List of Unranked Pass/Fail Medical Schools

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What are specific medical schools that follow unranked pass/fail scale?
 
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Master Thinker

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Would be a long list. Most are pass/fail. Better question is which is not
 

Lawpy

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What are specific medical schools that follow pass/fail scale?
Would be a long list. Most are pass/fail. Better question is which is not

Pretty sure a better question is: which schools are unranked pass/fail? Ranked pass/fail is no different from a graded system, and schools with ranked pass/fail can be more stressful/competitive... and thus a huge turnoff for many people.
 
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Pretty sure a better question is: which schools are unranked pass/fail? Ranked pass/fail is no different from a graded system, and schools with ranked pass/fail can be more stressful/competitive... and thus a huge turnoff for many people.
What is the difference between ranked and unranked pass/fail? Reworded Thanks for suggestion!
 
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freedoctor17

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What is the difference between ranked and unranked pass/fail? Reworded Thanks for suggestion!

Ranked is pass/fail but number the students by performance so might as well have grades... (Each school does it differently, some rank top 10% only, some rank in quartiles, some rank ever last person individually). Those schools can be stressful due to competition. Unranked pass/fail doesn't have that annoyance. Most schools are now pass/fail for years 1 and 2 but whether they're ranked or not is what's important.
 
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Lawpy

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What is the difference between ranked and unranked pass/fail?

Ranked pass/fail has internal rankings that are listed in a student’s evaluation report to be seen by residency program directors. Students are basically still graded in their preclinical blocks but rather than having specific grades (like honors, high pass etc.), anyone who exceeds the pass threshold get a pass grade. But those who do very well may be ranked in the top quartile/top percentile etc.

Ranked pass/fail is basically the same as a honors/high pass/pass/fail graded system but it’s more deceptive because students are misled into thinking passing is fine without realizing they are being ranked. And residency directors at competitive programs and specialties do care about percentile ranks since internal ranking guces them a way to see how students fare relative to their class.

Unranked pass/fail has no internal ranking. Students who pass have simple comments saying they passed their courses without any mention of their rank. Since unranked pass/fail is truly pass/fail and lacks the deceptive internal ranking, students don’t have to worry or be competitive/stressed in preclinical years that they otherwise would have been under a ranked pass/fail system.

For more information: Which Top 20 schools are pass/fail?
Which Schools Are True Pass/Fail?

These links may be outdated as curricula change regularly. School websites probably give good information regarding their grading policy, but some schools with pass/fail grading deceptively hide information regarding internal ranking. So hence the purpose of this thread.
 
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These links may be outdated as curricula change regularly. School websites probably give good information regarding their grading policy, but some schools with pass/fail grading deceptively hide information regarding internal ranking. So hence the purpose of this thread.

Tried looking and figuring it out by checking the sites of the schools I am interested in but had a hard time finding that information on their.
 
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deleted421268

I'm not sure this is correct based on what my school has told us. We were told that it is required for the performance of individual students to be compared to the whole class for the purpose of the MSPE, which is the letter written by your medical school that goes with your residency application. That may be a numerical rank or just top quartile, top 20%, etc., but I'm pretty sure every single school has to do this, regardless of whether they call themselves ranked or unranked or whether the students are made aware of this ranking. My school ranks us into quartiles and they told us that this is the most they can get away with in terms of being "unranked." This is discussed in at least one of the threads you linked.
Using pass/fail scales how do schools rank students if there are no letter grades assigned with GPA values?
 
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deleted421268

So is there no such thing as ''unranked'' pass/fail medical schools?
 

Lawpy

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I'm not sure this is correct based on what my school has told us. We were told that it is required for the performance of individual students to be compared to the whole class for the purpose of the MSPE, which is the letter written by your medical school that goes with your residency application. That may be a numerical rank or just top quartile, top 20%, etc., but I'm pretty sure every single school has to do this, regardless of whether they call themselves ranked or unranked or whether the students are made aware of this ranking. My school ranks us into quartiles and they told us that this is the most they can get away with in terms of being "unranked." This is discussed in at least one of the threads you linked.

Your school is simply justifying their grading policy. True unranked P/F schools just simply say that students have passed their preclinical curricula without any mention of rank for preclinical courses. Ranking here happens at the clinical level. There is no LCME requirement saying that schools have to rank their students, and in fact, few schools like Yale does fine with no ranks at all. Granted, school reputation plays a role, and top schools can get away without having ranks because of their reputation.

But I suggest that your school admins simply adopt a graded honors/high pass/pass/fail rather than quartile-based pass/fail. They are identical but the ranked pass/fail is deceptive by pretending to be true pass/fail when it's not.
 
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CyrilFiggis

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My program is unranked P/F for preclinical and ranked F/P/HP/H for 3rd year. Rankings are for superlatives and only differentiate those at the top of the class, not those at the bottom. Your residency letter will be the same as everyone else's unless you're in the Top 10% of the class.

They do maintain internal rankings for pre-clinical, but those are only used if you want to be a tutor.
 

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Unranked pass/fail schools exist. They are Harvard, Yale, Hopkins and Columbia. I'm pretty sure Sinai is also unranked pass/fail and few others are too but I don't know the full details.

UMich as well I believe for the first 2 years if anyone is making a list.
 
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deleted421268

Unranked pass/fail schools exist. They are Harvard, Yale, Hopkins and Columbia. I'm pretty sure Sinai is also unranked pass/fail and few others are too but I don't know the full details.
Are most of the unranked pass/fail medical schools top medical schools or are there mid tier and low tier MD schools also unranked pass/fail?
 

freedoctor17

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Case Western Reserve University is as well. Lerner (Cleveland clinic) has no grades whatsoever. So those probably count as well.
 

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This is something to consider when deciding where to matriculate among your acceptances, I wouldn't use this to decide where to apply. You'll find out the grading systems at interview days/second looks.

I don't mean this rudely, but you haven't correctly guessed my school's grading scheme (which I was purposely vague about for the sake of anonymity). I likely would not pass your recommendations onto them regardless lol.

I'd like to hear from someone who reviews MSPEs or is more familiar with the process to back up your assertion that some schools do not have any comparison whatsoever of how a student performs within their class. Based on my (admittedly limited) research, it appears to be the AAMC that sets the guidelines for the MSPE, not the LCME.

Here are their recommendations, which have multiple mentions of comparing individual students against the rest of their class, suggesting to me that this is an expected part of the MSPE: https://www.aamc.org/download/470400/data/mspe-recommendations.pdf
In particular:
  • "Graphic representations of students’ comparative performance should be incorporated within the body of the MSPE, not as appendices."
  • "Provide a summative assessment, based up on the school’s evaluation system, of the student’s comparative performance in medical school, relative to his/her peers, including information about any school-specific categories used in differentiating among levels of student performance."
  • "In keeping with one of the guiding principles for the new MPSE recommendations, this letter should be one method through which schools can provide comparative information on applicants. "
  • "It is imperative that the information used to compare students is clearly stated in the summary. For example, 'Quartile placement was determined using a point system of 3 points for each honors grade, 2 points for high pass, 1 point for pass and -1 point for a failing grade. Every course in the M1-M3 year is counted equally (no weighting of courses or clerkships). USMLE scores, community service, or research are not considered in quartile placement.' "
Nowhere in any of what you quoted does it say preclinical comparisons must be made. I can tell you 100% the school I'm at does not mention rank/quartile/etc regarding preclinical grades, only clinical rotations.
 
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deleted421268

This is something to consider when deciding where to matriculate among your acceptances, I wouldn't use this to decide where to apply. You'll find out the grading systems at interview days/second looks.

But what if someone just has one acceptance
 

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I don't mean this rudely, but you haven't correctly guessed my school's grading scheme (which I was purposely vague about for the sake of anonymity). I likely would not pass your recommendations onto them regardless lol.

I'd like to hear from someone who reviews MSPEs or is more familiar with the process to back up your assertion that some schools do not have any comparison whatsoever of how a student performs within their class. Based on my (admittedly limited) research, it appears to be the AAMC that sets the guidelines for the MSPE, not the LCME.

Here are their recommendations, which have multiple mentions of comparing individual students against the rest of their class, suggesting to me that this is an expected part of the MSPE: https://www.aamc.org/download/470400/data/mspe-recommendations.pdf
In particular:
  • "Graphic representations of students’ comparative performance should be incorporated within the body of the MSPE, not as appendices."
  • "Provide a summative assessment, based up on the school’s evaluation system, of the student’s comparative performance in medical school, relative to his/her peers, including information about any school-specific categories used in differentiating among levels of student performance."
  • "In keeping with one of the guiding principles for the new MPSE recommendations, this letter should be one method through which schools can provide comparative information on applicants. "
  • "It is imperative that the information used to compare students is clearly stated in the summary. For example, 'Quartile placement was determined using a point system of 3 points for each honors grade, 2 points for high pass, 1 point for pass and -1 point for a failing grade. Every course in the M1-M3 year is counted equally (no weighting of courses or clerkships). USMLE scores, community service, or research are not considered in quartile placement.' "

ETA: And it looks like they put in your shelf exam scores and that sort of thing anyway, which is a direct comparison of your performance to the average US medical student, is it not?

Edit: NVM answered. Preclinical might not be, but clinical is it seems.
 
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deleted421268

In terms of stress between ranked pass/fail and ranked grading letter grade system what is more stressful?
 
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ciestar

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But what if someone just has one acceptance

This was my situation. My school does ranked P/F pre-clinical (apparently... nobody mentions it), but an honors system for clinical. They have said for AOA that clinical factors in much more, but I already know that i’ve blown it due to my grades.
 
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deleted421268

For someone who is trying to figure out what schools I want to apply to considering whether a school is unranked P/F, Ranked P/F, letter grade system should be of no value in terms of considering what schools I want to apply to?
 

ciestar

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For someone who is trying to figure out what schools I want to apply to considering whether a school is unranked P/F, Ranked P/F, letter grade system should be of no value in terms of considering what schools I want to apply to?

To an extent, no. If it truly is a concern, maybe leave the letter grade system off your list. Overall, worry about getting into medical school first.
 
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ciestar

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And honestly, as I mentioned, my school is not strictly pass/fail for the majority of our courses and ranks us by quartiles for our MSPE. It is PLENTY collaborative/non-competitive - people share study resources and go above and beyond to help each other out all the time. I have never heard of anybody trying to sabotage somebody to get a better grade or anything like that. I think it's more about the culture of the school/personality of the students than the grading system. Perhaps the grading system might contribute to a more competitive atmosphere at some schools, but that hasn't been my experience.

And regarding stress - I don't think I would work any less hard if I knew I wasn't being ranked against my classmates. Because I'm not just studying to get a good grade on an individual test or get a high ranking. I'm studying to prepare for my boards and prepare to be a good doctor. So even without being ranked, I would still work as hard as I reasonably could while maintaining my physical and mental health.

I have a friend at a honors system school, and the pressure they’re under is much greater than what I face with ranked P/F. To them, anything less than an Honors in a class is seen as a “failure”. (This is more of an internal competition, though)

I also agree. I don’t consider my classmates when it comes to studying. At the end of the day, my performance is what it is and acing my boards matters a ton more.
 

Lawpy

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I don't mean this rudely, but you haven't correctly guessed my school's grading scheme (which I was purposely vague about for the sake of anonymity). I likely would not pass your recommendations onto them regardless lol.
My school ranks us into quartiles and they told us that this is the most they can get away with in terms of being "unranked." This is discussed in at least one of the threads you linked.

Why guess when you basically told us what your school's grading system is?

I'd like to hear from someone who reviews MSPEs or is more familiar with the process to back up your assertion that some schools do not have any comparison whatsoever of how a student performs within their class. Based on my (admittedly limited) research, it appears to be the AAMC that sets the guidelines for the MSPE, not the LCME.

Here are their recommendations, which have multiple mentions of comparing individual students against the rest of their class, suggesting to me that this is an expected part of the MSPE: https://www.aamc.org/download/470400/data/mspe-recommendations.pdf
In particular:
  • "Graphic representations of students’ comparative performance should be incorporated within the body of the MSPE, not as appendices."
  • "Provide a summative assessment, based up on the school’s evaluation system, of the student’s comparative performance in medical school, relative to his/her peers, including information about any school-specific categories used in differentiating among levels of student performance."
  • "In keeping with one of the guiding principles for the new MPSE recommendations, this letter should be one method through which schools can provide comparative information on applicants. "
  • "It is imperative that the information used to compare students is clearly stated in the summary. For example, 'Quartile placement was determined using a point system of 3 points for each honors grade, 2 points for high pass, 1 point for pass and -1 point for a failing grade. Every course in the M1-M3 year is counted equally (no weighting of courses or clerkships). USMLE scores, community service, or research are not considered in quartile placement.' "

ETA: And it looks like they put in your shelf exam scores and that sort of thing anyway, which is a direct comparison of your performance to the average US medical student, is it not?

All my posts here and what OP wants and the threads I linked discuss pass/fail graded systems for preclinical curricula. I know clinical grades need to be taken into account and are important because they tell how the students will perform in residency. What I am discussing is strictly preclinical grading, and why I oppose ranked pass/fail systems because they are deceptive.
 

efle

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Okay, sure. I guess I assumed that students looking for "true pass/fail unranked" wanted it all 4 years and not just preclinical. Bottom line, you will be ranked comparatively at some point no matter what school you go to.
Yeah I def haven't ever heard of unranked clinical years!
 

freedoctor17

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does ranking even matter much at all if going for primary care? I always here about shortage in primary care doctors in the US and that's what I'm going for. I would still try my best as I wouldn't be satisfied with myself otherwise but it'd be nice not having to stress about your best not being good enough for whatever residency you plan for.
 
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Lawpy

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Well no, I didn't tell you what my school's grading system is. I told you that they rank us into quartiles for the MSPE, not whether it's P/F or letter grades or Honors/P/F or H/HP/P/F, what the grading system is in each year, how they determine that quartile rank, etc. You assumed that my school is/describes itself as true pass/fail, and that's not correct.

"My school ranks us into quartiles and they told us that this is the most they can get away with in terms of being "unranked."". I mean that sentence there tells me that your school isn't true pass/fail for preclinical years, especially since it doesn't make sense for schools to focus on being unranked for clinical years.

OP did not specifically mention that they were asking about preclinical years. In fact, I'm sure you didn't do this on purpose or anything, but you didn't even specify in your posts that you were talking about only preclinical years until now, unless I'm missing something.

I mean I thought it's common knowledge that all schools factor in clinical grades into the MSPEs and that's where the ranking takes place. Everyone agrees that clinical grades are important for residency even if they are subjective. When people discuss pass/fail vs graded, the discussion pertains to preclinical grading because people don't want to stress out during their preclinical years focusing on class exams when they can spend their time more productively by doing research or volunteering or social activities etc.

But clarification always helps and it's good we got it cleared up.

And most premeds don't mention/realize that M3/M4 might be different when I see these types of posts. As an applicant, I certainly didn't realize that no matter what I would be ranked/competing for grades for at least half of med school. I just think it's important to be honest with pre-meds insofar as there is no such thing as an unranked, true pass-fail system for all 4 years of medical school.

I agree.

I agree that ranked pass/fail systems are dumb. I don't think we're actually in disagreement about anything here. I'm just pointing out to OP and others in this thread that every single school ranks their students at one point or another, and you will be competing with your classmates regardless in the clinical years when it really counts. I'm not sure why you seem to be in opposition to me stating that truth.

My only opposition in this thread is with schools' preclinical curricula. I don't disagree with clinical grades and competing with classmates to get more honors in clinical years, since I think these are very important data for residency directors to take note. However, preclinical grades are very low in importance, so it's annoying to me when schools worsen the stress by adding ranked pass/fail or graded systems rather than just having unranked pass/fail for preclinical years.

Medical school is undoubtedly stressful, so wouldn't it help everyone if they can just focus the stress on the last two years where they most matter? And that's why having unranked pass/fail for preclinical years helps a lot, even if there is a drawback of placing higher weight on subjective clinical grades for AOA/ranking/MSPE purposes.
 
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AnatomyGrey12

Using pass/fail scales how do schools rank students if there are no letter grades assigned with GPA values?

Because ranking isn't based on GPA, its simply based on total overall points and percentages. For example, two students can both have 3.0 GPAs but one could be ranked a lot higher because they consistently got 89%s on everything and the other sat at 80% the whole semester
 

efle

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Lol lawper the yale system describes preclinical years pretty sure. Can't have optional attendance clinical rotations or optional shelf exams
 

Lawpy

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Yeah, I guess for me and my friends, that was not common knowledge, so that's where I'm coming from here. And a lot of the applicants I talk about this with seem surprised.

Well it's good we agree then. I don't know of any school that doesn't grade or rank clinical years. IIRC I read in an NRMP report that clinical grades are highly important, so grades/ranks are justified. The sad part is grades can be subjective... but so is everything in residency/fellowship/job etc.

Lol lawper the yale system describes preclinical years pretty sure. Can't have optional attendance clinical rotations or optional shelf exams

Ok that's what I thought but wasn't sure. Eliminating grades for clinical years doesn't really make much sense imo.
 
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Because ranking isn't based on GPA, its simply based on total overall points and percentages. For example, two students can both have 3.0 GPAs but one could be ranked a lot higher because they consistently got 89%s on everything and the other sat at 80% the whole semester

Very true. A point that sometimes gets lost in this discussion is the fact that just because a school doesn't compile a formal rank of its students doesn't mean that it does not have copious amounts of performance data. The question comes down to what the school decides to do with it all.

Also, there ranking and then there is ranking. The old school method was a linear scale with every student numbered. Now it's more common to see quartiles or quintiles, which allows some camouflage for lower performing students. You can argue that both are ranking systems, although I believe there are substantial difference between the two approaches.

If you go to a AAMC meeting, standardizing the MSPE is one of the top two dead, beaten horses (#1 is a cap on residency applications). With the release of the MSPE Task Force's report last year it will be interesting to see how much uptake occurs in the next few years.

With regard to the "comparative information" included in MSPE's, a lot of it involves histograms of grade distributions to provide some context for a given student's marks. An Honors means a lot more if it's earned by 10% of the class versus 50%. Conversely, a Pass isn't so damning if that grade is given to 80% of the class.
 
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Lawpy

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Very true. A point that sometimes gets lost in this discussion is the fact that just because a school doesn't compile a formal rank of its students doesn't mean that it does not have copious amounts of performance data. The question comes down to what the school decides to do with it all.

Also, there ranking and then there is ranking. The old school method was a linear scale with every student numbered. Now it's more common to see quartiles or quintiles, which allows some camouflage for lower performing students. You can argue that both are ranking systems, although I believe there are substantial difference between the two approaches.

If you go to a AAMC meeting, standardizing the MSPE is one of the top two dead, beaten horses (#1 is a cap on residency applications). With the release of the MSPE Task Force's report last year it will be interesting to see how much uptake occurs in the next few years.

With regard to the "comparative information" included in MSPE's, a lot of it involves histograms of grade distributions to provide some context for a given student's marks. An Honors means a lot more if it's earned by 10% of the class versus 50%. Conversely, a Pass isn't so damning if that grade is given to 80% of the class.

I'm pretty sure as long as each school continues to follow its own curriculum and has its own grading criteria, MSPEs won't be standardized anytime soon.

I always propose the strategy of making preclinical years of every school unranked pass/fail and then proceed to standardize clinical grading. But as long as some schools refuse to accept unranked pass/fail preclinical curricula for AOA purposes (which other schools don't have nor care), the MSPEs will continue to be unstandardized and difficult to interpret.
 
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deleted421268

Do residency programs care if one attends a P/F or letter grade med school? I'm guessing they don't put too much value into that
 
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I'm pretty sure as long as each school continues to follow its own curriculum and has its own grading criteria, MSPEs won't be standardized anytime soon.

I always propose the strategy of making preclinical years of every school unranked pass/fail and then proceed to standardize clinical grading. But as long as some schools refuse to accept unranked pass/fail preclinical curricula for AOA purposes (which other schools don't have nor care), the MSPEs will continue to be unstandardized and difficult to interpret.

The recommendations of the MSPE Task Force are relatively adaptable:
  • Highlight the six ACGME Core Competencies when possible.
  • Include details on professionalism—both deficient and exemplary performance.
  • Replace “Unique Characteristics” with “Noteworthy Characteristics.”
  • Limit “Noteworthy Characteristics” to three bulleted items that highlight an applicant's salient experiences and attributes.
  • Locate comparative data in the body of the MSPE.
  • Include information on how final grades and comparative data are derived (i.e., grading schemes).
  • Provide school-wide comparisons if using the final “adjective” or “overall rating and define terms used.
  • Limit the MSPE to 7 single-spaced pages in 12-point font.
  • Include six sections: Identifying Information, Noteworthy Characteristics, Academic History, Academic Progress, Summary, and Medical School Information. Please see the MSPE Recommendations for more detailed guidance on content in each section.
The main barrier to a more uniform approach isn't the variety of curricula or grading criteria, it's inertia. That, and the general reluctance of Student Affairs Deans to expose the blemishes of their bottom students.

AOA can get the data it needs even if the school doesn't create a formal rank.
 
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Perfect Hair Day

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University of Miami has an unusual policy. The grading is reported as Pass/Fail, but there are numerical grades that do get reported on the transcript - pretty stressful. Making things even more complicated, is a block may have several different courses within it, but all are reported under one block - for example: "Host Defense, Pathogens and Pathology" is the course reported on the transcript, but it is comprised of three separate courses - Microbiology, Immunology, and Pathology. Micro and Immuno are each worth 40%, and then Patho is worth 20%. Oddly, if one were to score 100% on Micro and Immuno and get 50% on Path (for a total score of 90%), their grade would be reported as "90 - Fail", because of the failure in the Pathology component. It makes absolutely no sense.

The moral of the story here is, when you attend your interviews if grading scale is this important to you - ask them to specify if numerical/letter grades are reported on your transcript, or if it just reports Pass/Fail.
 

21Rush12

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Out of curiosity...do any of the students here actually feel non-P/F grading causing some kind of pressure or competition IRL?
 
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deleted421268

The moral of the story here is, when you attend your interviews if grading scale is this important to you - ask them to specify if numerical/letter grades are reported on your transcript, or if it just reports Pass/Fail.

Like when I am doing an interview assuming I get an interview I should ask interviewer that question?
 
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Out of curiosity...do any of the students here actually feel non-P/F grading causing some kind of pressure or competition IRL?

There are a number of ways to mix-and-match different grading/reporting elements:

Grading system:
Graded with bottom ~5% always failing
Graded with everyone capable of passing
Pass/Fail
One grading system for entire curriculum
Different grading systems throughout curriculum

MSPE:
No comparative data or rank/partition (programs will only get USMLE scores)
Comparative data but no rank/partition
Comparative data with partition (e.g. quartile, quintile, etc.)
Comparative data and rank (i.e. X out of Y students)

Also consider that each school has a unique culture, and each class has a unique character. There is evidence to support the idea that P/F grading improves student well being (review here), but this has to be counterbalanced by the fact that not assigning grades gives residency programs less information to make decisions.
 
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Oddly, if one were to score 100% on Micro and Immuno and get 50% on Path (for a total score of 90%), their grade would be reported as "90 - Fail", because of the failure in the Pathology component. It makes absolutely no sense.

Having to pass each defined element in an integrated curriculum makes perfect sense. Especially when you see how much pathology is on Step 1.
 
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Perfect Hair Day

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Having to pass each defined element in an integrated curriculum makes perfect sense. Especially when you see how much pathology is on Step 1.

I don't disagree - but it appears very peculiar that a transcript might indicate a student earned a 90 but still failed the course, an ambiguity that could be remedied with choosing either P/F or Numerical grade reporting on the transcript.
 
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I don't disagree - but it appears very peculiar that a transcript might indicate a student earned a 90 but still failed the course, an ambiguity that could be remedied with choosing either P/F or Numerical grade reporting on the transcript.

What does the transcript show after successful remediation?
 

Perfect Hair Day

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What does the transcript show after successful remediation?

I am unsure because I haven't personally encountered such a predicament. It was something I noted during my second year when I learned about the grading for that course.
 

Welshman

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Also consider that each school has a unique culture, and each class has a unique character. There is evidence to support the idea that P/F grading improves student well being (review here), but this has to be counterbalanced by the fact that not assigning grades gives residency programs less information to make decisions.

I was under the impression that pre-clinical grades were largely ignored when applying for residency as step 1 takes priority. So in effect, unless you have a strong internal desire to be at the top of your class and "know everything" then it doesn't matter what you get pre-clinical as long as you pass. Essentially a graded system is effectively the same as P/F if one treats it that way...

At least this was what one school and its students tried to push at their interview, Is this accurate?
 
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