Pass/fail vs Grades--quality of life?

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I've read on sdn that pre-clinical grades mean little when it comes to residency apps, but I'm wondering if people can comment on how the different grading systems affect med student quality of life. Specifically, are the students more competitive with each other at schools with grading than pass/fail. Specifically, I'm thinking of baylor vs. ut southwestern if that helps.

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I've read on sdn that pre-clinical grades mean little when it comes to residency apps, but I'm wondering if people can comment on how the different grading systems affect med student quality of life. Specifically, are the students more competitive with each other at schools with grading than pass/fail. Specifically, I'm thinking of baylor vs. ut southwestern if that helps.

Ooh, I don't think you want me commenting on this thread. :whistle:
 
I've read on sdn that pre-clinical grades mean little when it comes to residency apps, but I'm wondering if people can comment on how the different grading systems affect med student quality of life. Specifically, are the students more competitive with each other at schools with grading than pass/fail. Specifically, I'm thinking of baylor vs. ut southwestern if that helps.

I do think this blog excellently addresses your concerns regarding grading systems in the first 2 years of medical schools, using actual data (which I love that he/she was able to do) http://anastomosed.wordpress.com/2012/12/01/preclinical-passfail/

@chronicidal
 
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Whether or not you are receiving actual grades or not, both schools are ranking you internally for thinks like determining AOA. I would imagine that schools that have grades based on a bell curve might be more competitive, but UTSW grades are based on cutoffs. So if everyone gets above a certain percentage, everyone could potentially get an A. I haven't felt like there is any competition among classmates. Obviously there are people that want to get straight A's, but they never try to bring anyone else down, so I don't see anything wrong with that. The vast majority of people are very willing to help each other. Students may or may not feel more relaxed at a pass/fail school, but that could be a little misleading because, like I said before, they are still ranking you whether you get grades or not.

The actual preclinical grades aren't weighed heavily in terms of residency apps, but AOA membership is typically weighed more heavily. So overall, the grading scheme shouldn't be a deciding factor in your decision. Things to think about would be the curriculum (1.5 vs 2 year preclinicals), affiliated hospitals for 3rd/4th year rotations, cost, city, etc...
 
Whether or not you are receiving actual grades or not, both schools are ranking you internally for thinks like determining AOA. I would imagine that schools that have grades based on a bell curve might be more competitive, but UTSW grades are based on cutoffs. So if everyone gets above a certain percentage, everyone could potentially get an A. I haven't felt like there is any competition among classmates. Obviously there are people that want to get straight A's, but they never try to bring anyone else down, so I don't see anything wrong with that. The vast majority of people are very willing to help each other. Students may or may not feel more relaxed at a pass/fail school, but that could be a little misleading because, like I said before, they are still ranking you whether you get grades or not.

The actual preclinical grades aren't weighed heavily in terms of residency apps, but AOA membership is typically weighed more heavily. So overall, the grading scheme shouldn't be a deciding factor in your decision. Things to think about would be the curriculum (1.5 vs 2 year preclinicals), affiliated hospitals for 3rd/4th year rotations, cost, city, etc...

There's a difference as to whether a school is "true" P/F in the first 2 years or not. UTSW is P/F in the first semester (seriously, who does semesters in medical school?) and is "true" P/F that semester. After that, it's A/B+/B/C/F, which would then obviously contribute to your rank.

Baylor is P/F throughout the first 2 years, but maybe @jturkel can tell us if it is in fact "true" P/F in the first 2 years (like Case Western) or whether they keep your grade of H/HP/SP/MP/F internally for rank and AOA calculation.
 
like stated above, there is no true p/f. all schools internally rank for AOA purposes and overall class standing for that special word on your dean's letter. BCM's first 1.5 yrs are P/F in this way (remember...BCM does 1.5 yrs preclinical and starts clinicals second half of MS2 yr). Say block 5, you've got infectious disease (worth 7 units), neurology (7 units), ethics (3 units), and psych(3 units)....note all units are approimate...i dont remember the examt numbers....and being the good student you are, you went hard at the first two and less so at the latter two getting like a 90%, 90%, 85%, and 75% for each course in that block. good job. those numbers are recorded internally and you can see those numbers. however, when the transcripts are uploaded and sent out to residency programs, they do not see that i got a 75% on psych b/c i hated it/didnt wanna study it etc....they simply see that i got a "P"...a matter of fact, a P for all my preclinical courses. so no one can differentiate between a 99% and a borderline failing grade...they're all pass. now, the transcript DOES show what my clinical grades were....like H in Medicine, HP in surgery, etc. That's how it works here and that's how i think it works most places. when they calculate AOA they use those percents from preclinical (and the weight in units they are worth) as well as the clinical ones (which are worth much more...ie i think our IM is worth 24)...and come up with the to 12-15% being AOA or something

do preclinical grades matter? no not really...except for maybe some minor preparation for clinics and improving your chances for AOA, but residency prgrams dont care. most imprtant things for getting the interview are your step1 score and are you AOA. after that, i'd say it's some combo of your clinical grades and letters of rec. then further down maybe some other random stuff like ECs, leadership...no one really cares much about preclinicals. just dont fail.

there was no prblem with competitiveness in our p/f curriculum. we basically created classwide study guides/notes for everyone to study from...we all pitched in and you just studied as much as you felt necessary/wanted to. so i loved it. i cant comment on a curriculum that is graded since i didnt go to one that had that, but i did consider that when choosing a medical school. is it possible that it could have been the same? yes. do i know for sure? no
 
how can you turn down the candyland of medicine known as TMC?

Both schools have similar facilities including a county hospital, private hospital, solo children's, and VA. MD Anderson is amazing though, but if I'm not mistaken, it's associated with UT Houston and not all BCM students rotate there (although I think it may be an option?).
 
like stated above, there is no true p/f. all schools internally rank for AOA purposes and overall class standing for that special word on your dean's letter. BCM's first 1.5 yrs are P/F in this way (remember...BCM does 1.5 yrs preclinical and starts clinicals second half of MS2 yr). Say block 5, you've got infectious disease (worth 7 units), neurology (7 units), ethics (3 units), and psych(3 units)....note all units are approimate...i dont remember the examt numbers....and being the good student you are, you went hard at the first two and less so at the latter two getting like a 90%, 90%, 85%, and 75% for each course in that block. good job. those numbers are recorded internally and you can see those numbers. however, when the transcripts are uploaded and sent out to residency programs, they do not see that i got a 75% on psych b/c i hated it/didnt wanna study it etc....they simply see that i got a "P"...a matter of fact, a P for all my preclinical courses. so no one can differentiate between a 99% and a borderline failing grade...they're all pass. now, the transcript DOES show what my clinical grades were....like H in Medicine, HP in surgery, etc. That's how it works here and that's how i think it works most places. when they calculate AOA they use those percents from preclinical (and the weight in units they are worth) as well as the clinical ones (which are worth much more...ie i think our IM is worth 24)...and come up with the to 12-15% being AOA or something

do preclinical grades matter? no not really...except for maybe some minor preparation for clinics and improving your chances for AOA, but residency prgrams dont care. most imprtant things for getting the interview are your step1 score and are you AOA. after that, i'd say it's some combo of your clinical grades and letters of rec. then further down maybe some other random stuff like ECs, leadership...no one really cares much about preclinicals. just dont fail.

there was no prblem with competitiveness in our p/f curriculum. we basically created classwide study guides/notes for everyone to study from...we all pitched in and you just studied as much as you felt necessary/wanted to. so i loved it. i cant comment on a curriculum that is graded since i didnt go to one that had that, but i did consider that when choosing a medical school. is it possible that it could have been the same? yes. do i know for sure? no

Just so that the information is out there are some schools that are "true" P/F and do not internally rank in the first 2 years (Case Western is one example I know of, but there are others). Does Baylor internally rank in the fir 2 years by the specific percentile average or whether you fit in the range of H (100-90)/HP(89-80)/SP/MP/F? Seems rather picky if they do the percentile thing.
 
how can you turn down the candyland of medicine known as TMC?

This. After interviewing at great programs for residency all over, I can still easily say there is nothing like the Texas Medical Center....largest med center in the world. Truly epic
 
Both schools have similar facilities including a county hospital, private hospital, solo children's, and VA. MD Anderson is amazing though, but if I'm not mistaken, it's associated with UT Houston and not all BCM students rotate there (although I think it may be an option?).
Ben Taub is crazier than Parkland. Our children's hospital is top 4 or 5, our VA is the second largest govt building in the country and does among the most advanced surgeries/therapies of any VA in the country. St Luke's is old...not much to say except the first successful heart transplant was done there and will soon be replaced by the new Baylor hospital as part of the CHI. Ur not mistaken about me Anderson. We can do some rotations at. Methodist as well.

But tmc is more than the hospitals we rotate at....two medical schools, several nursing schools, pa schools, dental, many more hospitals, TIRR rehab, md Anderson, Menninger....the list goes on. Google a pic of the TMC and read up on how many medical/healthcare/research related buildings there are. It is unparalleled. It creates this incredible intellectual atmosphere that cannot be found elsewhere.
 
Just so that the information is out there are some schools that are "true" P/F and do not internally rank in the first 2 years (Case Western is one example I know of, but there are others). Does Baylor internally rank in the fir 2 years by the specific percentile average or whether you fit in the range of H (100-90)/HP(89-80)/SP/MP/F? Seems rather picky if they do the percentile thing.

I believe it is percentage. Though I would imagine that is how it would have to be elsewhere since elsewhere technically everyone can get the same grade range each block/course....thus there needs to be a greater degree of separation to determine aoa since with the ranges, I'd imagine there would be a lot of "ties"
 
I go to a P/F school with internal rankings and tight grade distributions and people are still neurotic as hell about where they are on the distribution. I can't imagine how bad it would be if there were letter grades. IMO letter grading is a herpaderp idea in general, even worse when applied to a group of people as uptight as medical students.
 
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I believe it is percentage. Though I would imagine that is how it would have to be elsewhere since elsewhere technically everyone can get the same grade range each block/course....thus there needs to be a greater degree of separation to determine aoa since with the ranges, I'd imagine there would be a lot of "ties"

Wow, that's quite a neurotic way to calculate rank (and AOA) based on the specific percentile scored (91 vs. 92) vs. a range (H/HP/P/MP/F). Of course, it's not like everyone can get AOA, anyways. For most other schools, the distribution of H/HP/P/etc. happens to be wide enough based on how class performs, H = 100-90, HP = 89-80, P = 79-70, etc. that ranking down to the percentile isn't necessary.

Baylor just happens to have very high-achieving students, so maybe ranges wouldn't work for Baylor students, bc you'd have more than half the class getting Honors. Of course Baylor has so many other great characteristics that UTSW can't match anyways (IMHO grading A/B+/B/C/F on clinical rotations is just weird).
 
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I go to a P/F school with internal rankings and tight grade distributions and people are still neurotic as hell about where they are on the distribution. I can't imagine how bad it would be if there were letter grades. IMO letter grading is a herpaderp idea in general, even worse when applied to a group of people as uptight as medical students.

I can assure you grades vs. no grades makes no practical difference, and you kind of just proved the point. Some people are always going to worry about their ranking. Being assigned a letter grade doesn't change that. Having P/F (with internal ranking) may be a way to make some students feel better because they see a 'P' instead of a 'B'or a 'C', but does it really change anything? The only true difference is what shows up on the transcript.
 
P/F, grades, golden stars, whatever...none of it is better or less stressful as long as class rankings keep my anal sphincter sympathetics synapsing.

i know we shouldn't care about class rank...but we do.

#gunnin'tillMATCHDAY
 
My school had letter grades all 4 years. I never felt any competitiveness/pressure from anyone but myself. My class was awesome.
 
My school had letter grades all 4 years. I never felt any competitiveness/pressure from anyone but myself. My class was awesome.
😆You have to be kidding. I'm sure actual grades made things a little more stressful.
 
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I go to a P/F school with internal rankings and tight grade distributions and people are still neurotic as hell about where they are on the distribution. I can't imagine how bad it would be if there were letter grades. IMO letter grading is a herpaderp idea in general, even worse when applied to a group of people as uptight as medical students.

That's bc your class isn't "true" P/F bc it still has internal rankings (I'm guessing based on percentiles?). Case and USC-Keck are 2 examples of "true" P/F in the first 2 years.
 
Wow, that's quite a neurotic way to calculate rank (and AOA) based on the specific percentile scored (91 vs. 92) vs. a range (H/HP/P/MP/F). Of course, it's not like everyone can get AOA, anyways. For most other schools, the distribution of H/HP/P/etc. happens to be wide enough based on how class performs, H = 100-90, HP = 89-80, P = 79-70, etc. that ranking down to the percentile isn't necessary.

Baylor just happens to have very high-achieving students, so maybe ranges wouldn't work for Baylor students, bc you'd have more than half the class getting Honors. Of course Baylor has so many other great characteristics that UTSW can't match anyways (IMHO grading A/B+/B/C/F on clinical rotations is just weird).

Again I could be wrong since I'm obviously not in the room determining who gets aoa, but that is what I have been led to believe. I can assure anyone on here that there the competitiveness is here is minimal and the environment is truly collegial and beneficent
 
I'd also like to chime in and say that "true P/F" goes exist, at least for the first two years- my school ranks us for AOA based solely on our grades from 3rd year.
 
Ben Taub is crazier than Parkland. Our children's hospital is top 4 or 5, our VA is the second largest govt building in the country and does among the most advanced surgeries/therapies of any VA in the country. St Luke's is old...not much to say except the first successful heart transplant was done there and will soon be replaced by the new Baylor hospital as part of the CHI. Ur not mistaken about me Anderson. We can do some rotations at. Methodist as well.

But tmc is more than the hospitals we rotate at....two medical schools, several nursing schools, pa schools, dental, many more hospitals, TIRR rehab, md Anderson, Menninger....the list goes on. Google a pic of the TMC and read up on how many medical/healthcare/research related buildings there are. It is unparalleled. It creates this incredible intellectual atmosphere that cannot be found elsewhere.

Person for person though, it seems utsw research is far better. 5 Nobel laureates vs 0, 14 hhmi investigators vs 3.
 
Person for person though, it seems utsw research is far better. 5 Nobel laureates vs 0, 14 hhmi investigators vs 3.
I've had no problems with research. I highly doubt you would do research with one of them anyway.

And not that I care or believe these are accurate, but us news says Baylor is a better research school....every yr. utsw being ranked 26 is not far better than Baylor being ranked 21 for research.....so.....

grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-medical-schools/research-rankings
 
I've read on sdn that pre-clinical grades mean little when it comes to residency apps, but I'm wondering if people can comment on how the different grading systems affect med student quality of life. Specifically, are the students more competitive with each other at schools with grading than pass/fail. Specifically, I'm thinking of baylor vs. ut southwestern if that helps.


I am at a school that is all P/F, and we do not have internal rankings (despite what above posters said, not all schools rank).

It is awesome!!!

The atmosphere is great. The students help each other out, and the feeling among the administration is that they really want everyone to pass. That being said, several students did flunk out, so they are not just moving along the herd.

The pass fail grades continue into clerkships as well, which is nice because it eliminates a lot of the subjectivity among evaluations.

The only problem is that this system puts a greater emphasis on Step 1 scores, because it becomes the only means by which to differentiate students from my school, but so be it. That test is really the end all anyways.

I have two childhood friends who attend the other state medical school, and they describe a much more cutthroat atmosphere.
 
There are only a few reasons why someone with the right stats/mindset shouldn't at least pass all the courses in med school. There's no reason why there should be several such someones. It really pisses me off that schools have such high attrition rates, they really should make more of an effort to help kids who're struggling.

This is a bit of a rant towards my own school, where we lost 8 kids in the first year, and now 3 in the second, and no one seems to give a flying ****.
 
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There are only a few reasons why someone with the right stats/mindset shouldn't at least pass all the courses in med school. There's no reason why there should be several such someones. It really pisses me off that schools have such high attrition rates, they really should make more of an effort to help kids who're struggling.

This is a bit of a rant towards my own school, where we lost 8 kids in the first year, and now 3 in the second, and no one seems to give a flying ****.


You misunderstand be entirely. My administration gives us ample opportunities before kicking us out. What I mean to illustrate is that even though they try as hard as possible to get us all through, they are not doing so at the expense of ensuring minimally competent physicians.

I have heard many a tale about administrations like you are describing. Their attitude is "10% of you will fail this test", which is complete crap.
 
Yep, was ranting about my own school. Wasn't supposed to be a reply to yours. Corrected that.
 
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From my perspective (awful, awful student in undergrad) going to a graded school is the best choice I ever made (actually, I didn't have a choice because of the aforementioned).

I had no shot at a scholarship before, but now that I'm in med school I get a chance to get one every year via merit. If a school had no internal ranking at all, there would be no way to earn merit scholarships. In fact, I would probably do just enough to pass and pick up a part time job on the side. Now that doing well in school can equal financial benefit, my incentive is to study every day as if it were my job. I think in the end that will benefit me the most.

Fostering an environment of competitiveness has its downside to be sure, but I wanted to put my 2 cents out there on why maintaining some form of ranking can be good.
 
From my perspective (awful, awful student in undergrad) going to a graded school is the best choice I ever made (actually, I didn't have a choice because of the aforementioned).

I had no shot at a scholarship before, but now that I'm in med school I get a chance to get one every year via merit. If a school had no internal ranking at all, there would be no way to earn merit scholarships. In fact, I would probably do just enough to pass and pick up a part time job on the side. Now that doing well in school can equal financial benefit, my incentive is to study every day as if it were my job. I think in the end that will benefit me the most.

Fostering an environment of competitiveness has its downside to be sure, but I wanted to put my 2 cents out there on why maintaining some form of ranking can be good.

I have a hard time imagining the learning atmosphere if at a top med school the amount of financial aid you got was tied to your grades. Pay for performance is absolutely malignant if the outcome measures have weak validity, which definitely applies for preclinical grades.
 
I am at a school that is all P/F, and we do not have internal rankings (despite what above posters said, not all schools rank).

It is awesome!!!

The atmosphere is great. The students help each other out, and the feeling among the administration is that they really want everyone to pass. That being said, several students did flunk out, so they are not just moving along the herd.

The pass fail grades continue into clerkships as well, which is nice because it eliminates a lot of the subjectivity among evaluations.

The only problem is that this system puts a greater emphasis on Step 1 scores, because it becomes the only means by which to differentiate students from my school, but so be it. That test is really the end all anyways.

I have two childhood friends who attend the other state medical school, and they describe a much more cutthroat atmosphere.

You must go to Stanford.
 
I have a hard time imagining the learning atmosphere if at a top med school the amount of financial aid you got was tied to your grades. Pay for performance is absolutely malignant if the outcome measures have weak validity, which definitely applies for preclinical grades.

The traditional way to disburse scholarships is based on undergraduate performance, which has even worse validity.
 
The traditional way to disburse scholarships is based on undergraduate performance, which has even worse validity.

The problem is that medical schools have nothing else to go by but your undergraduate record. It may not be a perfect marker, but you'll find many much worse markers. There is no undergraduate curriculum that fully reproduces medical school.You can say it's a great thing now, bc you did a complete 180, which is hardly the case for most when past is prologue. The P4P scheme that your medical school does brings in many unintended consequences, and is even worse for MS-3 when a lot of grading/evaluation is out of your control.
 
The problem is that medical schools have nothing else to go by but your undergraduate record. It may not be a perfect marker, but you'll find many much worse markers. There is no undergraduate curriculum that fully reproduces medical school.You can say it's a great thing now, bc you did a complete 180, which is hardly the case for most when past is prologue. The P4P scheme that your medical school does brings in many unintended consequences, and is even worse for MS-3 when a lot of grading/evaluation is out of your control.

I assume you mean poisoning the cooperative atmosphere among students? That's definitely a risk, but I just haven't seen it here.
 
I assume you mean poisoning the cooperative atmosphere among students? That's definitely a risk, but I just haven't seen it here.

Not necessarily just that, but increasing the stress and neuroticism of the class, as a whole.
 
True pass/fail here for the first two years and I'm loving it. They did add an honor's letter component here, but you have to get X% for all the classes in the first two years so once you miss out on it for one class, there's no chance after that. (I missed it by 1 percentage point the first course so I stopped caring about it at that point). I'm a non-trad so the idea of giving up all my free time for the next 3 years was not too appealing to me. The P/F curriculum definitely helps me have a life and not feel guilty about it, lol.
 
True pass/fail here for the first two years and I'm loving it. They did add an honor's letter component here, but you have to get X% for all the classes in the first two years so once you miss out on it for one class, there's no chance after that. (I missed it by 1 percentage point the first course so I stopped caring about it at that point). I'm a non-trad so the idea of giving up all my free time for the next 3 years was not too appealing to me. The P/F curriculum definitely helps me have a life and not feel guilty about it, lol.

I truly think there should be an SDN list made of "true" P/F schools in the first 2 years vs. P/F schools in the first 2 years that still internalize rank. God knows all schools are not transparent on this either on interviews or on their websites.
 
I would hate going to a ranked school. One of the best things about not worrying about grades is I can focus all my attention to what information will be necessary for step 1 and avoid all the professor specific minutia. That said we still receive grades after exams so I still try to do as well as I possibly can because I am internally competitive. There is absolutely no competitiveness among class mates though. We generally always help each other out. If someone missed class and there was something important there, its guaranteed someone will post it on facebook for everyone to see.
 
Do people think grades makes students more competitive even when the grades are not based on a curve
 
Do people think grades makes students more competitive even when the grades are not based on a curve

Grades may not be "based on a curve", but if a majority of the class starts making "As" you know the professor will start making the exams harder.
 
I truly think there should be an SDN list made of "true" P/F schools in the first 2 years vs. P/F schools in the first 2 years that still internalize rank. God knows all schools are not transparent on this either on interviews or on their websites.

I'm at USF. It's true P/F now. On the downside, we do have a good # of mandatory lectures in addition to doctoring and anatomy lab (which are mandatory. Usually about 2 or 3 a week. There's usually only about 1 day a week if I'm lucky in which I don't have to come to class.
 
True pass/fail here for the first two years and I'm loving it. They did add an honor's letter component here, but you have to get X% for all the classes in the first two years so once you miss out on it for one class, there's no chance after that. (I missed it by 1 percentage point the first course so I stopped caring about it at that point). I'm a non-trad so the idea of giving up all my free time for the next 3 years was not too appealing to me. The P/F curriculum definitely helps me have a life and not feel guilty about it, lol.

If they are tracking your % score for each class, it's not a true pass fail...
 
Were graded all my life and loving it, wtf is this, are we communists now.

I can understand the reasons why so many top tier schools have p/f, and the reasons are atrocious.
 
Were graded all my life and loving it, wtf is this, are we communists now.

I can understand the reasons why so many top tier schools have p/f, and the reasons are atrocious.

Kevin Chang is that you? Very nice to see you again.

its-not-enough-that-i-should-succeed-others-should-fail-kevin-chang.jpg
 
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Incorrect

Sorry, I thought you were saying that you had a "true" P/F only curriculum in all 4 years. All schools rank whether that be: exact rank, quartiles (or other ways to divide the class), or the specific "adjective" used in the Dean's letter.
 
Sorry, I thought you were saying that you had a "true" P/F only curriculum in all 4 years. All schools rank whether that be: exact rank, quartiles (or other ways to divide the class), or the specific "adjective" used in the Dean's letter.

It is possible that my school keeps some sort of internal rankings, but it seems unlikely. I know that no such rankings appear on our dean's letter. We have only P/F all four years, no honors.

I am a DO though, so that could have something to do with it.
 
It is possible that my school keeps some sort of internal rankings, but it seems unlikely. I know that no such rankings appear on our dean's letter. We have only P/F all four years, no honors.

I am a DO though, so that could have something to do with it.

Yes, but you're given an adjective in your Dean's letter: "HooliganSnail will make an outstanding house officer." vs. "HoooliganSnail will make an excellent house officer." These code words give your standing in the class as those code words are defined in the Dean's letter as to where you stand.
 
Yes, but you're given an adjective in your Dean's letter: "HooliganSnail will make an outstanding house officer." vs. "HoooliganSnail will make an excellent house officer." These code words give your standing in the class as those code words are defined in the Dean's letter as to where you stand.


Ahhhhh......very sneaky. I could see this being possible. I did not know about that. They discussed the Dean's letter at one of our class meetings, and did not allude to any such thing, but I would not put it past them.
 
Ahhhhh......very sneaky. I could see this being possible. I did not know about that. They discussed the Dean's letter at one of our class meetings, and did not allude to any such thing, but I would not put it past them.

Yes, I agree it is very sneaky. The code words usually go along the lines of "outstanding", "excellent", "very good", and "good". Thus a school can proclaim without conscience that they don't "rank" their students which is correct technically as they're not giving your exact ordinal rank in the class (i.e. HooliganSnails ranks 5 out of class of 130 students).
 
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