Does the P/F System Make Med School Easier?

[Medschoolready95]

For current medical schools, I feel like I may have an inaccurate understanding of the P/F system and need some clarification. Based on my understanding, the P/F system makes medical school less stressful overall. Yes, there still is a lot of material that needs to be learned but when you don't have to worry about receiving a grade, you have the opportunity to do the bare minimum just to pass. How accurate is this?

P.s. the school I will be attending has no internal rank either

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[Palindr0me]

Completely accurate. Can attest from personal experience. It makes things so much easier to handle.


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[OneTwoThreeFour]

For current medical schools, I feel like I may have an inaccurate understanding of the P/F system and need some clarification. Based on my understanding, the P/F system makes medical school less stressful overall. Yes, there still is a lot of material that needs to be learned but when you don't have to worry about receiving a grade, you have the opportunity to do the bare minimum just to pass. How accurate is this?

P.s. the school I will be attending has no internal rank either

I'd also add that it removes any incentive the more...aggressively upward mobile classmates have to hoard info. Really a general feeling of everyone wanting to help everyone else succeed. At least in my experience.

 

[jurisburger]

Definitely. As a result of having true pass/fail (i.e. no internal rank), I honestly felt less stressed during preclinicals than I was as a premed. It's a wonder how much not having to care about getting a 89 vs. 90 can do for your quality of life.

 

[Medschoolready95]

This is very reassuring! Thank you for all the responses!!

 

[NickNaylor]

The downside of P/F curriculae which is rarely talked about is that it results in much greater emphasis being placed on step 1 scores and clinical clerkship performance. I'm involved in the selection committee for my residency, and at the end of the day we still need a way to differentiate among applicants. At our programs, step performance is relatively unimportant but, second only to interviews, clerkship performance is heavily emphasized. The content of letters - both LORs and the MSPE - also becomes more important.

I don't think this is something that should even come close to playing a role in your medical school decision, and, in general, I still strongly favor P/F curriculae, but there are downsides and consequences for making this shift. It isn't all roses and rainbows.

 

[lagbydesign]

The downside of P/F curriculae which is rarely talked about is that it results in much greater emphasis being placed on step 1 scores and clinical clerkship performance. I'm involved in the selection committee for my residency, and at the end of the day we still need a way to differentiate among applicants. At our programs, step performance is relatively unimportant but, second only to interviews, clerkship performance is heavily emphasized. The content of letters - both LORs and the MSPE - also becomes more important.

I don't think this is something that should even come close to playing a role in your medical school decision, and, in general, I still strongly favor P/F curriculae, but there are downsides and consequences for making this shift. It isn't all roses and rainbows.

But before p/f, did anyone even really specifically care about preclinical performance besides AOA nomination (depending on the school), not being in the bottom quartile, and at least passing all your classes? I've never heard of residencies actually caring about preclinical grades. They're usually quickly glanced over or ignored entirely. I can at least say this is true for the most competitive specialties (ortho, PRS, ENT, etc).

The reasoning is that preclinical grades aren't standardized, so there's no point in using it to evaluate applicants. The barrier of entry has become step over time, which has it's pluses and minuses. Step wasn't even meant to be used as a screening tool, as per the NBME.

But I understand your point about it being impossible to differentiate so many similar applicants. Personally, I am in favor of enacting a specialty specific exam, like @operaman has proposed.

 

[kb1900]

But before p/f, did anyone even really specifically care about preclinical performance besides AOA nomination (depending on the school), not being in the bottom quartile, and at least passing all your classes? I've never heard of residencies actually caring about preclinical grades. They're usually quickly glanced over or ignored entirely. I can at least say this is true for the most competitive specialties (ortho, PRS, ENT, etc).

The reasoning is that preclinical grades aren't standardized, so there's no point in using it to evaluate applicants. The barrier of entry has become step over time, which has it's pluses and minuses. Step wasn't even meant to be used as a screening tool, as per the NBME.

But I understand your point about it being impossible to differentiate so many similar applicants. Personally, I am in favor of enacting a specialty specific exam, like @operaman has proposed.

More exams? Lol the shelf exam isn’t enough alongside letters, research, Evals etc.?


this proposal of another metric/exam being needed reminds me of the bs video interview things that EM applicants have to do. Or the CASPR exam I had to take when applying to a few med schools. So stupid

 

[fantasticman221]

I basically go to a graded school. It's somewhat stressful in everyone tries and say it's total not competitive, but we all know it is. People say they just wanna pass, but then they end up getting grumpy over losing 2 points instead of 1 on an exam. Also, keep in mind, I'm pretty sure at pass fail schools you still receive individual grades on tests and in the class, except those just translate to P/F on the transcript. So regardless, I would expect some level of competitiveness in that regard

 

[Lawpy]

The downside of P/F curriculae which is rarely talked about is that it results in much greater emphasis being placed on step 1 scores and clinical clerkship performance. I'm involved in the selection committee for my residency, and at the end of the day we still need a way to differentiate among applicants. At our programs, step performance is relatively unimportant but, second only to interviews, clerkship performance is heavily emphasized. The content of letters - both LORs and the MSPE - also becomes more important.

I don't think this is something that should even come close to playing a role in your medical school decision, and, in general, I still strongly favor P/F curriculae, but there are downsides and consequences for making this shift. It isn't all roses and rainbows.

In either system, Step scores, clinical grades, AOA, letters etc. are all very important.

But it doesn't matter because the schools that have a true, unranked pass/fail are top schools and their name carries a major boost for their students applying for residency.

 

[mistafab]

Yes

 

[Goro]

For current medical schools, I feel like I may have an inaccurate understanding of the P/F system and need some clarification. Based on my understanding, the P/F system makes medical school less stressful overall. Yes, there still is a lot of material that needs to be learned but when you don't have to worry about receiving a grade, you have the opportunity to do the bare minimum just to pass. How accurate is this?

P.s. the school I will be attending has no internal rank either

From all the posts I've seen from SDNers on the subject, I'd say the answer is yes. I'm all in favor of less stressed students; Gawd knows you have enough stress as it is. BTW, my school will be switching soon to P/F, based upon my recommendation.

There are two caveats I find with P/F grading systems:
1) Because you can do fine with a 70% (or 75 or 80%) to pass, you don't get a sense of how your performance will predict Board scores. The best predictor for Boards performance is preclinical GPA (and yes, this is for schools that have GPAs and NOT PF systems). I believe that there will always be a subset of students who will do their best and ace exams, even though all they need is a 70%

2) There is always a risk that schools can't help themselves and will modify PF -> Honors/P/F. This invariably gets corrupted into H/HP/P/F, and we're right back at A/B/C/F!!!

 

[The Knife & Gun Club]

From those I’ve talked to - being PF does make it less stressful, but obviously some degree of stress will remain.

I go to a graded school though and it’s never really bothered me all that much. At the end of the day it’s hard for residencies to interpret preclinical grades anyway, so they end up having pretty low weight in the residency selection process.

 

[hurtem&healem]

But it doesn't matter because the schools that have a true, unranked pass/fail are top schools and their name carries a major boost for their students applying for residency.

The movement may have started at top schools, but it has spread well beyond there now.

My school has true, unranked P/F during preclinical. During my interview day and even after starting classes I kept asking different people about "code words" in the dean's letter or anything, but there really is no external sign of a class ranking. It is nice. I obviously don't have experience at schools with rankings, but there are a lot of stories about competitiveness and shadiness out there, and there's just nothing even remotely like that at my school. Everyone really does want everyone else to succeed.

As far as making it easier, that kind of depends on the individual I think. It's definitely less stressful in that I'm not at all worried about hitting 70% on my exams (not with any of the material so far, at least). And I'm sure there are students in my class for whom that's all that matters. But for me and most of the people I'm close with, "just passing" is not anywhere close to good enough. I want to crush every exam because:
a) I'm competitive with myself. I want a great score because it makes me happy to do well, not because I scored an sd above the class average. With that said, not having class rankings, I'm okay with only scoring 0.5 sd above the mean, because it doesn't actually make any difference. Particularly in the instructor generated question portion of our exams. Half of each exam is NBME, and I'm free to focus more on that material rather than memorizing the third line of the text box in the corner of slide 62, covering something completely irrelevant to medicine.
b) Two years goes quick, and that big exam is looming. Our preclinical years are much more than only a STEP 1 prep course, but it is also a two year STEP 1 prep course. The more I learn now, the more prepared I can be for when that time comes. Even if we didn't have course exams at all, I would be doing similar questions on my own as a learning tool. That's actually kind of how our exams feel. They are there as checkpoints to make sure we're studying effectively rather than a way to judge us.

So yeah, I would say unranked P/F makes for a better environment. I don't think it should make med school easier intellectually, though. It can, for sure, but that approach will definitely come back to bite you come dedicated/STEP 1 time.

 

[Aerus]

My school is unranked for first two year pre-clinical grades, but we still have rankings overall, just based off of Step 1 score and clinical grades, which I prefer a lot more to preclinical grades 100%.