P/F vs grades

[OrthoRehab33]

Can any current students tell me how these grading systems are different? Well, I mean I know how they are different but I consistently hear, "oh thank god my school is p/f and not graded". Does having graded scales really make that much of a difference as being less stressful?

---

Members don't see this ad.

 

[scoKraz4]

My school has A/B/C/F grading and it isn't too bad. I would think p/f would be less stressful but if it is graded on a curve it can still be a little stressful..it is going to be stressful no matter what so I wouldn't worry to much! You will get plenty of stress!

Overall, pre-clinical grades are not worth worrying too much about. When applying to residency, it is pretty low on the list of things they consider on applications.

 

[FrkyBgStok]

The biggest problem with grades is that it turns an already competitive process into a more competitive one. In addition, people get so caught up on grades that they lose focus on what is important. Not only do you take time away from yourself, but clinicians come and present (and test on) crap like proper selection of ventilators, the history of neurosurgery, the evolution of the naming of leukemia, crap like that, and you realize that you are spending time studying the wrong stuff (or at least the wrong stuff for boards). This isn't always the case, but halfway through second year I have seen numerous clinicians say variations of "these are the same slides i use for residents, so just do your best."

 

[Mr Kenobi]

I wish my school did a straight P/F system. The competitive atmosphere is palpable when it come to grades...
Studies have shown that P/F decreases a lot of this anxiety and stress while promoting a more cooperative class atmosphere, all while showing no decline in performance by students.
http://www.ncbi.nlm.nih.gov/m/pubmed/19704204/?i=3&from=/21848714/related
http://www.ncbi.nlm.nih.gov/m/pubmed/17120399/?i=5&from=/21848714/related
http://www.ncbi.nlm.nih.gov/m/pubmed/7718068/

 

[touchpause13]

At the end of the day how much does A/B/C matter? As long as you are passing and do well on the COMLEX, does it really matter?

 

[NeuroLAX]

Just out of curiosity, does anybody else have numerical grades (%) instead of letter grades (A/B/C/etc)? This is the first time I've had numerical grades without letters. We have P/F for the minor non-science courses, and numerical grades for the rest.

 

[notbobtrustme]

We are the final class to have grades and our Dean flat-out told us that pre-clinical grades and residency match have almost nothing to do with each other.

 

[FrkyBgStok]

No preclinical grades don't really matter, but that doesn't change the competitiveness. Everyone is like a smoker. They know there is no reason to freak out when they don't get As on everything, but everyone does anyway.

 

[FutureDO2016]

Everyone says preclinical grades don't matter, but in some ways they do...For example, some programs look at class rank which is based on grades...It's not as important as board scores or clinical rotation performance, but it's not like the student with straight C's is going to be chosen over the straight A individual....

Unfortunately, my school is a numerical grading system with no letter grades but 70-100 grading scale...I wish we were pass/fail because then it wouldn't feel like my grades are already low and I'm already at a disadvantage going into 3rd year...

 

[nardini46]

My school does A B C grading. It didn't effect me that much. I still studied hard in school and it worked out for boards.

 

[Mr Kenobi]

At the end of the day how much does A/B/C matter? As long as you are passing and do well on the COMLEX, does it really matter?

No, it doesn't. It is so hard for medical students to swallow this pill though. So very, very hard. Dat type A personality doe. Even when clinical faculty and visiting residency program directors have straight told people in my class, "just pass your classes"...the gunning continue. I mean don't get me wrong. Everyone should attempt to do there best or whatever, but having a % based grading scale allows people to judge other students and causes a lot of uneccessary unprofessionalism among peers. People end up feeling bad about themselves or feel stupid because the people who are vocal about grades are usually the people who say they get top scores. It's pretty sad.

Also, someone's post above brought up class rank. It was my understanding that 3rd years clinical grades hold much more weight factoring into class rank. Both class rank and preclinical grades are not nearly as important as boards and audition rotations. Think of preclinical grades as kind of like that 1 EC you had on your med school app where you handed out soup to homeless folks for A few hours--it was a nice addition to your app, but it probably held close to zero weight on the decision to admit you. Its been said to me by [a few] program PDs that audition rotations are actually THE most important piece of the residency game!

Either way...the point is, try hard. Try to learn the material for rention. But if you are pulling Cs don't feel bad about it, because for the most part, it really does not matter. If anything it's just a good self indicator for weak spots you might want to put extra effort into when prepping for boards.

 

[notbobtrustme]

Everyone says preclinical grades don't matter, but in some ways they do...For example, some programs look at class rank which is based on grades...It's not as important as board scores or clinical rotation performance, but it's not like the student with straight C's is going to be chosen over the straight A individual....

Unfortunately, my school is a numerical grading system with no letter grades but 70-100 grading scale...I wish we were pass/fail because then it wouldn't feel like my grades are already low and I'm already at a disadvantage going into 3rd year...

class rank is the most important of all the things that don't matter. Class rank doesn't make up for board scores nor LORs. They are a part, but not the entire story, of your clinical grades, which DO matter.

 

[FutureDO2016]

So if your ranked in the bottom 25% of the class and your preclinical grades are mostly C's and you end up scoring well on boards and doing well on clinical rotations, you can still apply to competitive specialties??

 

[FrkyBgStok]

So if your ranked in the bottom 25% of the class and your preclinical grades are mostly C's and you end up scoring well on boards and doing well on clinical rotations, you can still apply to competitive specialties??

yes. especially if you do well in your clinical years. that being said, you may be out of the running for a few, but doing well on your boards will make up for Bs and Cs. No worries.

 

[SurgeDO]

class rank is the most important of all the things that don't matter. Class rank doesn't make up for board scores nor LORs. They are a part, but not the entire story, of your clinical grades, which DO matter.

agreed.

my school is P/F with a preclinical ranking system. the ease and relaxation that is supposed to come with a P/F system is nearly eliminated when class rank is involved. albeit, the insignificance of class rank is well described by notbobtrustme.

 

[thecgrblue]

If you look at this JAMA article:
http://jama.jamanetwork.com/data/Journals/JAMA/929415/jax130003.pdf

You'll notice that only 13% of MD-granting schools use letter grades in preclinical years.

My school uses letter grades and I think its unnecessary. Students whine about missed points here and there and the focus is totally on the grade you get, not how well you really know it (which, despite what professors say, don't go hand in hand).

 

[hallowmann]

One thing to remember though is that while most MD schools don't have letter grades (A, B, C, F), many do have a tiered grading system (Honors, High Pass, Pass, Fail), which comes out to pretty much the same scale. Its not a straight P/F scale.

Ultimately though, as people are saying, preclinical grades tend to mean very little, provided you pass everything. Clinical grades tend to mean much more both in terms of class rank and in terms how programs evaluate you. Again, though, they are still low on the list for what programs look at.

Aim for doing your best, first to pass, then to retain/understand the material. Beyond that, don't kill yourself.

Unfortunately, my school limits your rotation options if you get below a 2.5, and if you get below a 3.0, you have to attend a board review course in the final semester and aren't allowed to participate in school clubs. So there are extra goals you need to set for yourself to not be "at risk".

 

[BigSib]

Here is what every osteopathic college does: http://www.aacom.org/data/curriculum/Documents/2012-13-performance-evalmethods.pdf

 

[group_theory]

class rank is the most important of all the things that don't matter. Class rank doesn't make up for board scores nor LORs. They are a part, but not the entire story, of your clinical grades, which DO matter.

I look at overall class rank (or where the applicant fall within his/her class). It's a good overview of how the applicant did in both pre-clinical and clinical years (ERAS is time consuming when reviewing materials, and many school transcripts are multi-pages long (and not all standardize) so a quick view at class rank is generally a good summary of how the applicant did in med school.) Class rank to me are more important than LORs.

Most people have good LORs. A semi-OK LOR will hurt you (because why is your LOR semi-OK when everyone else is glowing). Otherwise, I just make sure the LOR doesn't raise any red flag, is from a clinical faculty at an academic institution, and ideally from faculty where students were SubIs/AIs.

And even if the school doesn't give out letter grades (but only use P/F), a lot of schools still have "hidden" numerical grades that they use to compute class rank. That's something that I've noticed after reviewing many ERAS.

So if your ranked in the bottom 25% of the class and your preclinical grades are mostly C's and you end up scoring well on boards and doing well on clinical rotations, you can still apply to competitive specialties??

You probably won't be invited to interview at my residency program. And if you do get invited to interview, probably won't be in the top 50% of the rank list, unless you made such an impression (ie audition rotation that impressed faculty and residents) that we bump you higher than where you would normally sit on our rank list. Remember when you are applying for residency, you are competing against other applicants - so you would want to position yourself as best as you can.

One thing to keep in mind - it's hard (and rare) to suddenly do well on USMLE/COMLEX if you struggled through 2 years of medical school with mostly Cs (and are in bottom quartile). If you were to talk to your dean or your academic advisors, they will tell you that there are more examples of people in the bottom quartile of the class who are at risk for failing the boards than people who rock the boards (from the bottom quartile of the class). It's possible, and you'll hear stories of people doing it, but don't underestimate the difficulty in doing well on these board exams.

 

[ilMaestro]

I look at overall class rank (or where the applicant fall within his/her class). It's a good overview of how the applicant did in both pre-clinical and clinical years (ERAS is time consuming when reviewing materials, and many school transcripts are multi-pages long (and not all standardize) so a quick view at class rank is generally a good summary of how the applicant did in med school.) Class rank to me are more important than LORs.

My school determines class rank based on your gpa in the preclinical years.
I can only hope my school issues a disclaimer when they report our class rank.

 

[babdoc]

I've discussed this ad nasuem with my wife, who is in the process of getting a PhD in education. She would argue (and I tend to agree) that, not only is the whole ABCDF grading system is flawed, the concept of using testing to determine grades/ranking is flawed. The purpose of testing should be to guide your own learning, to show yourself where you should put your effort. And, furthermore, testing does not have to be the high stakes type exams that we are used to. There are a lot of ways to evaluate your knowledge. I feel that the emphasis should be placed on meaningful feedback (which goes both ways, between the student and the teacher) rather than class stratification. This, however, would be difficult to do in our entrenched, type-A medical education system.