pass/fail in med school

[luckyducky87]

I've heard about this pass/fail notion in the first two years of med school... I might be missing an important point, but if the majority (if not all) of the class gets a "pass" mark, how does that contribute when you apply for residencies? I mean... if you end up with a "pass" at one school like everyone else versus if you actually earn an "A" which only a few others in your class did? Do residency programs really not care about your classroom grades??

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[OrangeandMaroon]

http://forums.studentdoctor.net/showthread.php?t=781985&highlight=pass+fail

 

[NickNaylor]

...

 

[raltima07]

excellent question!!! Jk, it sucked.

 

[Perrotfish]

excellent question!!! Jk, it sucked.

The pass/fail policy for the first two years is an acknowledgement that residencies don't care about your preclinical grades, other than that you passed on the first try. The way that they actually assess your clinical knowledge is step 1. A P/F policy frees you up to study iinformation that is relevant to either the USMLE or clinical rotations rather than , say, your biochem professors lecuture on his research in signal transduction.

 

[DoctwoB]

Grades first 2 years do matter. They just matter much less than step 1 and clinical grades. Read the featured article on SDN this week. "40% cited honors earned in the basic science grades as important in deciding whom to interview" (this is compared to 70% for step 1).

The vast majority of P/F schools still keep a class rank. This will be conveyed in your deans letter (though often in more of a overly-positive, code like manner than a specific number, like the top 10% are "astounding", top 25% are "great", bottom 25% are "solid"). It is really just a disguised grading system, and residency directors have seen enough applicants to pick out the meaning from the deans letter wording.

People at P/F schools would have you believe that everyone at a graded school is a gunner that slits their classes throats to move from pass to honors. People at graded schools will say that P/F gives you no motivation to study and they'll all bomb step 1. The reality is that neither of those are really true.

 

[slowbutsteady]

I've heard about this pass/fail notion in the first two years of med school... I might be missing an important point, but if the majority (if not all) of the class gets a "pass" mark, how does that contribute when you apply for residencies? I mean... if you end up with a "pass" at one school like everyone else versus if you actually earn an "A" which only a few others in your class did? Do residency programs really not care about your classroom grades??

Residency directors care about your Step I and your clinical year grades, among other things.

 

[patel2]

The pass/fail policy for the first two years is an acknowledgement that residencies don't care about your preclinical grades, other than that you passed on the first try. The way that they actually assess your clinical knowledge is step 1. A P/F policy frees you up to study iinformation that is relevant to either the USMLE or clinical rotations rather than , say, your biochem professors lecuture on his research in signal transduction.

But do they care about your rank/quartile? If every pass/fail school gives a deans letter that either tells your specific rank or area in the class, this leads me to believe your preclinical grades do actually matter, perhaps even significantly (but well after usmle and clinicals) in the more competitive specialties. I wish schools would be more transparent about how they indicate grades on the letter, instead of lying and saying they are unconditionally pass/fail

 

[swamprat]

Before I got to med school I was happy I was at a P/F school.. now realizing I'm pulling high 80s and low 90s in all my classes and passing is a 70..it sucks since I get a P just like Joe Blo with the 72. Honoring is difficult because its usually above a 90 and if you slack on one test u usually F that up.

 

[mvenus929]

Preclinical grades are among the lowest things they look at in assessing someone's residency application. Clerkship grades are really infinitely more important.

P/F honestly takes a lot of stress out of it. We just had a massive exam this past week, and the average was just above 80 (slightly lower than our usual exam scores). A few people failed, but most people passed, getting somewhere between 70 and 85). Honestly, if I was worrying about getting an A in the class, rather than just passing it, I wouldn't have a life. I was already studying a ton the week before the exam; if I had studied more, I probably would have done worse. So P/F makes me feel better because I don't have to worry about feeling like a failure for getting a C (cause let's face it, most med students are used to much higher grades than that) on an exam that basically determines my grade for the course.

 

[Ok2Panic]

But do they care about your rank/quartile? If every pass/fail school gives a deans letter that either tells your specific rank or area in the class, this leads me to believe your preclinical grades do actually matter, perhaps even significantly (but well after usmle and clinicals) in the more competitive specialties. I wish schools would be more transparent about how they indicate grades on the letter, instead of lying and saying they are unconditionally pass/fail

There are schools that are P/F but still use your pre-clinical grades to determine class rank, and then there are schools that are P/F and don't use your pre-clinical grades to determine rank. So, not all P/F is alike. But, still better than non-P/F, imo.

 

[cowme]

But do they care about your rank/quartile? If every pass/fail school gives a deans letter that either tells your specific rank or area in the class, this leads me to believe your preclinical grades do actually matter, perhaps even significantly (but well after usmle and clinicals) in the more competitive specialties. I wish schools would be more transparent about how they indicate grades on the letter, instead of lying and saying they are unconditionally pass/fail

At our school, M1 is P/F and does not count towards class rank unless you fail. It is one sentence of our deans letter
M2 is H/P/F. It is in our deans letter as a list of classes honored (1-6 lines on page)
M3 is eight rotations graded H/HP/P/F. It comprises 6 pages of our deans letter.
So, M1-M2 takes up about 1/4 of a page and M3 takes 5 and 3/4 pages.

Your class rank is determined by 9 grades: the 8 M3 rotations, and 1 averaged M2 year grade. So, no, P/F grades do not count towards class rank or deans letter, but H/P/F does count to some extent (at least at our school).

 

[qwerty89]

The thing that is inconsistent with people from P/F schools though is that they say that they can focus on the STEP 1/Clinicals rather than obscure facts. But if preclinical grades dont matter, why not focus on STEP 1/Clinically relevant information only anyway? You would still get a score which is considered passing.

And most P/F schools still have ranking which is more important than the grade anyway.

So basically grading system in med school doesn't matter for the most part.

 

[gravitywave]

The thing that is inconsistent with people from P/F schools though is that they say that they can focus on the STEP 1/Clinicals rather than obscure facts. But if preclinical grades dont matter, why not focus on STEP 1/Clinically relevant information only anyway? You would still get a score which is considered passing.

And most P/F schools still have ranking which is more important than the grade anyway.

So basically grading system in med school doesn't matter for the most part.

Given the results of the PD surveys, pre-clinical grades don't matter much. 3rd year is another story.

people at (H/)P/F schools have done just as you say, flirting with failure on every exam and then rocking the Step at the end. It's not a bad way to go if you have the balls to plot your own course through all this stuff. Most require more structure.

P/F is done for the sake of the students. most students don't feel as pressured with a P/F system, and thus feel freer to pursue things like ECs, research, and a balanced lifestyle.

 

[lord_jeebus]

The dirty secret of P/F schools, that many students don't learn until they apply to residency, is that they all indicate how your overall med school performance compared to that of your peers in the MSPE (aka "Dean's Letter"). Basically, an "adjective" in the final paragraph of the letter ("_____ is an outstanding/excellent/very good/good/adequate medical student") is the part that residency programs specifically look at.

Although this standing often emphasizes 3rd year clerkship performance, 1st and 2nd year coursework is generally also taken into account, even if the transcript grading reflects only Pass vs Fail.

 

[afob100]

The dirty secret of P/F schools, that many students don't learn until they apply to residency, is that they all indicate how your overall med school performance compared to that of your peers in the MSPE (aka "Dean's Letter"). Basically, an "adjective" in the final paragraph of the letter ("_____ is an outstanding/excellent/very good/good/adequate medical student") is the part that residency programs specifically look at.

Although this standing often emphasizes 3rd year clerkship performance, 1st and 2nd year coursework is generally also taken into account, even if the transcript grading reflects only Pass vs Fail.

I believe this generally varies from school to school, no? I'm not 100% sure, but I believe class rank at UVa is based on clinical grades and nothing from pre-clinical years (which are P/F). But again this varies depending on school.

 

[ucsfstudents]

They look at the USMLE scores and clinical grades.

 

[lord_jeebus]

The dirty secret of P/F schools, that many students don't learn until they apply to residency, is that they all indicate how your overall med school performance compared to that of your peers in the MSPE (aka "Dean's Letter"). Basically, an "adjective" in the final paragraph of the letter ("_____ is an outstanding/excellent/very good/good/adequate medical student") is the part that residency programs specifically look at.

Although this standing often emphasizes 3rd year clerkship performance, 1st and 2nd year coursework is generally also taken into account, even if the transcript grading reflects only Pass vs Fail.

I believe this generally varies from school to school, no? I'm not 100% sure, but I believe class rank at UVa is based on clinical grades and nothing from pre-clinical years (which are P/F). But again this varies depending on school.

Yes, how it is assigned is up to the school.

 

[mdeast]

The dirty secret of P/F schools, that many students don't learn until they apply to residency, is that they all indicate how your overall med school performance compared to that of your peers in the MSPE (aka "Dean's Letter"). Basically, an "adjective" in the final paragraph of the letter ("_____ is an outstanding/excellent/very good/good/adequate medical student") is the part that residency programs specifically look at.

Although this standing often emphasizes 3rd year clerkship performance, 1st and 2nd year coursework is generally also taken into account, even if the transcript grading reflects only Pass vs Fail.

I don't think this is true at every school. Our Deans have access to our clerkship grades, but NOT our specific pre-clin grades. Only the course directors have these....and they use these mainly for internal purposes of making exams more fair and/or in the selection of Teaching Assistants (TAs) for the following years course. So essentially...whatever you do your first two years is more or less valuable in making your Step 1 score better. Residency programs won't find out about them....even from the Dean, because he won't know.

 

[TexasPhysician]

They look at the USMLE scores and clinical grades.

Agreed. Pre-clinical stuff only matters to get a good step score.

 

[lord_jeebus]

I don't think this is true at every school. Our Deans have access to our clerkship grades, but NOT our specific pre-clin grades. Only the course directors have these....and they use these mainly for internal purposes of making exams more fair and/or in the selection of Teaching Assistants (TAs) for the following years course. So essentially...whatever you do your first two years is more or less valuable in making your Step 1 score better. Residency programs won't find out about them....even from the Dean, because he won't know.

Stanford is an exception for a lot of things. Do you guys still have pure +/- grading for clerkships?

 

[BBender716]

Our school has P/F on Step 1 AND Step 2. We don't even compete on a national level. That's how anti-competition we are.