BUSPM has a strict no rounding policy. The whole-letter grade only system is a double edged sword. If you're really struggling and scrape by with an 80.1, you get the same grade as someone who is a gunner but just fell short at 89.7. I've had it work for me and against me in the same semester. Just missed an A in an easy stats class, and barely made a B in Gross anatomy.
In a perfect world.... Our classes are pass/fail and our boards are percentile based, so we are ranked against the rest of the students at other schools. That would require an overhaul of our Boards, which are really haphazard in both content and delivery. Right now, the boards are minimum competency. You never even know your score, unless you fail. I'd guess a chunk of students who fail part 1 boards are actually quite competent, they just don't make extensive exam preparations since the juice is not worth the squeeze- whether you get 100% or pass by one question, it makes no difference. Also- the exam is not uniform in content delivery. You might get a ton of radiology questions, your classmate might get disproportionate anatomy questions, and another classmate may get a bunch of Physio questions. I'm of the opinion this isn't fair or ideal, because when you're studying, you're focusing on high yield topics. However, those high yields are only a probability. You may be particularly weak in one subject area, but if your exam has a lot of questions about that subject, you may fail. That fail is not representative of the overall knowledge base- another student who is equally weak in that subject area may not get as much of that subject and pass.
TL;DR- IMO, Our board exam is haphazard, and our classes should be pass/fail.