How important are preclinical grades?

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Thank you cs24 and thank you to the significant other of cs24.
 
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Everyone's different. For me, 2-3 years of busting my ass was worth 2-3 decades (or more) of loving life. Small investment up front for huge payout.
But was this serendipity or were you specifically aiming for an "A" in every preclinical course?
 
But was this serendipity or were you specifically aiming for an "A" in every preclinical course?

I was definitely aiming for an "A" (well, "Honors", more specifically) in every preclinical course.
 
I was definitely aiming for an "A" (well, "Honors", more specifically) in every preclinical course.
I figured that was the case. Sorry, I thought you had said your preclinicals were letter graded for some reason.
 
I figured that was the case. Sorry, I thought you had said your preclinicals were letter graded for some reason.

Oh, they were.

We had A/B/C/F, but also had Honors (better than an A, obviously) for the top 5-10% (it varied by course and there were other factors considered). This was also the case for clinical years (which probably explains why I can't wrap my head around this "my school gives out 30-40% Honors" madness).
 
Oh, they were.

We had A/B/C/F, but also had Honors (better than an A, obviously) for the top 5-10% (it varied by course and there were other factors considered). This was also the case for clinical years (which probably explains why I can't wrap my head around this "my school gives out 30-40% Honors" madness).
With all due respect, that grading system is absolutely ridiculous, esp. with AOA calculation. Even worse bc it is norm-referenced.
 
With all due respect, that grading system is absolutely ridiculous, esp. with AOA calculation. Even worse bc it is norm-referenced.

To be fair, a 90+ was an A regardless of what other people scored. 80-89.9 was a B, and so forth. Of course, most of the course exams were pretty good at getting consistent and similar means/SD, but in theory there was nothing stopping 100% of the class from earning a grade of "A". To get Honors, you have to not only be above 90%, but also be in the top 10% of the class for that course as well usually.

So, if a course was particularly hard, and someone was within the top 10% of the class with a score of 88, they would get a B and not get Honors. That seems pretty silly, I agree, but I don't think it ever happened with us at least.
 
To be fair, a 90+ was an A regardless of what other people scored. 80-89.9 was a B, and so forth. Of course, most of the course exams were pretty good at getting consistent and similar means/SD, but in theory there was nothing stopping 100% of the class from earning a grade of "A". To get Honors, you have to not only be above 90%, but also be in the top 10% of the class for that course as well usually.

So, if a course was particularly hard, and someone was within the top 10% of the class with a score of 88, they would get a B and not get Honors. That seems pretty silly, I agree, but I don't think it ever happened with us at least.
Right, but for AOA calculation and class rank, an "Honors" means more than an "A". Thus it's more norm referenced vs. criterion referenced.
 
To be fair, a 90+ was an A regardless of what other people scored. 80-89.9 was a B, and so forth. Of course, most of the course exams were pretty good at getting consistent and similar means/SD, but in theory there was nothing stopping 100% of the class from earning a grade of "A". To get Honors, you have to not only be above 90%, but also be in the top 10% of the class for that course as well usually.

So, if a course was particularly hard, and someone was within the top 10% of the class with a score of 88, they would get a B and not get Honors. That seems pretty silly, I agree, but I don't think it ever happened with us at least.

It's like they're trying to get students to be more competitive with each other, I just don't understand why they would include that silly honors distinction. Uncurved grades are whatever, but as soon as you put a limit as to how many students can achieve something, you automatically foster competition.
 
It's like they're trying to get students to be more competitive with each other, I just don't understand why they would include that silly honors distinction. Uncurved grades are whatever, but as soon as you put a limit as to how many students can achieve something, you automatically foster competition.
Yes, that's what I didn't understand either. Medical students, by definition, are already a competitive breed to begin with. What do you gain by not having someone go for an "A" but also for them to be one of that top percentage?

When you say, only a certain percent of people are allowed to get "Honors" then you create competitive feelings. Maybe that's what the med school wants though. There are some med schools that need to get out of the stone age level of thinking.
 
Yes, that's what I didn't understand either. Medical students, by definition, are already a competitive breed to begin with. What do you gain by not having someone go for an "A" but also for them to be one of that top percentage?

When you say, only a certain percent of people are allowed to get "Honors" then you create competitive feelings. Maybe that's what the med school wants though. There are some med schools that need to get out of the stone age level of thinking.

I never felt the heat or competitiveness during my 4 years. Really, just my own internal competitive drive.

What's the point of having Honors if you devalue it? Honors should indicate exceptional performance that stands out above most others. When you start playing the "everyone gets Honors and a chocolate chip cookie" game, you start to pander to the entitlement generation who thinks everything is owed to them.

And to be very honest, there is nothing wrong with "competitive feelings." If it leads to people sabotaging others, yeah that's a problem. But I honestly didn't see that kind of thing in my school.

Pressure and competition are a part of life. Eventually people have to learn that.
 
I never felt the heat or competitiveness during my 4 years. Really, just my own internal competitive drive.

What's the point of having Honors if you devalue it? Honors should indicate exceptional performance that stands out above most others. When you start playing the "everyone gets Honors and a chocolate chip cookie" game, you start to pander to the entitlement generation who thinks everything is owed to them.
If you're always at the top of the pack, of course you're not going to "feel the heat" or "competitiveness". You're at the top of the pack.

My point is that an "A" is already a high grade, but to qualify it even further for "Honors" that not only do you have to have an "A", but you have to be in top 10% of your class, which depending on the class size, isn't many people, is silly. The amount of learning difference is negligible, if not non-existent, and most med schools have recognized this.
 
And to be very honest, there is nothing wrong with "competitive feelings." If it leads to people sabotaging others, yeah that's a problem. But I honestly didn't see that kind of thing in my school.

Pressure and competition are a part of life. Eventually people have to learn that.
Yes, @GuyWhoDoesStuff, but competitive feelings hardly allow people to work as a team on rotations. Active sabotage is rare -- due to professionalism concern reports, however, if a person is floundering, his classmates are less likely to throw him a life jacket bc they feel they are competing against him.
 
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What's the point of having Honors if you devalue it? Honors should indicate exceptional performance that stands out above most others. When you start playing the "everyone gets Honors and a chocolate chip cookie" game, you start to pander to the entitlement generation who thinks everything is owed to them.

Grade quotas are stupid, IMO. Whether it's called an "A" or honors doesn't matter. It's stupid. Grades are supposed to be an indicator of how well the relevant material is mastered, and that indicator is supposed to be internally consistent. By arbitrarily setting a cut-off, it ignores the entire concept of variance, ergo precluding the possibility that a group may actually have a greater than X% of students who mastered the material sufficiently to earn the corresponding grade.
 
Grade quotas are stupid, IMO. Whether it's called an "A" or honors doesn't matter. It's stupid. Grades are supposed to be an indicator of how well the relevant material is mastered, and that indicator is supposed to be internally consistent. By arbitrarily setting a cut-off, it ignores the entire concept of variance, ergo precluding the possibility that a group may actually have a greater than X% of students who mastered the material sufficiently to earn the corresponding grade.

Like I said, the whole point is that ANYONE can achieve any letter grade they want.

The "Honors" designation is just that. An additional honor to those who not only excel, but do so at a higher level than all but a few.

Nothing is stopping everyone from mastering the material and getting A's.

Not everyone is going to get Honors, though. With good reason. You want something extra special? You'd better work extra hard.
 
Like I said, the whole point is that ANYONE can achieve any letter grade they want.

The "Honors" designation is just that. An additional honor to those who not only excel, but do so at a higher level than all but a few.

Nothing is stopping everyone from mastering the material and getting A's.

Not everyone is going to get Honors, though. With good reason. You want something extra special? You'd better work extra hard.
So then what incentive would have you have to work with classmates, esp. during MS-3, in which people feel they are competing against eachother for Honors?
 
So then what incentive would have you have to work with classmates, esp. during MS-3, in which you are fighting for Honors?

Learning from each other. Co-operation will only make you a better physician. I was part of a study group through MS-1 and 2. There was a lot of stuff I misread/misunderstood that someone else corrected me on. Some of us received medals/honors, while others didn't. We didn't begrudge them, and I hope they didn't begrudge me, we're friends.

If someone else gets honors, I should have worked harder.
 
Like I said, the whole point is that ANYONE can achieve any letter grade they want.

The "Honors" designation is just that. An additional honor to those who not only excel, but do so at a higher level than all but a few.

Nothing is stopping everyone from mastering the material and getting A's.

Not everyone is going to get Honors, though. With good reason. You want something extra special? You'd better work extra hard.

But is there really a true distinction between the last person that got honors and the top person who barely missed it? I mean, the difference could come down to a tenth of a point, or even less! It's that kind of idea that adds unnecessary stress to students. The idea behind preset cutoffs is that you are competing against yourself to get a certain percentage of questions correct. When you start saying that only a certain number of students can get a distinction, you are no longer just trying to do the best that YOU can do, it one comes down to how everyone else performs. And since you are now worried about how others are doing, you are way less likely to work with others and help each other out, since that means you are helping someone take one of those few spots that you desire.

Is honors at your school used to determine class rank/AOA? Or is it just an extra mark on the transcript? If it's the former, I have a problem with it. If it's the latter, I still don't like it, but it's not as big of a deal.
 
So then what incentive would have you have to work with classmates, esp. during MS-3, in which people feel they are competing against eachother for Honors?

I think you're way overselling this whole "competition" thing. The incentive to work with classmates is "hey you know we can both look awesome if we help each other out here." ****, most of the time the major difference in clinical grades ends up being the shelf exam anyway because on a large scale many of the evaluations may vary quite a bit based on subjectivity (which is another subject altogether).
 
Learning from each other. Co-operation will only make you a better physician. I was part of a study group through MS-1 and 2. Some of us received medals/honors, while others didn't. We didn't begrudge them, they're our friends.

If someone else gets honors, I should have worked harder.
Right and at the same token, if someone gets access to an old previously released exam, they won't share it with their friends in order to gain an edge and get "Honors". There's a reason that many medical schools, esp. the forward thinking top-tier schools, have made the first two years P/F grading, if not "true" P/F grading.
 
I think you're way overselling this whole "competition" thing. The incentive to work with classmates is "hey you know we can both look awesome if we help each other out here." ****, most of the time the major difference in clinical grades ends up being the shelf exam anyway because on a large scale many of the evaluations may vary quite a bit based on subjectivity (which is another subject altogether).
It's not a question of whether I'm overselling it. Medical students act on perception, whether it's valid or not. Do you esp. think during MS-1/MS-2 that students will study together collaboratively, if they believe by helping others they decrease their chances of getting "Honors"?
 
Right and at the same token, if someone gets access to an old previously released exam, they won't share it with their friends in order to gain an edge and get "Honors". There's a reason that many medical schools, esp. the forward thinking top-tier schools, have made the first two years P/F grading, if not "true" P/F grading.

Then they're not their friends. That's gunning, but it's a part of the 'real world'. There will always be old exams, nepotism, etc. It's up to you to be better.
 
But is there really a true distinction between the last person that got honors and the top person who barely missed it? I mean, the difference could come down to a tenth of a point, or even less! It's that kind of idea that adds unnecessary stress to students. The idea behind preset cutoffs is that you are competing against yourself to get a certain percentage of questions correct. When you start saying that only a certain number of students can get a distinction, you are no longer just trying to do the best that YOU can do, it one comes down to how everyone else performs. And since you are now worried about how others are doing, you are way less likely to work with others and help each other out, since that means you are helping someone take one of those few spots that you desire.

Is honors at your school used to determine class rank/AOA? Or is it just an extra mark on the transcript. If it's the former, I have a problem with it. If it's the latter, I still don't like it, but it's not as big of a deal.

First of all, most of M1/M2 is self-directed learning anyway. How do you guys define "helping each other out"? Oh look someone sent out a study guide. Cool.

I was never worried about what other people were doing. I was worried about trying to meet my own high personal standards. If others exceeded them, then good on them, they deserve everything they earn.

If someone is ALWAYS getting Honors, I think it's pretty clear there truly is a distinction between them and other people who aren't.

And yes, Honors is used to calculate class rank/AOA. We don't just hand out blue ribbons with "AOA" on them to everyone.
 
First of all, most of M1/M2 is self-directed learning anyway. How do you guys define "helping each other out"? Oh look someone sent out a study guide. Cool.

I was never worried about what other people were doing. I was worried about trying to meet my own high personal standards. If others exceeded them, then good on them, they deserve everything they earn.

If someone is ALWAYS getting Honors, I think it's pretty clear there truly is a distinction between them and other people who aren't.

And yes, Honors is used to calculate class rank/AOA. We don't just hand out blue ribbons with "AOA" on them to everyone.
Yes, sending out and sharing pre-made study guides and charts that people were nice enough to make, studying in groups and quizzing eachother, yes that is what I am talking about. I'm sorry you don't consider that a big deal. I think it builds comradery. Different strokes I guess.
 
Yes, sending out and sharing pre-made study guides and charts that people were nice enough to make, studying in groups and quizzing eachother, yes that is what I am talking about. I'm sorry you don't consider that a big deal. I think it builds comradery. Different strokes I guess.

It's not that I don't consider it a big deal. It's that I consider it woefully inefficient and a poor use of time (not the study guide thing, but the group work for the most part).
 
But is there really a true distinction between the last person that got honors and the top person who barely missed it? I mean, the difference could come down to a tenth of a point, or even less! It's that kind of idea that adds unnecessary stress to students. The idea behind preset cutoffs is that you are competing against yourself to get a certain percentage of questions correct. When you start saying that only a certain number of students can get a distinction, you are no longer just trying to do the best that YOU can do, it one comes down to how everyone else performs. And since you are now worried about how others are doing, you are way less likely to work with others and help each other out, since that means you are helping someone take one of those few spots that you desire.
Exactly, and it's now norm referenced rather than criterion referenced, based on how you perform relative to others, with no real gain, learning-wise.
 
Like I said, the whole point is that ANYONE can achieve any letter grade they want.

The "Honors" designation is just that. An additional honor to those who not only excel, but do so at a higher level than all but a few.

Nothing is stopping everyone from mastering the material and getting A's.

Not everyone is going to get Honors, though. With good reason. You want something extra special? You'd better work extra hard.

I feel like I'm not getting my point across, so let me give an example.

As an MS-3, my IM clerkship only gave out As to the top 20% of students. It didn't matter what your shelf score or evaluations said, if you were in the top 20% you got an A. I did my medicine clerkship right after Christmas, along with a lot of people aiming for IM. My shelf score and evaluations came out to a grade of 92% (90-100% was an A at my school), but my final grade for the clerkship was a B. If I had done the same rotation with the same score any other block, then I would have gotten an A. How does that make any sense?

The same concept applies to this "honors" designation. The point is not to give everyone honors; the idea is to give it to everyone who has mastered the material at an exceptional level the designation they've earned. By setting a quota, it ignores the possibility that greater than a certain percentage of the class can master the material at an "honors" level. Grades are already relative to the school, but typically remain internally consistent across year groups. Quotas make grades relative within a class, except that we already have a metric for that - class rank.
 
It's not that I don't consider it a big deal. It's that I consider it woefully inefficient and a poor use of time (not the study guide thing, but the group work for the most part).
Ok well forget the group study thing for a moment (even though many people use it, for example, if one person is having trouble with a concept, then someone else who knows it can teach it to them and vice-versa).

What about making charts and study guides and sharing them? Do you really think in your grading system, that people are going to do that, knowing that they might be helping someone get Honors, above them?
 
It's not that I don't consider it a big deal. It's that I consider it woefully inefficient and a poor use of time (not the study guide thing, but the group work for the most part).

I'm gonna have to guess that you consistently performed towards the top of your class and never had any trouble understanding any material. For others, talking through difficult concepts can point out areas that you thought you understood, but you actually has a skewed view of what's actually going on. I'm not a fan of trying to learn new material in groups, but as far as review before a test goes, talking through the material with a friend or two is one of the best ways to do it.
 
I feel like I'm not getting my point across, so let me give an example.

As an MS-3, my IM clerkship only gave out As to the top 20% of students. It didn't matter what your shelf score or evaluations said, if you were in the top 20% you got an A. I did my medicine clerkship right after Christmas, along with a lot of people aiming for IM. My shelf score and evaluations came out to a grade of 92% (90-100% was an A at my school), but my final grade for the clerkship was a B. If I had done the same rotation with the same score any other block, then I would have gotten an A. How does that make any sense?

The same concept applies to this "honors" designation. The point is not to give everyone honors; the idea is to give it to everyone who has mastered the material at an exceptional level the designation they've earned. By setting a quota, it ignores the possibility that greater than a certain percentage of the class can master the material at an "honors" level. Grades are already relative to the school, but typically remain internally consistent across year groups. Quotas make grades relative within a class, except that we already have a metric for that - class rank.
You have to be Top 20% for that specific block?!!? That's even more nuts.
 
I feel like I'm not getting my point across, so let me give an example.

As an MS-3, my IM clerkship only gave out As to the top 20% of students. It didn't matter what your shelf score or evaluations said, if you were in the top 20% you got an A. I did my medicine clerkship right after Christmas, along with a lot of people aiming for IM. My shelf score and evaluations came out to a grade of 92% (90-100% was an A at my school), but my final grade for the clerkship was a B. If I had done the same rotation with the same score any other block, then I would have gotten an A. How does that make any sense?

The same concept applies to this "honors" designation. The point is not to give everyone honors; the idea is to give it to everyone who has mastered the material at an exceptional level the designation they've earned. By setting a quota, it ignores the possibility that greater than a certain percentage of the class can master the material at an "honors" level. Grades are already relative to the school, but typically remain internally consistent across year groups. Quotas make grades relative within a class, except that we already have a metric for that - class rank.

They really aren't the same thing, even though a similar approach is taken. In your school, earning a 92 could get you a B. That simply couldn't happen at my school. As far as I'm concerned, an "A" is a fantastic grade, and indicates you really mastered the material.

Going that one extra step for the top 5-10% is the icing on the cake. Sure, more than those 5-10% mastered the material in all likelihood (however you want to define that), but the "Honors" awarded recognizes those that not only mastered the information, but were able to go above and beyond in either understanding or memorizing the information (which, whether you like it nor not, is a part of education at any level).
 
I'm gonna have to guess that you consistently performed towards the top of your class and never had any trouble understanding any material. For others, talking through difficult concepts can point out areas that you thought you understood, but you actually has a skewed view of what's actually going on. I'm not a fan of trying to learn new material in groups, but as far as review before a test goes, talking through the material with a friend or two is one of the best ways to do it.
👍
 
You have to be Top 20% for that specific block?!!? That's even more nuts.

Yeah, it was ridiculous. Now that I'm on the other end of things, it's difficult to be bitter because it all worked out. But at the time, as an extremely grade-conscious MS3 unsure of his future specialty, I was pretty angry.
 
I'm gonna have to guess that you consistently performed towards the top of your class and never had any trouble understanding any material. For others, talking through difficult concepts can point out areas that you thought you understood, but you actually has a skewed view of what's actually going on. I'm not a fan of trying to learn new material in groups, but as far as review before a test goes, talking through the material with a friend or two is one of the best ways to do it.

I did well, and my best friend sometimes struggled. We'd occasionally talk/review/hash out ideas over GChat while studying in our respective houses. Nothing wrong with that, as it wasn't a big time sink.

I just get these visions of a half dozen medical students sitting around a table the week of an exam quizzing each other inefficiently on random things when they could probably be spending their time more efficiently. Different strokes, indeed, of course.
 
They really aren't the same thing, even though a similar approach is taken. In your school, earning a 92 could get you a B. That simply couldn't happen at my school. As far as I'm concerned, an "A" is a fantastic grade, and indicates you really mastered the material.

Going that one extra step for the top 5-10% is the icing on the cake. Sure, more than those 5-10% mastered the material in all likelihood (however you want to define that), but the "Honors" awarded recognizes those that not only mastered the information, but were able to go above and beyond in either understanding or memorizing the information (which, whether you like it nor not, is a part of education at any level).
So "above and beyond" = just beating everyone else, not necessarily understanding or memorizing the information better as it is norm-referenced.
 
Yeah, it was ridiculous. Now that I'm on the other end of things, it's difficult to be bitter because it all worked out. But at the time, as an extremely grade-conscious MS3 unsure of his future specialty, I was pretty angry.
I don't blame you. Most medical students would be. Until the match is over, everything is up in the air, and not to mention those years can leave behind very deep scars.
 
They really aren't the same thing, even though a similar approach is taken. In your school, earning a 92 could get you a B. That simply couldn't happen at my school. As far as I'm concerned, an "A" is a fantastic grade, and indicates you really mastered the material.

Going that one extra step for the top 5-10% is the icing on the cake. Sure, more than those 5-10% mastered the material in all likelihood (however you want to define that), but the "Honors" awarded recognizes those that not only mastered the information, but were able to go above and beyond in either understanding or memorizing the information (which, whether you like it nor not, is a part of education at any level).

Well, I disagree that they're conceptually different - only different in scale, but moving on...

So, then, are you willing to concede that if no more than X% of a class can earn "honors" that - in certain groups or years - fewer than the allowable "honors" should be awarded. Because surely there will be some classes where X% just didn't "go above and beyond".
 
So "above and beyond" = just beating everyone else, not necessarily understanding or memorizing the information better as it is norm-referenced.

**** man. I don't know how else to explain this to you. Everyone can be a special flower with an A, but not everyone can be the specialest flower. This is not the USSR.

Yes, above and beyond = beating everyone else in addition to memorizing and understanding the material.
 
Well, I disagree that they're conceptually different - only different in scale, but moving on...

So, then, are you willing to concede that if no more than X% of a class can earn "honors" that - in certain groups or years - fewer than the allowable "honors" should be awarded. Because surely there will be some classes where X% just didn't "go above and beyond".

Abso****inglutely. Which is how it worked in my school, and I explained that yesterday on this very thread.
 
I just get these visions of a half dozen medical students sitting around a table the week of an exam quizzing each other inefficiently on random things when they could probably be spending their time more efficiently. Different strokes, indeed, of course.
I would say more like a group of 2-3, maybe meeting every once in a while to keep everyone on track and explain to each other things that someone else didn't understand.
 
I would say more like a group of 2-3, maybe meeting every once in a while to keep everyone on track and explain to each other things that someone else didn't understand.

And you literally think this won't/can't/doesn't happen in a school set up like mine was?

I don't know what else to say, then
 
**** man. I don't know how else to explain this to you. Everyone can be a special flower with an A, but not everyone can be the specialest flower. This is not the USSR.

Yes, above and beyond = beating everyone else in addition to memorizing and understanding the material.
Like I said, most medical schools have progressed beyond this type of thinking to where it's necessary to crown the specialest of special flowers. Being a special flower is enough - hence H/P/F or H/HP/P/F or H/HP/SP/MP/F, where each category is a range of scores and by itself already has a good enough distribution. Then of course, you have the medical schools that are "true" P/F, or P/F with grades internally ranked.
 
I missed that, sorry.

So, were the criteria for getting "honors" well known? I mean, everyone knows what it takes to get an A, B, etc., was it the same for honors?

It's clearly outlined in our handbook that to get a grade of "A", you need to be 90+, a "B" was 80-89.9, and so forth. Additionally, it's clearly outlined that in order to get "Honors", you must be in the top 10% of the class AND earn an overall grade of "A" for that course.
 
It's clearly outlined in our handbook that to get a grade of "A", you need to be 90+, a "B" was 80-89.9, and so forth. Additionally, it's clearly outlined that in order to get "Honors", you must be in the top 10% of the class AND earn an overall grade of "A" for that course.

So, everyone that earned an A and was in the top 10% got honors? I mean, that's a relative standard. It means it's better to be smart among relative dummies than to be supersmart among geniuses. Just doesn't sit well with me.
 
And you literally think this won't/can't/doesn't happen in a school set up like mine was?

I don't know what else to say, then
Probably not as often, as what could possibly be, if people didn't feel they were competing against eachother for Honors. I realize some people won't be in the A range anyway, but I'm talking about those in the A range competing for Honors.
 
So, everyone that earned an A and was in the top 10% got honors? I mean, that's a relative standard. It means it's better to be smart among relative dummies than to be supersmart among geniuses. Just doesn't sit well with me.
Pretty much. If you have a dumb class, then getting Honors won't be a problem. If you have a smarter or more cutthroat class, then you'll have a more difficult time being designated Honors.
 
So, everyone that earned an A and was in the top 10% got honors? I mean, that's a relative standard. It means it's better to be smart among relative dummies than to be supersmart among geniuses. Just doesn't sit well with me.

By the same token, if you accept the premise that dummies exist in medical school (whether you want to use MCAT, GPA, medical school grades, Step I, IQ, whatever as this metric), it sure seems pretty important to have a way to designate those few who are not dummies, no? Seems like a relative grading scale would be a perfect way to do that.
 
Class got me more points on Step 1 than review books.

Don't underestimate the importance of minutia in class. That's where the real big scores come with respect to high board scores. Every idiot will know that Crohn's disease is skip lesions, etc etc etc, but not too many people will know that anti-NMDA antibodies are responsible for teratoma-induced seizures. If you really want to score 250+ on Step 1, you have to know both and no review source will cover the second factoid.
 
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