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Is there really a difficulty difference between med schools?

Discussion in 'Pre-Medical Allopathic [ MD ]' started by Thego2guy, Mar 21, 2012.

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  1. SpecterGT260

    SpecterGT260 Catdoucheus

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    I would say look at board scores for schools... A school's difficulty and caliber of students cannot be necessarily separated using this metric, but both of these things will contribute to average step1 scores.
  2. willen101383

    willen101383 Junior Member

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    Grade inflation at ivies is rampant and well known. Hell, even at larger private colleges it is rampant. I went to a small no name undergrad school and a 73 was a C...an 83 is a B....a 93 was an A and so on. No curves EVER. In graduate school (large private institution) for some exams high 70s were As...with a mid B almost always an A.

    Ive heard this echoed across the board from students ive met in medical school.
  3. willen101383

    willen101383 Junior Member

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    I just cant see how one medical school will be "more difficult" than another...unless they cram 2 preclinical years into 1.5/1 year.

    Maybe one medical school will be more of a pain in the ass than another...in terms of dumb side bullshit they make you do. Such as waste of time activities like diversity workshops/patient perspectives, ethics mini courses, etc.
  4. SpecterGT260

    SpecterGT260 Catdoucheus

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    why couldn't one be harder than another? there is a measure of difficulty in terms of volume and complexity at each school, and there is no rule saying that every school has the same volume and complexity to their curriculum. a theoretical school that has a low board pass rate either has the same curriculum as a high passing school with a lower quality student, or the same quality student with a curriculum that did not prepare them appropriately (i.e. easier)... and various mixtures of those two scenarios.... this is why I said you cannot separate the variables - IMO they can be thought of as two slider scales and moving each back and forth has an effect on the outcome (score) but it is impossible to tell simply given a score which is the predominant variable).

    y=mx+nz where x and z are ability and difficulty. Given a point "y", you cannot solve for either variable but we know they still play a role.

    to be less abstract - a school could present the same information and only test on 1st order concepts. Here is a thing. is it a)bicep b)tricep c)head d)florida. or here is a bicep, is it innervated by a)median n. b)musculocutaneous c)radial d)florida.

    A more difficult school would test on 3rd order concepts.
    A patient comes into the clinic with a stab wound to the anterior aspect of the brachium and has difficulty flexing the elbow. you are concerned that this difficulty is not simply secondary to injured muscle tissue and that underlying structures may be damaged. Which will most appropriately test your suspicion?
    a)check the ability of the patient to adduct and abduct his fingers
    b)check for sensation on anterior (ventral) base of the thumb
    c)ask the patient to adduct his thumb.
    d)florida

    There is no information in the 2nd question that was not covered in the 1st question, but the application, level of integration, and difficulty are quite different.
    Many of the things we get in medical school we have heard before in undergrad courses (often to a lower depth) but the integration is off the scales. There is no rule dictating sole use of or specific quantity of 3rd order questions by school. Therefore it is possible for one school to go easier on the students even with the same information. That said, it is also possible for one school to give more information than another.

    I cannot point any schools out, i am just saying there are plenty of ways for schools to be different, and we cannot assume they do all the same things in all the same ways or that their differences do not impact difficulty level.
  5. anbuitachi

    anbuitachi

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    Ivy i went to is based on the same system for majority of classes. Only the really tough ones gets curved. I mean our Orgo avgs were in the 40s cause the exams were insane and I'm 100% sure if you give the same test to a state school, the avg will be much lower than the 40s that we get. But anyway, it has to be curved b/c you can't have 80% of the class get Fs

    And curve here doesn't mean curve up. It only means curved to the Bell curve. If you had a 95 avg but everyone else had 100s, your gonna get the F. too bad this never happens lol
  6. ppfizenm

    ppfizenm

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    with the admitted nepotism and breeding that goes on in those places I am sure that is not entirely accurate.
  7. SpecterGT260

    SpecterGT260 Catdoucheus

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    there isnt anything wrong with curving grades.... they don't always inflate.... a bell curve can make a 60 an A just as easily as it can make a 95 a D
  8. willen101383

    willen101383 Junior Member

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    Yeah this is true. You clearly thought way more into this than me. Granted I only have attended one med school (as have you I am sure) so who knows how topics are tested at other med schools. We rarely saw exam questions that were cut and dry as in "what muscle is innervated by the long thoracic nerve." They were all things like "a patient took an overdose of a common OTC pharmaceutical. After 12 hours of intense n/v they present to the emergency room tachycardic with icteric sclarae. Results of a CMP reveal an elevated AST of 658 and ALT of 1250. An an appropriate intervention would be: A. activated charcoal B. bicarb C. IV glutathione D. florida. They would then usually have another question (or more) based on the correct identification of the drug in question.

    I assumed all med schools asked questions like this. I see your point....I am just not sure that question asking varies that much from school to school (or maybe it does..i have no experience with more than my school as i said.) I still feel as if most traditional 2 year preclinical schools are going to be pretty similar in terms of difficulty. Who knows.
  9. ppfizenm

    ppfizenm

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    And I am sure no school has ever employed the practice to: boost university stats, impress future employers, placate angry alumni parents, ect.
  10. ppfizenm

    ppfizenm

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    The answer is obviously Florida.
  11. Narmerguy

    Narmerguy Member Moderator

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    Why do people get so worked up about this stuff when we'll never have sufficient, objective information to answer it? Just pick a school you enjoy and do your best. If you try hard your school is not going to hold you back.
  12. willen101383

    willen101383 Junior Member

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    :hungover:
  13. SpecterGT260

    SpecterGT260 Catdoucheus

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    ya.. I am not sure either and I cannot claim one way or the other. the only point was that we also cannot assume the other way that they are all the same. not knowing is not knowing.

    side note - one of my biggest pet peeves is the "well we don't know that it doesnt work" argument for things like alternative treatments... lol. assuming schools are the same because we don't know they are different is essentially the same. It just bugs me to draw a conclusion based on an assumption, ya know? leave it open. if we dont know dont publish on it until we do :thumbup: (not coming after u on that one, just a side example of where Im coming from)
  14. SpecterGT260

    SpecterGT260 Catdoucheus

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    I think people often think we are getting worked up or bent out of shape in these discussions. I personally just think it is interesting and fun to apply stats in a real world situation.
  15. Narmerguy

    Narmerguy Member Moderator

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    Fair enough, I'm a happy lover of stats myself. However, a lot of people do get worked up and bent out of shape over this stuff.
  16. SpecterGT260

    SpecterGT260 Catdoucheus

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    I don't disagree with you. I just think it is silly. IMO getting bent out of shape over a statement in a way validates the statement.
  17. ppfizenm

    ppfizenm

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    Getting other people angry isn't a valid way to make your point unless you are the Westboro Baptist Church and we all know how true their opinions are.
  18. SpecterGT260

    SpecterGT260 Catdoucheus

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    the only person who controls who gets angry is the person getting angry....

    it is also a fallacy to assume that because westboro baptists are angering and their points are invalid that all angering tactics can only support invalid points.
  19. ppfizenm

    ppfizenm

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    That particular fallacy works both ways in this case.
  20. SpecterGT260

    SpecterGT260 Catdoucheus

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    I don't follow.... saying something is a fallacy states there is no correlation.... so it works in every way. I don't know what you mean by "both ways"
  21. ppfizenm

    ppfizenm

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    It's just as wrong to assume you are right when others are mad.
  22. SpecterGT260

    SpecterGT260 Catdoucheus

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    oh I see.

    what I meant in the previous post was that I don't see a reason to get mad at a false statement which describes you. If it pangs a little, the likely reason is because it struck too close to home or struck a nerve on a pre-existing sensitivity. I didn't say it makes the statement true, i just said IMO it lends it some validity.

    I will usually tell someone this when they are getting all butthurt at me rather than addressing the topics logically. "calm down and tell me why I am wrong or I will just have to assume that the previous statement was too true for comfort"
  23. ppfizenm

    ppfizenm

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    is butthurt an industry term b/c I've only really ever seen it on here?

    And I see your point. In the eyes of people who don't know better the one getting angry looks less credible.
  24. SpecterGT260

    SpecterGT260 Catdoucheus

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    so basically.... I wasn't saying that you can prove your point by making people angry with it.

    I was saying that someone getting upset over an otherwise benign comment indicates some uncomfortable truth to the comment.
  25. SpecterGT260

    SpecterGT260 Catdoucheus

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    it is common on all of the car/motorcycle/ and reptile forums I have been on in the past. pre-meds seem to be the only ones that are not familiar with it....but dont worry, im bringin sexy back :cool:
  26. johnnydrama

    johnnydrama I'm no Superman

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    Awful advice. By this criterion you might as well go to First Aid U.

    Look at match lists.
  27. SpecterGT260

    SpecterGT260 Catdoucheus

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    By your logic there is zero correlation between board scores and matches. I offered it as a quick and dirty method and did not claim it ti be the best. U should read for context before you so strongly condemn advice. And since I am not aware of "firstAidU"s match lists I challenge you to find a school w stellar board scores and crappy matches.

    In addition, matching is a partially subjective process. The most competitive applicant could rank a crappy program highly for personal reasons so.... awful advice. Look at board scores :rolleyes:
  28. johnnydrama

    johnnydrama I'm no Superman

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    Did I say zero correlation?

    Most of the Caribbean schools boast good board scores (they fail out the students who can't cut it and often train directly to the test).

    A 220 from Columbia trumps a 260 from SGU. I did very well on the boards, but the handful of international applicants I met I talked to did better. I'm sure I was still ranked higher by programs.

    Yes, board scores are predictive WITHIN a school, but are almost pointless between schools and are a bad way to compare medical schools. Most of the studying for the boards is done on your own at reputable programs (some weaker ones are glorified test prep). I would expect the MCAT to be more relevant (more of an aptitude test than the boards, which are mainly rote memorization and roughly proportional to time spent studying).

    In the end, aside from research opportunities and intellectual curiosity, to some extent the only point of medical school is to get you into a good residency. Match lists are available if you look for them, so why use proxies? Use the real thing.
  29. Chrome19

    Chrome19

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    Many pre-meds take prep courses for the MCAT and prep courses do help. Does this make their MCAT scores less meaningful?

    Residency programs are biased towards US students purely for sociopolitical reasons. US residency spots are limited, and it's politically correct to give preference to US grads. There are brilliant students from foreign medical schools, and your post suggests as much.

  30. SpecterGT260

    SpecterGT260 Catdoucheus

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    i'm not debating whether one is better than the other. Just pointing out that you need to slow your role a little bit when my original post made it clear that the advice was meant to serve as a quick and easy way. I can gather average board scores and compare in a very small % of the time it takes me to look at match lists, look at every matched program, figure out how good the program is for every specialty...ect...

    another thing match lists do not do, is account for things like primary care incentives or PCP pushes, and self selection. Most schools use USMLE as an internal standard, just because some schools train specifically for the test does not break the rule (or IMO does not break it any more than self selection and incentives can skew a match list). SO better advice would be to keep these exceptions in mind while moving forward, but if I accept that an individual's board scores are a reflection of that person's ability and the effectiveness of the training that person received, I can then also accept that the board scores of 20,000 people are also indicative of the same things. I can then reasonably group them by institution. I said earlier, that it is impossible to separate calibur of student and quality of education using these numbers, but I still think it stands as an acceptable estimation tool without having to go through all the leg work of translating match lists.

    now, if every school published the rank of the matched programs with this data that would be something different. But the match lists I have seen simply say "John Doe, Indiana, Internal medicine"

    Since I am not interested in IM, i have no idea if this is a good program or a crappy one. See the issue here?
  31. SpecterGT260

    SpecterGT260 Catdoucheus

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    If we assume this happens, it has no bearing on the appropriateness of putting grades on a bell curve.
    Inflating grades is a different sort of curve. Bell curves are nice because it takes the "d-bag teacher" component out of things. If we assume that every class is representative of national abilities then we assume that there are some people who will stand out and some that will fail out. But a d-bag teacher can flunk even the brightest student if the scores are not internally normalized. Grade inflation is a top-curve, where we compare everybody against an arbitrary mark. there is nothing arbitrary about a bell curve.
  32. johnnydrama

    johnnydrama I'm no Superman

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    In a word, yes.

    Teaching directly to a test always makes it less valid. There is far more content in the USMLE than the MCAT, which is primarily reading comprehension with a little bit of science (most questions, even on science questions, can be answered from the passages with little outside knowledge).


    Didn't want to get into this debate and derail the thread.

    Was mainly giving Caribbean schools as an example where high USMLE scores do not always translate into good residency matches. What you said may be true of some real international schools, but it's irrelevant to this topic.

    The Caribbean schools for US citizens, even the best ones, are all scams to some extent - over-promising and under-delivering, all while over-charging. Especially now that US MD spots are increasing, I would expect US citizens starting Caribbean programs now to be SOL when it comes to match day. Also, if seriously considering this option, ignore their statistics - they are heavily manipulated and exclude all the students kicked out after paying thousands of dollars for nothing.
  33. SpecterGT260

    SpecterGT260 Catdoucheus

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    What you aren't acknowledging is that poor residency matches does also NOT directly translate into a poor school, or poor applicant. Due to extenuating circumstances, the smartest man in the world could go to a caribbean school, get a high board score, and will STILL have difficulty matching. as he should! There is something to be said for accepting one's lot in life, and that road has more uphill sections than down as compared to US MD. Nobody is arguing that. And I am not arguing that carribean schools do not teach for the test and i am also not arguing that that is bad. They do, and it is.

    BUT, you are denying the possibility, even hypothetical, that a carib school could have a curriculum that is every bit as rigorous as a US MD school. For the sake of argument assume that only 1 school fits this description. Students from this school will still not match well only because the school is caribbean. Ergo the school's match list is not indicative of its effectiveness in training to the exact same degree that the board scores of its neighbor school is not indicative of its effectiveness. The point is a wash
  34. SpecterGT260

    SpecterGT260 Catdoucheus

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    Johnny, I would also like you to take your logic, as applied to carib schools (without making assumptions like teaching for the test, ect.... solely using match lists for comparison) and comment on the quality of education that one would get at Loyola Stritch vs CCOM :)

    (brace yourselves.... sh** storm coming)
  35. johnnydrama

    johnnydrama I'm no Superman

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    My point is you are unfamiliar with the USMLE if you think your medical school affects your score. I'd say it's more like standardized test ability * hours spent studying first aid + goljan. Your coursework in school will be surprisingly irrelevant, particularly at places that have renowned preclinical faculty (active areas of research aren't going to be on the test). I'd trust the MCAT more for student caliber and it's easier to find those scores (US news) than USMLE averages (I'm about to graduate and still don't know my school's average, not that I've really looked for it).

    If you already know what interests you, just look at match lists for those specialties. US news actually ranks IM residencies, so you can get info from IM matches as well. Look at numbers and placement in ROAD specialties and competitive surgical subspecialties (ENT, ortho, plastics). There is fluctuation in interest, but some of that is self-selection by applicants as well reflecting competitiveness. Also, match lists have a strong regional bias, so factor that in as well (and if you want a residency in CA, go there for medical school).

    And PCP incentives are a joke. Aside from a few noble souls, only people going into primary care are still those without options. For better or worse, good schools will have almost no one going into family medicine. The people doing primary care who would have otherwise had options mainly go to IM primary care tracks at top institutions.
  36. johnnydrama

    johnnydrama I'm no Superman

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    My point is training is irrelevant if you don't match.

    You should choose medical schools based upon how happy you will be there while you're there and where it will take you, weighted by your personal priorities.
  37. johnnydrama

    johnnydrama I'm no Superman

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    Don't know those programs. If osteopathic, still not sure if that is better than going international. I'd rather go to the Caribbean just because I find the idea of training in OMM offensive (I'd take voodoo more seriously), but I think DOs are slightly more competitive for residencies.

    The truth is that most of medicine is self-taught, and the school you attend is just a badge. Choose accordingly - it's one you'll be wearing a long time.
  38. SpecterGT260

    SpecterGT260 Catdoucheus

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    no that isnt a valid point. It may have real world application, but "you dont match" also is not solely dependent on the school you go to and this discussion is on ways to determine the quality of education had between schools. Either they are all identical or they are not. if they are not, estimations could be made to determine how
  39. SpecterGT260

    SpecterGT260 Catdoucheus

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    you arent really following me here.

    The point is, you stated earlier that match lists are a reasonable metric for determining the quality of the school.

    DO schools do not match as competitively as MD schools in the vast majority of cases

    Therefore, by your logic, DO schools do not provide the same level of education as MD schools.

    What i was trying to point out is that these programs and their ability to match applicants competitively is not directly related to the quality of the education. Simply being DO or carib MD or FMG will put you at a disadvantage an it is COMPLETELY independent of the quality of education that your school provides. Therefore, to answer the question posed by the OP, match lists are insufficient.


    I am not arguing that matching isnt important or that in the real world none of it matters if you do not match. that is obvious. But the OP's question was a little more theoretical than that.
  40. Chrome19

    Chrome19

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    Nice :thumbup:
  41. Chrome19

    Chrome19

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    lol
  42. Morsetlis

    Morsetlis SGU MS-3

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    He has valid points and invalid points and can't see the difference between them. That's all right.
  43. johnnydrama

    johnnydrama I'm no Superman

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    If your point is that these don't reflect the abstract measure that is quality of training, true. So what?

    You will be sufficiently trained at almost any LCME accredited school. The only factors that should affect your decision making are happiness during medical school and post-graduation opportunities. The first is subjective, the second is most directly measured by looking at match lists.

    For clinical training, any school with a busy non-private hospital will work.

    My main objection to a previous poster was thinking the USMLE tells you anything about a school - it doesn't. Talk to medical students who have taken it and ask how relevant it was to their coursework. Most just take 1-2 months studying on their own, no matter what school they attend.
  44. johnnydrama

    johnnydrama I'm no Superman

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    I don't think you were following me. I said USMLE scores are an incredibly bad indicator for the quality of a school. Match lists don't necessarily reflect quality of training, but where a medical school will get you which is frankly much more important.

    Your training in medical school will be irrelevant or outdated by the time you practice - real training is in residency.

    The only metric of school quality that counts in the end is the match. It combines student achievement with both deserved and undeserved school reputation. Ignoring it is just doing a disservice to yourself, but that's your choice.
  45. phltz

    phltz

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    Why does everyone assume that harder means better? Sure, one school might be harder because they expect you to know the material at a higher level and with less room for error. But a school can also be harder because it teaches poorly and provides few resources.

    Imagine there are two schools, A and B. At school A, at the end of orientation, the students are taken to the library and told "In this library are books that have all the information you need to know for your preclinical years. Learn it. Also, due to budget cutbacks, there are no lightbulbs in here. After you take Step 1, we'll start you on rotations. Until then, get to reading." At school B, dedicated and skilled teachers present everything in a coherent way, provide both details and a big-picture view of how everything fits together, what's important, and why. They work closely with students over the preclinical years, teaching, testing, and helping students to identify where they're doing well and where they need more work.

    School A in this example is undeniably harder, and undeniably much, much worse.
  46. SpecterGT260

    SpecterGT260 Catdoucheus

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    well then we are coming at it with two different understandings of what the OP meant by "better". I agree with you that a school which has a higher pedigree is a "better" school by that definition. But this doesn't reflect quality of training, and while the situation you bring up is correct: that quality of training doesn't mean dick if you don't match, the qualifier "if" there means that in every other situation the quality of your training does matter. depends what you want to look at i suppose
  47. johnnydrama

    johnnydrama I'm no Superman

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    You're reading too much into that "if". For better or worse, a better "pedigree" as you put it will help you in the match, both in the superficial impressions program directors will form of your application and the influence of your references.

    This isn't college where it might make sense to choose a school based upon a specific course you'd really like to take with a certain professor, the training is more or less uniform and frankly much of it will be irrelevant to your career.

    Ignore the effect of your school's name on your future residency prospects at your peril.

    If you thinks you can be the absolute top of your class no matter where you go, sure, choose however you like. If you're not, go to the biggest name.
  48. Donald Juan

    Donald Juan

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    As I was reading through I started thinking the exact same thing since everyone here seems to equate "quality" directly proportional with "difficulty." I've heard of engineering classes at difficult schools where the highest grade on the exams ends up being a 40% and the average is a 15%, and it always makes me wonder, "does that mean the class learned more?"

    Although, I'd agree that a class does need to be difficult, I just think there is a line where more difficult no longer equals more quality.
  49. SpecterGT260

    SpecterGT260 Catdoucheus

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    Id like to remind everyone the OP question was "difference in difficulty". We have since moved on to better/worse type discussions....
  50. SpecterGT260

    SpecterGT260 Catdoucheus

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    And while match lists may pertain to a "better or worse" discussion, as proven by johnny they don't speak to difficulty. As per the OP question im still going w board scores

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