Pass/Fail vs Letter Grade Schools

[RySerr21]

Me studying for classes helped me immensely for Step 1. Not all of what we were taught in class was Step 1 relevant, but most of it was. It really didn't take that much extra time to study the Step-1 non-relevant stuff. Maybe your school was different. And all those time sinks you talk about, like you mention, you have to do them anyways and at our school, even though we aren't strictly pass fail, those lame assignments usually were graded pass/fail.

Doing well in classes and doing well in Step 1 should go hand in hand. I don't think sacrificing class grades is essential to getting a great Step 1 score. Yeah it may help if all you read is Step 1 stuff and ingore class, but my argument is that you can do both. If you don't want a social/family life.

false. its school and student dependent. My school is P/F. I love it b/c I ignore the useless info they try and make us learn and focus on things that will help me practice medicine. I can do this knowing that I will take a hit on unimportant questions but still feel confident that I have a solid understandindg of what is important. In this respect, my school test scores do not accurately reflect my knowledge. And this shows when we take shelf exams that are well written, with clinically relevant questions, and we are compared to students on a national level.

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[grotto]

false. its school and student dependent. My school is P/F. I love it b/c I ignore the useless info they try and make us learn and focus on things that will help me practice medicine. I can do this knowing that I will take a hit on unimportant questions but still feel confident that I have a solid understandindg of what is important. In this respect, my school test scores do not accurately reflect my knowledge. And this shows when we take shelf exams that are well written, with clinically relevant questions, and we are compared to students on a national level.

Isn't it a bit presumptuous to think you know better than your professors and/or deans what is going to help you practice medicine or what is "important"? Yes, First Aid, RR, HY and various review books lay things out nicely, I use them as well, but it seems kind of depressing to just limit yourself to that information. I think one of the big points of being in school is to learn to love learning, not just to learn what is "important" and then shut it down. Whatever though, different strokes for different folks.

 

[2012mdc]

Isn't it a bit presumptuous to think you know better than your professors and/or deans what is going to help you practice medicine or what is "important"? Yes, First Aid, RR, HY and various review books lay things out nicely, I use them as well, but it seems kind of depressing to just limit yourself to that information. I think one of the big points of being in school is to learn to love learning, not just to learn what is "important" and then shut it down. Whatever though, different strokes for different folks.

It really depends on the particular professor and class. At my school there are the professors who have legendary status and have the track record of preparing people for Step 1 and there are the professors who are PhD's and think lecture is a great time to talk about their obscure research. Many times it is very easy to tell which information is more important. It's impossible to know everything in med school anyway

 

[michigangirl]

went to pass-fail school-- best way in my opinion-- leads to a very collaborative, non-cut throat atmosphere among the students-- it was phenomenal. 8 years out, i can tell you I learned what I needed to know.

 

[TheLesPaul]

My school uses grades, but there are predetermined cutoffs for A/B/C/F (like someone was saying). Isn't that the way most of these schools with grades do it? I really don't see how anyone is in competition with anyone else when all these grade cutoffs are set in stone before the class begins...

 

[MCAT guy]

I just wanted to say thank you to all of the posters who shared their experiences.

I've learned a lot from you. Thanks.

 

[MedStudentWanna]

My school uses grades, but there are predetermined cutoffs for A/B/C/F (like someone was saying). Isn't that the way most of these schools with grades do it? I really don't see how anyone is in competition with anyone else when all these grade cutoffs are set in stone before the class begins...

Some schools curve so how you do is partly determined by how others do.

 

[2012mdc]

My school uses grades, but there are predetermined cutoffs for A/B/C/F (like someone was saying). Isn't that the way most of these schools with grades do it? I really don't see how anyone is in competition with anyone else when all these grade cutoffs are set in stone before the class begins...

My school uses ABCfail and is not competitive at all but I think that's more due to the class makeup then the system. Even in an ABCfail system with no curve there is going to be class rank.

Theoretically if one knows they cannot make straight A's or very close to it they could sabotage others in order to make their class rank higher and obtaining AOA easier. I could see this happening if a class had a unusual high number of extreme gunners.

 

[Charles_Carmichael]

Honestly, does it even matter if you go to a P/F school or one that's A/B/C/D/F/whatever? No matter what grading system, the majority of schools keep an internal ranking that's reflected on your Dean's letter, based on my understanding. The only school I can think of off the top of my head that doesn't do this is Yale. So, ultimately, who cares? It's still up to you to teach yourself the majority of the preclinical material, isn't it?

 

[RySerr21]

Isn't it a bit presumptuous to think you know better than your professors and/or deans what is going to help you practice medicine or what is "important"? Yes, First Aid, RR, HY and various review books lay things out nicely, I use them as well, but it seems kind of depressing to just limit yourself to that information. I think one of the big points of being in school is to learn to love learning, not just to learn what is "important" and then shut it down. Whatever though, different strokes for different folks.

No... Our classes are taught by Phds and researchers, not clinicians (for the most part). And when they are taught by clinicians, you dont' see the BS crap that we dont actually need to know. When a researcher is teaching, there is going to be a bias towards what they are researching and learning about, which i dont blame them for, but they shouldnt blame me for not really caring. For example, instead of focusing on clincial presentation and treatment of viruses, we are told to learn the intricacies of poly A capping and inverted virus sequences. Really? Why? And I do love to learn, but at the same time there is an overload of information. I'm not going to be able to learn it all, so I cut out the stuff that I know I will not remember/never use. You can spend that extra time loving to learn whatever they spit at you. I'll spend it at the beach.

 

[RySerr21]

Honestly, does it even matter if you go to a P/F school or one that's A/B/C/D/F/whatever? No matter what grading system, the majority of schools keep an internal ranking that's reflected on your Dean's letter, based on my understanding. The only school I can think of off the top of my head that doesn't do this is Yale. So, ultimately, who cares? It's still up to you to teach yourself the majority of the preclinical material, isn't it?

There is no ranking for the first two years at UC Irvine...i'm pretty sure a few of the other UCs are like this as well (UCLA?)

 

[MrBeauregard]

I'm at an A/B/C/fail school and I personally like it. That grading system helps me strive to do the absolute best I can. I'm not so much competing with my fellow students as I am with myself to see how well I can do. I also feel as if a school with a tiered grading system can help those who are shooting for competitive residencies. Whether we like it or not, medicine is competitive, and we will most likely be competing the rest of our lives. We competed to get into medical school. We competed against ourselves (or in many cases against our classmates) for good grades. We will compete for good residency spots. We will then compete for patients once in practice. It is simply something we cannot escape.

 

[marele86]

No matter what grading system, the majority of schools keep an internal ranking that's reflected on your Dean's letter, based on my understanding. The only school I can think of off the top of my head that doesn't do this is Yale.

There is no ranking for the first two years at UC Irvine...i'm pretty sure a few of the other UCs are like this as well (UCLA?)

Columbia uses P/F without internal ranking as well.

 

[ArcGurren]

I'm at a school which uses H/HP/P/F currently through all four years but is switching to a P/CP/F (pass/conditional pass/fail) system for the preclinical years and retaining the H/HP/P/F system for clinical years. I prefer having P/F for preclinical to be honest, as someone earlier mentioned doing well in these classes (save for maybe our micro/immuno and our anatomy class) is not representative of how well you know that subject, it's representative of how well you can memorize lecture facts. Plus many lecturers love to throw in their "pet favorite" topics and test on those... useless nonsense. We still end up learning 70-80% of what we need to know for Step 1 in general but instead of focusing on sort of condensing and integrating info we end up wasting time on stupid crap. At least with a P/F system I can not give two **** about what minor nonsense I'm being taught and focus on doing well for NBMEs/Step 1, so long as I pass the class. I also have no real AOA ambition, so that's not a factor either.

In clinical years I think it makes a little more sense since you do need to differentiate who's a better clinician in one field versus another and assigning grades based on evaluations makes sense.

 

[futuredoctor10]

Yep I think there are many advantages in the P/F system: if its truly P/F.

Systems which are Honors/Pass/Fail or Honors/HP/P/F end up being pretty close to the traditional ABCD grading scheme in practice, I think!

 

[itellitlikeitis]

Yep I think there are many advantages in the P/F system: if its truly P/F.

Systems which are Honors/Pass/Fail or Honors/HP/P/F end up being pretty close to the traditional ABCD grading scheme in practice, I think!

Most graded schools rarely use "ABCD". Anything more than "P/F" is a graded system

Like others have already said, most P/F schools still keep internal rankings so the schools just hide the actual details from the students. The only "true P/F schools" are the ones that simultaneously don't keep internal rankings, which are very, very rare

 

[VenusinFurs]

So I feel like I've stepped into bizarro world, but upon reflection, I think I like being graded. It gives me a concrete measure of just how much of a disappointment I am to myself.

 

[Valvool]

Officially my school is H/HP/P/F, and in first year just P/F. But practically speaking, our grades have always been reported as percentages so it feels like we use the A-F scale, even though it doesn't show up that way on our transcripts.

 

[Ansar]

true P/F
(i.e. No internal ranking)

 

[nitemagi]

I'm on the admission committee for our residency now, and looking through lots of transcripts. Seems like it's a bit more of a detriment than a help. If you have Pass/Fail on your preclinical transcript, then as an interviewer I hone in on the clinical grades only, which is what should matter more anyway. If you have grades on preclinicals that's more areas to scrutinize.

If you're in a less than stellar med school then I suppose acing everything could make you shine.

 

[ArcGurren]

I'm on the admission committee for our residency now, and looking through lots of transcripts. Seems like it's a bit more of a detriment than a help. If you have Pass/Fail on your preclinical transcript, then as an interviewer I hone in on the clinical grades only, which is what should matter more anyway. If you have grades on preclinicals that's more areas to scrutinize.

If you're in a less than stellar med school then I suppose acing everything could make you shine.

What do you mean by "less than stellar"? My school isn't ranked in the top 10 but we get taught what we need to know and our class rankings for boards are higher than the national average... not to mention everyone matches and usually in pretty nice programs. I'm just curious as to what distinction you make here since that seems entirely subjective... if it's a question of accreditation that's another whole matter.

 

[fahimaz7]

I'm on the admission committee for our residency now, and looking through lots of transcripts. Seems like it's a bit more of a detriment than a help. If you have Pass/Fail on your preclinical transcript, then as an interviewer I hone in on the clinical grades only, which is what should matter more anyway. If you have grades on preclinicals that's more areas to scrutinize.

If you're in a less than stellar med school then I suppose acing everything could make you shine.

Psych residencies care about grades/board scores? Interesting...

 

[nitemagi]

Psych residencies care about grades/board scores? Interesting...

Yeah, typically we just take them based on their ability to be empathic.

Good psych residencies are as competitive as good residencies in other specialties. I can't speak for other programs.

All that being said, we don't only look at grades, and we weigh the essay, dean's letter, and interview heavily as well. According to my PD, there's been research done on who would be a "bad" resident. Neither grades, board scores, or even interviews correlated with problematic outcomes. The only thing that did was negative comments in a dean's letter. Since usually dean's letter just omits the negative, if they chose to include it, it means there's something really wrong with you.

As to the question of stellar medical school, I should have stated a low ranked medical school. Having all high grades might show that you're an outstanding student. Transcripts do show where each student falls within their class, whether it's just the breakdown of good/very good/excellent/outstanding (an overall ranking in your dean's letter), or the full point grade standing. I've read a couple of DO school transcripts, and they all seem to go by point systems. Imagine having to track every point in a competition for all of medical school.

 

[ArcGurren]

Yeah, typically we just take them based on their ability to be empathic.

Good psych residencies are as competitive as good residencies in other specialties. I can't speak for other programs.

All that being said, we don't only look at grades, and we weigh the essay, dean's letter, and interview heavily as well. According to my PD, there's been research done on who would be a "bad" resident. Neither grades, board scores, or even interviews correlated with problematic outcomes. The only thing that did was negative comments in a dean's letter. Since usually dean's letter just omits the negative, if they chose to include it, it means there's something really wrong with you.

As to the question of stellar medical school, I should have stated a low ranked medical school. Having all high grades might show that you're an outstanding student. Transcripts do show where each student falls within their class, whether it's just the breakdown of good/very good/excellent/outstanding (an overall ranking in your dean's letter), or the full point grade standing. I've read a couple of DO school transcripts, and they all seem to go by point systems. Imagine having to track every point in a competition for all of medical school.

Pretty pathetic that you guys even care about the ranking of the medical school, but okay.

 

[nitemagi]

Pretty pathetic that you guys even care about the ranking of the medical school, but okay.

I wouldn't say we look it up on the list. But by this point of being around, and of course based on region, there's some schools you've heard of and some you haven't. Sadly reputation and politics plays into everything, though again other things can trump all that. An amazing essay can raise an application that might not otherwise.

 

[fahimaz7]

Yeah, typically we just take them based on their ability to be empathic.

Good psych residencies are as competitive as good residencies in other specialties. I can't speak for other programs.

All that being said, we don't only look at grades, and we weigh the essay, dean's letter, and interview heavily as well. According to my PD, there's been research done on who would be a "bad" resident. Neither grades, board scores, or even interviews correlated with problematic outcomes. The only thing that did was negative comments in a dean's letter. Since usually dean's letter just omits the negative, if they chose to include it, it means there's something really wrong with you.

As to the question of stellar medical school, I should have stated a low ranked medical school. Having all high grades might show that you're an outstanding student. Transcripts do show where each student falls within their class, whether it's just the breakdown of good/very good/excellent/outstanding (an overall ranking in your dean's letter), or the full point grade standing. I've read a couple of DO school transcripts, and they all seem to go by point systems. Imagine having to track every point in a competition for all of medical school.

Yea, I could see how a psych residency is as competitive as a plastic surgery spot. Average 216 on NRMP. Our radiology chair told us that the his department doesn't care what the dean letter, MS1/2 grades, etc say... all that they really care about are clerkship scores, step 1 scores, and faculty letters of recommendation.

 

[nitemagi]

Yea, I could see how a psych residency is as competitive as a plastic surgery spot. Average 216 on NRMP. Our radiology chair told us that the his department doesn't care what the dean letter, MS1/2 grades, etc say... all that they really care about are clerkship scores, step 1 scores, and faculty letters of recommendation.

Why don't you read the post before writing an ass of a comment? I said Good psych residencies, meaning top programs. I've seen a ridiculous number of applicants this year with 262's on step 1 applying. If you average every psych residency together, sure the numbers go down. But thankfully numbers aren't all we look at.

And bully for the rads dean. That's his prerogative. My original post was just reflecting on the possible pro's/con's on having grades in preclinical years, that's all.

And I guarantee if he saw someone come from a school with letter grades in pre-clinical classes that had all C's, that might be a flag on the application.

 

[MedStudentWanna]

And I guarantee if he saw someone come from a school with letter grades in pre-clinical classes that had all C's, that might be a flag on the application.

Not exactly fair, is it? Someone who got by with just P's, could have made 70% in all his/her classes.

 

[ar2388]

Not exactly fair, is it? Someone who got by with just P's, could have made 70% in all his/her classes.

exactly!!

how does one get around that? seems like pass/fail schools will always have that advantage.

 

[canjosh]

exactly!!

how does one get around that? seems like pass/fail schools will always have that advantage.

Even with graded schools, can you make an apples to apples comparison between schools? Is an H at Duke equal to an H at Nevada? Who's to say? This is why we all take the great equalizer. This is why the Step 1 is heavily weighted by PDs.

http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf

Figures 1 & 2

My P/F school still does an internal ranking, which is more important to PDs than basic science honors.

 

[MossPoh]

Not exactly fair, is it? Someone who got by with just P's, could have made 70% in all his/her classes.

Yes and that probably will bite them in the arse later on. If you don't have the internal drive to do the best you can do regardless of the grade format then you probably don't have the drive to be the best physician you can be. The learning never stops in medicine. I don't care if my classmate gets 70s and gets a P while I get 90s and get a P. I want the 90% for myself. It is my personal goal. If they want to take the easy route then so be it.

I am at a school with a standard grading system, but I try to treat it like it is P/F. If I'm studying my hardest and learning everything there is to learn, then I am going to pass no matter what. I don't spend my time learning extraneous details that are thrown in to make sure we studied their lecture/research and to separate an A from a B. I use multiple resources and see what is talked about the most and focus things around that. The results have been almost comedic. I will have a solid B in a class, yet get in the 90% on an NBME whereas others with A's in the class will get in the 60 or 70%.

 

[MilkmanAl]

If you don't have the internal drive to do the best you can do regardless of the grade format then you probably don't have the drive to be the best physician you can be.

Definitely disagree on this point because "doing well" in the first two years requires a lot of memorizing essentially useless facts (which you apparently don't do, either ). There's nothing wrong with learning what you need to know and moving on. If you run into one of those zebras the NBME loves to test during your practicing years, you're going to have to look it up anyway.

The results have been almost comedic. I will have a solid B in a class, yet get in the 90% on an NBME whereas others with A's in the class will get in the 60 or 70%.

I made a living of doing that in the first two years. Very satisfying, indeed.

 

[MedStudentWanna]

Even with graded schools, can you make an apples to apples comparison between schools? Is an H at Duke equal to an H at Nevada? Who's to say? This is why we all take the great equalizer. This is why the Step 1 is heavily weighted by PDs.

Yes, but the person I was replying to clearly said that someone with C's at a graded school was at a disadvantage compared to someone with all P's from a P/F school.

 

[MedStudentWanna]

Yes and that probably will bite them in the arse later on. If you don't have the internal drive to do the best you can do regardless of the grade format then you probably don't have the drive to be the best physician you can be. The learning never stops in medicine. I don't care if my classmate gets 70s and gets a P while I get 90s and get a P. I want the 90% for myself. It is my personal goal. If they want to take the easy route then so be it.

I am at a school with a standard grading system, but I try to treat it like it is P/F. If I'm studying my hardest and learning everything there is to learn, then I am going to pass no matter what. I don't spend my time learning extraneous details that are thrown in to make sure we studied their lecture/research and to separate an A from a B. I use multiple resources and see what is talked about the most and focus things around that. The results have been almost comedic. I will have a solid B in a class, yet get in the 90% on an NBME whereas others with A's in the class will get in the 60 or 70%.

Not sure what that has to do with my post about residency selection, but okay. If you're trying to argue Step 1 scores, I'd offer that the person making C's in a graded system and the person making P's with 70% were likely to get similar Step 1 scores, if we take your theory to heart. That would mean the person with the P's would still have the advantage, according to the other poster. That's what I'm arguing is unfair.

 

[2012mdc]

Yes and that probably will bite them in the arse later on. If you don't have the internal drive to do the best you can do regardless of the grade format then you probably don't have the drive to be the best physician you can be. The learning never stops in medicine. I don't care if my classmate gets 70s and gets a P while I get 90s and get a P. I want the 90% for myself. It is my personal goal. If they want to take the easy route then so be it.

I am at a school with a standard grading system, but I try to treat it like it is P/F. If I'm studying my hardest and learning everything there is to learn, then I am going to pass no matter what. I don't spend my time learning extraneous details that are thrown in to make sure we studied their lecture/research and to separate an A from a B. I use multiple resources and see what is talked about the most and focus things around that. The results have been almost comedic. I will have a solid B in a class, yet get in the 90% on an NBME whereas others with A's in the class will get in the 60 or 70%.

I will never understand why there are curricula that seem so discordant with the standardized exams.

Yes, but the person I was replying to clearly said that someone with C's at a graded school was at a disadvantage compared to someone with all P's from a P/F school.

And it's unfair that the meaning of a C varies so much from school to school. At schools where the curriculum has a lot of BS then a C may not mean much at all, in schools with a lot less BS straight C's would be a huge red flag and deservedly so

 

[MedStudentWanna]

And it's unfair that the meaning of a C varies so much from school to school. At schools where the curriculum has a lot of BS then a C may not mean much at all, in schools with a lot less BS straight C's would be a huge red flag and deservedly so

Part of me thinks that's why first and second year grades, short of failure, shouldn't carry any weight at all for residency matching, especially when comparing a person with letter grades to someone with strictly P/F. The other part thinks that third year grades are subjective too, for the most part.

 

[putyou2sleep]

Part of me thinks that's why first and second year grades, short of failure, shouldn't carry any weight at all for residency matching, especially when comparing a person with letter grades to someone with strictly P/F. The other part thinks that third year grades are subjective too, for the most part.

And you are not the first to realize this. That is exactly the reason that many schools choose to use P/F during preclinical years. Institutions realize that as long as you get a basic grasp on something, you'll be able to re-learn it quickly later; if the need should arise.

 

[canjosh]

Yes, but the person I was replying to clearly said that someone with C's at a graded school was at a disadvantage compared to someone with all P's from a P/F school.

You replied to somebody who was predicting what a radiology PD from another person's school would say about straight Cs...sounds like tertiary hearsay or something.

This kinda illustrates the whole point...pre clinical grades don't really matter per se, because there's no way they can be objectively analyzed by an outside observer (i.e. a PD). This whole fair vs unfair argument is a waste of keystrokes, because it doesn't matter.

 

[2012mdc]

You replied to somebody who was predicting what a radiology PD from another person's school would say about straight Cs...sounds like tertiary hearsay or something.

This kinda illustrates the whole point...pre clinical grades don't really matter per se, because there's no way they can be objectively analyzed by an outside observer (i.e. a PD). This whole fair vs unfair argument is a waste of keystrokes, because it doesn't matter.

From what I've seen preclinical grades are pretty much useless unless you are getting junior AOA or failing classes