MS-1/MS-2: Is P/F really different from H/P/F ?

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CaliSurferDoc

CaliSurferDoc

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At medical schools that have a H/P/F grading system during their pre-clinical years, is this really that different than schools with strictly a P/F system?

If so, does not "honoring" most of your pre-clinical classes adversely affect your opportunities at more competitive specialities?

Any insights?
 
It completely depends on the school. Some only allow 10% to get honors, thus making it more competitive (ie. cut-throat) then other schools that allow all scoring over a 90% getting honors (even if the entire class does). Furthermore, many schools have class rank dependent on your %%; thus the 94% person is ranked higher then the 92%.

For residency, pre-clinical grades are further down the list, however, they are still there. Also, if you do well in classes, you'll probably do well on the boards. Other items, such as AOA, school awards, ect may be dependent on class rank, gpa, step 1, ect. Thus, it is always in your best interest to do your best. It's too easy for residency programs to compare ##'s vs applicants. Applicant A is top 10%, while applicant B is bottom 50%, ect.
 
I am a third year student at a top ten Ivy League med school. We are pass/fail our first two years. The students at my school embrace this. We work hard and focus on preparation for Step One but we do not feel competitive with one another. We know that our Step One scores and our performance in our third year rotations will have a huge influence on our residency opportunities. But we are not in a cutthroat situation with each other, and we like it that way.
 
ChiDO said:
Furthermore, many schools have class rank dependent on your %%; thus the 94% person is ranked higher then the 92%.
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I think this is very, very important to remember. I mean, what the hell good is P/F if they're going to rank you anyways??? The school I'm currently planning on attending is P/F and completely unranked the first two years. Third year clinical rotation grades will be very important to residency though.
 
CaliSurferDoc said:
At medical schools that have a H/P/F grading system during their pre-clinical years, is this really that different than schools with strictly a P/F system?

If so, does not "honoring" most of your pre-clinical classes adversely affect your opportunities at more competitive specialities?

Any insights?
Click to expand...

Well the thing about grades is dependent on what residency you want. If you come in knowing that you want to do IM instead of plastics then you can get by with not honoring all your classes. If you want to do a more competitive residency than you're going to want try to honor all you classes. However, it's important to keep in mind preclinical grades aren't really looked at that significantly whereas your STEP1 scores, clinical evals/grades, research/publications, recs, ECs/leadership are going to carry far more weight.

At the end of the day you want to try your best but to keep in mind you are still going to graduate a doctor from an american school and that's something a good chunk of applicants never get to see. Perspective, perspective, perspective.

You also need to realize that medicine is becoming more of a team effort and being cutthroat is sooo premed. YOu gotta be able to learn and work with other people. Looking out for yourself is gonna get you in trouble in the wards when a patient starts circling the drain with something you can't figure out.
 
Class rank is more important. At our school we do:

Honors: 90% and above. 3.0 Grade pts
Near Honors: 85%-89.9% 2.0
Satisfactory: 70%-84.9% 1.0

Sucks that getting a 71 and an 84 are the same. A true PF would be nice, it's all the same. Residencies have no way to compare all the different grading systems other than to place a lot of emphasis on class rank.
 
CRB said:
Class rank is more important. At our school we do:

Honors: 90% and above. 3.0 Grade pts
Near Honors: 85%-89.9% 2.0
Satisfactory: 70%-84.9% 1.0

Sucks that getting a 71 and an 84 are the same. A true PF would be nice, it's all the same. Residencies have no way to compare all the different grading systems other than to place a lot of emphasis on class rank.
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Do schools publish information about their ranking system (if it exists)?

Thanks for all the responses everyone 👍
 
This is a great thread and something I'm really thinking hard about as I pick a medical school... Are most schools ranked unless they specifically say they are not?
 
most schools rank you anyway whether they openly say it or not (results not made public obviously) so it doesn't really matter. And honestly, I see nothing wrong with ranking in a non-disclosed fashion. If you're working hard and doing well, you want your ranking to reflect that. I believe that more than anything else, unhealthy competition is a school thing not directly related to P/F or P/F/H systems. Just ask the students when you visit schools, see how happy they are, see if they share study aids, charts, and so on and go with your gut feeling.
 
I go to a true P/F unranked school, and I am extremely happy with it. I, like most former pre-meds, am not satisfied with grades which are merely passing. Indeed, I have found myself stressing over not hitting 90% on an exam a couple of times. I can't imagine how much more stressed I would be if I knew that there was an actual bar that I'd missed (honors), as opposed to a self-imposed bar. Your personal goals for yourself will likely be the same regardless of which school you go to. However, the standards imposed on you by outside sources will change depending on the grading system you find yourself in.
 
CRB said:
Class rank is more important. At our school we do:

Honors: 90% and above. 3.0 Grade pts
Near Honors: 85%-89.9% 2.0
Satisfactory: 70%-84.9% 1.0

Sucks that getting a 71 and an 84 are the same. A true PF would be nice, it's all the same. Residencies have no way to compare all the different grading systems other than to place a lot of emphasis on class rank.
Click to expand...

they may give you the same "grade," however, your class rank will reflect that difference. For example, I believe in most dean letters, your class %% is given and the average. Thus, they'll be able to see that Jimmy got a C with a score of 84%, while Tommy got a C and scored a 72%.

I believe the only school that I heard that has no class rank and strictly P/F is stanford. I also think Cleveland Clinic school has some weird stuff, like no grades, no class rank, but give a "portfolio" to residency applications....sounds like a disadvantage to me if you are a hard working student.

The best grading system with the least amount of stress is probably Stanford. The next best would probably be one that has a strict 90/80/70 cutoff; thus you get the grade you earn and it's not dependent on the rest of your class, which in turn, probably creates a friendlier learning environment.

Any school with a only xx% gets A/Honors is probably severely cut-throat.
 
I'm willing to bet that most, if not all, schools will rank you, regardless of whether or not they admit it. After all, they have to keep track of rank in some way for AOA recommendations.
 
I have seen schools with a H/P/F tier system, yet anyone (not just top 10%) will recieve honors with a 90% in the course. Also, some schools ranks individuals in 1/3rds (top third, middle third, lower third).

These seems to prevent competition and "cut-throat" spirits.
 
plauto said:
most schools rank you anyway whether they openly say it or not (results not made public obviously) so it doesn't really matter. And honestly, I see nothing wrong with ranking in a non-disclosed fashion. If you're working hard and doing well, you want your ranking to reflect that. I believe that more than anything else, unhealthy competition is a school thing not directly related to P/F or P/F/H systems. Just ask the students when you visit schools, see how happy they are, see if they share study aids, charts, and so on and go with your gut feeling.
Click to expand...


At an interview I was told that all school are required to provide rankings by the end of your third year. Not all schools disclose their rankings though.
 
mvenus929 said:
I'm willing to bet that most, if not all, schools will rank you, regardless of whether or not they admit it. After all, they have to keep track of rank in some way for AOA recommendations.
Click to expand...

Not all schools have AOA, though, and at some schools with P/F pre-clinical years, AOA is based on clinical grades. I'd imagine that there would be less stress over pre-clinical grades at these schools

Then again, if the argument is that they do something and just don't admit to it, it's sort of hard to prove either way.
 
I go to a H/HP/P school. Honestly, if your goal is to pass, treat it P/F. It will NOT hurt you to just pass your classes. I mean if you're gunning for derm, maybe it will, but not much. There are several studies that show that residency directors place pre-clinical grades ~10th on a list of ~13 factors. It really doesn't matter.
 
P/f During Pre-Clinical years is the way to go. Your preclinical grades are just a few sentences on your Deans letter

P/F/H during clinical years makes things a bit stressful, but I think it is important for schools to be able to evaluate you.

Really all your "grades" from medical school come from just your 3rd year.
 
Disinence2 said:
P/f During Pre-Clinical years is the way to go. Your preclinical grades are just a few sentences on your Deans letter

P/F/H during clinical years makes things a bit stressful, but I think it is important for schools to be able to evaluate you.

Really all your "grades" from medical school come from just your 3rd year.
Click to expand...

That just depends how your school does AOA... if you care about that. I'd rather have ABCD than P/F/H, personally. Our school does ABCD for 2nd year and 3rd year, I rather like the system.
 
A lot of people think that preclinical grades do no matter. sure, they're not one of the top things looked at for residency application. However, they are used by many schools for AOA and class rank (both very important for competitive residencies). In my school, clinical grades count twice as much as preclinical ones. So, if you honor many classes during year one and two, it gives you a substantial bump on class ranking/AOA.
 
Another thing you want to consider is "diminishing returns".

You have to be honest with yourself and realize how long it takes you to get through the material and pass, and how long it would take you to know the material well enough to H. This is dependent on your study skills, ability to memorize random stuff, how difficult the subject/professor is, etc. We're strictly P/F and not curved our first year. Next year, we add Honors. I hear from the upperclassmen that the people who get H second year are the same people who were doing obscenely well first year, so it's not really a matter of "extra motivation"- they're just really good studiers who study hard enough for a 90 regardless of the stakes.
I know a number of people in my class who have an eidetic (photographic) memory for whom the difference between an 80 and a 90 is just another read through the material (maybe a few more hours of work). Those are generally the people who are the biggest proponents of "getting Honors matters" and "you're learning this for your patients, not for your grades". On the other hand, I know that if I wanted to go from an 80 to a 90 in certain subjects, I'd have to basically double or triple my studying, forgoing extracurriculars and things that keep me sane. I'm just not willing to do that for a vague possibility of getting AOA which may or may not matter 4 years down the road.

And finally, even if you are willing to put in the extra effort to go from a P to an H, be mindful of the fact that while preclinical grades are way low on the list of things residencies care about, research experience is far higher for certain residencies. Taking up all the time you could be spending being a leader on campus, making contacts that will help you 4 years down the road, and doing research which might lead to getting published just to get a 95 better be worth it.

As far as I'm concerned, I feel that there must be a reason why most schools, especially those that are "high-ranked" are moving toward a P/F system. It clearly must not be a bad thing.
 
I think one think a lot of people forget, is you always find comments oh pre-clinical grades don't matter, just ace step 1, and ace your rotations. Well, I think everything goes hand in hand. It's not like the person who gets 75% on every test, is going to just wake up one day and get a 270 USMLE and Honors on all his rotations.

More then not, the people who are getting honors in pre-clinical are the same ones who will score high on the USMLE and get honors in rotations. There are a few who perform better clinically or pre-clinically, but don't expect to go from being a C student to a straight A student without extra work.

Everything goes hand in hand in medical school. Getting good grades in M1 and developing that work ethic will most likely lead to a good USMLE, AOA, class rank, ect. Thus, like I stated previously, everything counts and anything that you can do to give yourself an advantage over other applicants for residency is in your best interest.
 
ButImLETired said:
I know a number of people in my class who have an eidetic (photographic) memory
Click to expand...

Do you have any idea how rare a "real" photographic memory is? Just b/c your classmates have a "good" memory or claim that they have a photographic memory (which wouldn't surprise me, I've known a few gunners that do this), doesn't mean that they actually have it
 
ButImLETired said:
Another thing you want to consider is "diminishing returns".

On the other hand, I know that if I wanted to go from an 80 to a 90 in certain subjects, I'd have to basically double or triple my studying, forgoing extracurriculars and things that keep me sane. I'm just not willing to do that for a vague possibility of getting AOA which may or may not matter 4 years down the road.

And finally, even if you are willing to put in the extra effort to go from a P to an H, be mindful of the fact that while preclinical grades are way low on the list of things residencies care about, research experience is far higher for certain residencies. Taking up all the time you could be spending being a leader on campus, making contacts that will help you 4 years down the road, and doing research which might lead to getting published just to get a 95 better be worth it.
Click to expand...

Excellent point.

Does anyone know if residency advisors take into consideration any research done during undergraduate years or the summer before medical school?
 
This thread is informative.


I am in the position of choosing between schools that 1) are expensive with P/F or 2) are cheap with HH,H,HP,P,F etc.

Interesting to read this.
 
ThaliaNox said:
I go to a true P/F unranked school, and I am extremely happy with it. I, like most former pre-meds, am not satisfied with grades which are merely passing. Indeed, I have found myself stressing over not hitting 90% on an exam a couple of times. I can't imagine how much more stressed I would be if I knew that there was an actual bar that I'd missed (honors), as opposed to a self-imposed bar. Your personal goals for yourself will likely be the same regardless of which school you go to. However, the standards imposed on you by outside sources will change depending on the grading system you find yourself in.
Click to expand...

In that case, I assume AOA is determined on the sole basis of 3rd year clinical grades? I wonder how many other schools are true P/F?
 
searun said:
I am a third year student at a top ten Ivy League med school. We are pass/fail our first two years. The students at my school embrace this. We work hard and focus on preparation for Step One but we do not feel competitive with one another. We know that our Step One scores and our performance in our third year rotations will have a huge influence on our residency opportunities. But we are not in a cutthroat situation with each other, and we like it that way.
Click to expand...

This is the smartest way to do things. The first two years are not geared towards step 1 as much as they are towards learning what the profs think you should know. By making it pass/fail the first two years, you are free to study out of text-books and review books throughout the years instead of memorizing powerpoints.
 
ChiDO said:
I think one think a lot of people forget, is you always find comments oh pre-clinical grades don't matter, just ace step 1, and ace your rotations. Well, I think everything goes hand in hand. It's not like the person who gets 75% on every test, is going to just wake up one day and get a 270 USMLE and Honors on all his rotations.

More then not, the people who are getting honors in pre-clinical are the same ones who will score high on the USMLE and get honors in rotations. There are a few who perform better clinically or pre-clinically, but don't expect to go from being a C student to a straight A student without extra work.

Everything goes hand in hand in medical school. Getting good grades in M1 and developing that work ethic will most likely lead to a good USMLE, AOA, class rank, ect. Thus, like I stated previously, everything counts and anything that you can do to give yourself an advantage over other applicants for residency is in your best interest.
Click to expand...


ChiDO you really want to keep perpetuating your view on this (you have like 2 threads in the Allo on this).

I would again argue, that your view is short sighted. That those with good preclinical grades = great Step I. Why? Cause much of what I learn for class is either to much or to little for Step I. Therefore, in a P/F environment, I can focus my study on First Aid and more relevant sources (rather than the lecture notes my course director wants me to memorize). So, while some of my classesmates may score a 95 on an exam and I only score an 85, I would argue there is a good chance that my Step I score will be higher. The advantage of P/F is that you can do that, and not have it "look bad" that you did not honor all your 1-2nd year courses.
 
ChiDO said:
I think one think a lot of people forget, is you always find comments oh pre-clinical grades don't matter, just ace step 1, and ace your rotations. Well, I think everything goes hand in hand. It's not like the person who gets 75% on every test, is going to just wake up one day and get a 270 USMLE and Honors on all his rotations.

More then not, the people who are getting honors in pre-clinical are the same ones who will score high on the USMLE and get honors in rotations. There are a few who perform better clinically or pre-clinically, but don't expect to go from being a C student to a straight A student without extra work.

Everything goes hand in hand in medical school. Getting good grades in M1 and developing that work ethic will most likely lead to a good USMLE, AOA, class rank, ect. Thus, like I stated previously, everything counts and anything that you can do to give yourself an advantage over other applicants for residency is in your best interest.
Click to expand...

FutureDoc4 said:
ChiDO you really want to keep perpetuating your view on this (you have like 2 threads in the Allo on this).

I would again argue, that your view is short sighted. That those with good preclinical grades = great Step I. Why? Cause much of what I learn for class is either to much or to little for Step I. Therefore, in a P/F environment, I can focus my study on First Aid and more relevant sources (rather than the lecture notes my course director wants me to memorize). So, while some of my classesmates may score a 95 on an exam and I only score an 85, I would argue there is a good chance that my Step I score will be higher. The advantage of P/F is that you can do that, and not have it "look bad" that you did not honor all your 1-2nd year courses.
Click to expand...

I happen to agree with ChiDO. If your school is doing what it should, the curriculum will reflect what's important for the boards. It's in their best interest to have people nail the boards.

I recently took the NBME basic science exam and killed it. Not because I crammed for it insanely before I took it, but because the curriculum over the first half of medical school prepared me for it. I never studied First Aid until a couple of days before the test, and at that point I solely used it as a comprehensive way to review. At my school, honoring does equal killing Step I.

I personally think P/F with internal ranking really isn't any different than H/HP/P/MP/F. It just lulls you into thinking that it is and allows you to get lazy. I liked having the motivation to study that extra bit, and I feel like I'm reaping the rewards now because I've retained a lot of it. Regardless, you're still expected to know everything that they taught you in basic sciences when you get to the wards. It's to your advantage to learn everything you can now.
 
Last edited:
ChiDO said:
I think one think a lot of people forget, is you always find comments oh pre-clinical grades don't matter, just ace step 1, and ace your rotations. Well, I think everything goes hand in hand. It's not like the person who gets 75% on every test, is going to just wake up one day and get a 270 USMLE and Honors on all his rotations.

More then not, the people who are getting honors in pre-clinical are the same ones who will score high on the USMLE and get honors in rotations. There are a few who perform better clinically or pre-clinically, but don't expect to go from being a C student to a straight A student without extra work.

Everything goes hand in hand in medical school. Getting good grades in M1 and developing that work ethic will most likely lead to a good USMLE, AOA, class rank, ect. Thus, like I stated previously, everything counts and anything that you can do to give yourself an advantage over other applicants for residency is in your best interest.
Click to expand...

I agree as well. Everything is step by step, IMO.
 
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