SDN Members don't see this ad. (About Ads) 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?