some people who tend to get extremely high grades and want recognition for it (the gleaned knowledge alone is just not enought for some). If you can live with those downsides then I think you're making a great decision. Good luck!

Pass/fail is the bomb. Made the first 2 years of med school stress free, went out thurs-sat to clubs in LA. 3rd a different story, it's going to be hard regardless of the grading system, because subject evals come into play. But yeah i matched in what some consider a competitive residency and I went to a p/f school.

Originally Posted by soeagerun2or

There are no disadvantages. P/F is awesome. Yes you can enjoy life and get in to a competative residency.

According to Iserson, all things being equal, a student from a P/F school will have a slightly lower shot at getting the most competitive residency spots.
That being said, I personally believe that P/F is leaps and bounds better than a graded system, and the aforementioned disadvantage can easily be overcome with a little self motivation (good boards, good clerkship grades).

Originally Posted by Biscuit799

According to Iserson, all things being equal, a student from a P/F school will have a slightly lower shot at getting the most competitive residency spots.
That being said, I personally believe that P/F is leaps and bounds better than a graded system, and the aforementioned disadvantage can easily be overcome with a little self motivation (good boards, good clerkship grades).

The book can say what it wants but generally the top schools are pass fail: http://www.amsa.org/meded/grading_system.doc Meaning all other things being equal (research, pubs, USMLE Step I/II), the person coming from a school with traditional grading is from a lesser named school and thus stands a lower shot. Just saying

I'm at an H/P/F school where honors are limited to a set percentage of students. This creates a great deal of unnecessary stress. I salute those who had the good sense to go to a straight P/F school -- it sounds awesome.

And I'm sure if you're motivated you'll be just as competitive coming out of a straight P/F school. And probably happier, too.

Originally Posted by Long Dong

Pass/fail is the bomb. Made the first 2 years of med school stress free, went out thurs-sat to clubs in LA. 3rd a different story, it's going to be hard regardless of the grading system, because subject evals come into play. But yeah i matched in what some consider a competitive residency and I went to a p/f school.

I would definitely consider it competative (and at a good program). Congrats.

There is an easy answer for Iserson: Make all schools p/f!

Man, enjoy your completely P/F system-- I go to a H/P/F system and I wish that it was completely P/F, because when you end up 1 stinking point away from honors, it sucks. Have fun with it, because it gives you the freedom to really enjoy the material, to really learn the concepts, and to really learn the material that is boards-related without having to kill yourself memorizing all that stupid PhD irrelevant minutiae. If there are disadvantages, they are trumped by by the advantages. Take this gift, my son, and run with it. Count your blessings, young cricket.

Pass/Fail grading systems usually mean that your actual scores (raw or scaled) are not on your transcripts. There is a set passing level and you (by score) are above or below it. In terms of ranking, third-year evaluations are usually scored by some scale and USMLE Steps I & II figure into the mix. Your MSPE (what goes with your residency application) is likely to mention all of the above.

The P/F-type of grading is generally used to help foster a more cooperative learning environment as medicine is a very cooperative and team-oriented profession. No medical school wants to see anyone in their class fail and having the stronger students help the weaker students is very good. In many cases, the uber-competitive pre-med folks carried their competitivess into medical school with detrimental results (for both the gunner and the gunees) for the learning environment. The P/F system makes gunning pretty useless.

In any case, your best bet is to attempt to thoroughly master everything as best you can. After attending a medical school that was very laid back and cooperative, I can tell you that everyone benefitted from the cooperative environment. Having a strong third year will greatly increase your competiveness for residency and you don't have to run over your fellow classmates to have a strong third year.

If having "hard numbers" is totally necessary to spur you on to greatness, then avoid the P/F schools as you might not like the environment there. In general, the P/F schools have the minimum "pass" set high enough that having a string of "Ps" on your transcript is a very nice asset and shows that you have a strong knowledge base. You are likely not at a disadvantage when placed alongside a person with a transcript that has numbers. P does indeed equal MD.

Each has pros and cons. You will always find exceptions to the rule.

When you go to a school make sure you know everything about the grading system. Some schools will tell you how great the pass fail system is and then when you get there you realize that you are being ranked in some form. My school is A/B/C/fail and there is absolutely NO competition between classmates. Our class instructors will give everyone an A if they can score an A. If that were the case, then they would just rank from there when writing the deans letter (so if all the kids got an A, you would still have some who scored 90-93, 93-96 and >96).

I would not choose a school based solely on a pass fail system because in the end you still have to know ALL the material. You will still be taking the boards and have to do well since many programs will weigh this very heavily. You will still need to shine in your third and fourth year rotations and apply the knowledge you gained during first and second year. And, you will still need to know it when you start residency. So, all in all, you might gain a little less stress during those first two years.

Our school has an odd grading system -- it's A, AB, B, BC, etc. An AB is like an A-/B+. I must say, it's very discouraging to have studied the material and learned a lot, then end up with "only" an AB. While most people get A's, AB's and B's, it's not always easy to get that A. In one of our classes, an A is 96% and up -- that's only 8 questions wrong out of 200 between midterm and final.

We had a vote last year about switching to a true pass/fail system, and the majority voted to stay with the current system. In my opinion, the exams in medical school should be competency based. There should be certain questions that everyone who's going to be a doctor should be able to answer correctly -- everything else is just extra stuff you probably won't remember in a year or two anyway. Some of our professors put tricky questions on the exams just to differentiate an A from an AB from a B, etc. To me, that's just silly. I feel like at this point we shouldn't need grades to motivate us to learn. In a short time we're going to be on our own with no one looking over our shoulder to make sure we keep up with clinical and research literature.

I don't feel that the grading system creates competition, per se, but I think it does hurt morale a bit. I think I would definitely feel a lot better with a pass/fail system.

I have a P/F, no ranking no AOA system and I love it. Like others have said, it fosters cooperation over competition and board scores are some of the best in the nation (went up after they changed to P/F.) At this point in our careers, we should be motivated to learn without grades and class rankings to reassure us because that's what it's like in the real world. Of course, you will always be evaluated whether your an MS1 or an attending of 20 years, but the point of those evaluations are to strive for improvement, not to prove to someone else your the best.

However, if you are driven by competition or at least tangible numbers, you might be happier at a graded or tiered school.

As far as life in a P/F system - I think it's great! It depends on your curriculum as well, but I have a lot of spare time to get involved with extracurriculars, explore different fields of medicine & get patient clinical experience, and spend time with my family. several of my classmates are involved in research projects or have PT jobs as well. Flexibility is really high...we know what we are responsible for. One of my friends goes to a P/F school but they have honors (hidden, they don't tell you that) and it totally stresses her out.

The school that I'm considering-Stanford-is P/F all four years (no clerkship grades- though I think that there is a narrative eval at the end). Anyway, are there advantages/disadvantages to this approach?

Just want to put it out there that not all non P/F schools are uber competitive within a class. I was really really afraid of being in a school with the kill or be killed premed mentality that I had come to loathe, and while P/F definitely encourages less competition, some schools are chill even with the weird F/P/HP/H thing that basically equates to grades . . . except slightly more annoying because you have to keep track of what each course defines these grades as (but thats a whole n'other rant). Anywho, point being, that my school is sooo not competitive, we all share study guides and website links and tutor eachother on a volunteer basis, because we're just chill people. I think that this is what makes a medschool a good environment, and you can generally sense it from your interviewers and their demenor. . . interviews at my school were so relaxed and fun, I could just tell that they were looking for the type of chill people I would want to spend the next 4 years with.

I would say it depends on your personality. If you tend to slack without some sort of motivation (me) then H/P/F is honestly better than P/F. If it wasn't for my desire to stack up some Hs, I would not be learning this crap well enough to rock Step 1 (which is ultimately what all this is for). If you are the type that tends to massively overstudy and overstress about everything school related (and this is like 80% of my class) then you will be better off at P/F.

P/F is far superior to H/P/F.

To get honors, you have to spend an inordinate amount of time memorizing mundane details that will be ejected the second you hand in a test. If you have P/F, you have the opportunity to focus on concepts in detail and you will remember the minutae that you need to pass if you put in an honest effort.

Focus on long-term learning as much as possible. I honored physiology this last quarter and I would have learned much more if i wasn't forced to memorize a lot of ****.

Originally Posted by psipsina

.... F/P/HP/H thing that basically equates to grades . . .

Exactly.

Unless you go to a school with a truly P/F system, it's the same as having grades. My school is H/P/F, and they keep records of the percentage grade you got in each class for rankings and all that good stuff. It's the same BS in the end, the same as A/BC/DF or whatever They can call it whatever they want. It seems to me like the medical schools are running a psychology experiment on a massive scale...and we are the rats of course.

Originally Posted by mudphudwannabe

Our school has an odd grading system -- it's A, AB, B, BC, etc. An AB is like an A-/B+. I must say, it's very discouraging to have studied the material and learned a lot, then end up with "only" an AB. While most people get A's, AB's and B's, it's not always easy to get that A. In one of our classes, an A is 96% and up -- that's only 8 questions wrong out of 200 between midterm and final.

We had a vote last year about switching to a true pass/fail system, and the majority voted to stay with the current system. In my opinion, the exams in medical school should be competency based. There should be certain questions that everyone who's going to be a doctor should be able to answer correctly -- everything else is just extra stuff you probably won't remember in a year or two anyway. Some of our professors put tricky questions on the exams just to differentiate an A from an AB from a B, etc. To me, that's just silly. I feel like at this point we shouldn't need grades to motivate us to learn. In a short time we're going to be on our own with no one looking over our shoulder to make sure we keep up with clinical and research literature.

I don't feel that the grading system creates competition, per se, but I think it does hurt morale a bit. I think I would definitely feel a lot better with a pass/fail system.

Hey Mudphudwannbe-

I go to your school as well. I can't believe that they voted againist pass/fail I think that the current system creates stress, that I feel is totally unnecessary. The point of testing us should be to determine if we have a basic level of competency that every future doctor should have. Why is there this need to separate us into A, AB, B, BC, C level of medical student? Does that mean that we will become A, AB, B level of doctor based on these stupid grades? I completely agree with you that tests are designed with a couple of zinger questions to differentiate who gets what grade. Often times the difference between getting an A on a test and getting a B on a test is a matter of about a three question difference.

maybe the class really did vote for pass/fail and the administration is lying about the results

Originally Posted by Tony326

this is how I've come to feel about the P/F system:

-It really does promote cooperation. People at my school frequently share study guides and links to helpful websites

FWIW, just a quick response to Tony's thoughts:
My school has a six/seven grade system (A, AB, B, etc.) and is nevertheless super cooperative. Most courses are criteria-graded--that is, if you get the 96%, you get the A--rather than curved, so there's no reason not to help one another, and plenty of benefit to be had from pooling resources. We have an online forum where we share study guides, course objectives, notes, charts of drugs, you name it. I'm a little surprised, in fact, at how helpful everyone is.

Originally Posted by pike1

Hey Mudphudwannbe-

I go to your school as well. I can't believe that they voted againist pass/fail I think that the current system creates stress, that I feel is totally unnecessary. The point of testing us should be to determine if we have a basic level of competency that every future doctor should have. Why is there this need to separate us into A, AB, B, BC, C level of medical student? Does that mean that we will become A, AB, B level of doctor based on these stupid grades? I completely agree with you that tests are designed with a couple of zinger questions to differentiate who gets what grade. Often times the difference between getting an A on a test and getting a B on a test is a matter of about a three question difference.

OK, so this is becoming a cow-fest. I just responded to an earlier poster about cooperation at our school. Pike1, my impression is that your class has shared much much less than the current M2s and M3s, and I'm curious as to why. I voted for the current system, because no matter how we think medical education works, there is competition for many desirable specialties and residency, and those programs need to be able to differentiate between their 20 or 30 candidates for one position. They do this partly with board scores and class rank. I would rather have my class rank determined by my GPA than a hidden mysterious system of added up test scores. And I study harder, and learn more, if I'm trying to crack into A territory.

Originally Posted by mudphudwannabe

I don't feel that the grading system creates competition, per se, but I think it does hurt morale a bit. I think I would definitely feel a lot better with a pass/fail system.

Agreed on that one. And our academic resource staff, while really helpful, are sometimes less than 100% encouraging.

our first quarter class is P/F while most subsequent ones are H/P/F. For informational purposes we conducted a casual (admittedly not well-controlled) poll asking if it would be preferred to make the first quarter H/P/F from P/F. Over 90% voted to keep in P/F. It's amazing to me that so many people would favor H/P/F when such a small fraction realstically have anyting to gain from it.