Should med schools be allowed to have a "quasi pass-fail" grading scheme? [POLL]

[flatearth22]

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For those of you unaware, although many med schools claim to be pass-fail for the pre-clinical years, only some of them are "true pass-fail". That is, although students can see their percentage scores on exams or whatever, none of that information is passed on to the registrar and none of it affects class rank, AOA, dean's letter, etc (only 3rd year grades do, if the school even has class rank and AOA). In a quasi pass-fail school, this information is passed on to the registrar and it does affect your class rank, AOA, and dean's letter. So should schools get rid of quasi pass-fail grading and either be true pass-fail or letter grades (including H/P/F or H/HP/P/F)? Or does a quasi pass-fail system also have a place in med school grading schemes?

 

[ppfizenm]

For those of you unaware, although many med schools claim to be pass-fail for the pre-clinical years, only some of them are "true pass-fail". That is, although students can see their percentage scores on exams or whatever, none of that information is passed on to the registrar and none of it affects class rank, AOA, dean's letter, etc (only 3rd year grades do, if the school even has class rank and AOA). In a quasi pass-fail school, this information is passed on to the registrar and it does affect your class rank, AOA, and dean's letter. So should schools get rid of quasi pass-fail grading and either be true pass-fail or letter grades (including H/P/F or H/HP/P/F)? Or does a quasi pass-fail system also have a place in med school grading schemes?

I think it is relatively stupid to have a quasi pass/fail system for a group of students as concerned about their grades as med students are. Maybe if we cared less and were able to pretend the grades didn't matter I could see the benefit but I don't think the majority of students are like that. It's like telling someone they are taking a placebo.

 

[BA11]

Never been much of a fan of the pass/fail concept and "quasi" pass/fail is even more ridiculous as it is a grading system disguised as pass/fail.

 

[armybound]

Never been much of a fan of the pass/fail concept and "quasi" pass/fail is even more ridiculous as it is a grading system disguised as pass/fail.

Agreed.

And a future UT-Houstonian. Well done.

 

[Sephiroth]

Never been much of a fan of the pass/fail concept and "quasi" pass/fail is even more ridiculous as it is a grading system disguised as pass/fail.

P/F with internal rankings is worse IMO because at least with grades, as long as you get high enough for Honors, you're fine and don't need to worry about anyone else. With internal rankings, every point matters - even if you get a 95%, maybe getting a 97% would have bumped you up on the rankings, so it would seem to increase neuroticism and cutthroat mentality.

 

[aSagacious]

From what I've been told pre-clinical grades don't carry much weight as far as matching is concerned... so my vote is: grading scheme doesn't matter.

 

[drizzt3117]

From what I've been told pre-clinical grades don't carry much weight as far as matching is concerned... so my vote is: grading scheme doesn't matter.

Well AOA/class rank does matter.

 

[MT Headed]

P/F with internal rankings is worse IMO because at least with grades, as long as you get high enough for Honors, you're fine and don't need to worry about anyone else. With internal rankings, every point matters - even if you get a 95%, maybe getting a 97% would have bumped you up on the rankings, so it would seem to increase neuroticism and cutthroat mentality.

Nevada uses this line when you're on the interview circuit. They claim letter grades are better because everybody could conceivably get an A and all get honors, whereas in those evil P/F schools only a small percentage of students can get honors.

Of course nothing prevents a P/F school from saying "All students with exam score averages above 90% get honors". Of course nothing prevents a letter grade school from saying "Only the top x% of our students by exam score will get honors, even if all of you get rounded off to an A". So it sounded like a pretty stupid argument to me.

 

[Charles_Carmichael]

From what I've been told pre-clinical grades don't carry much weight as far as matching is concerned... so my vote is: grading scheme doesn't matter.

While the preclinical grades themselves not matter, depending on the criteria for AOA, they can play a major role. For example, at my school, how well you did in the basic science classes is pretty important if you want junior AOA (less of an emphasis on basic science grades for senior AOA). Also, from what my cardiology mentor tells me, your ranking does go on the MSPE when you're applying for residency. Not a direct rank (ex. 3/190) but using certain words like outstanding, which may mean that you're in the top 20th percentile of the class, etc.

I'm not sure how much of a role the latter plays in residency apps, but I wouldn't say that AOA doesn't carry much weight.

 

[gettheleadout]

Never been much of a fan of the pass/fail concept and "quasi" pass/fail is even more ridiculous as it is a grading system disguised as pass/fail.

May I ask why? I don't see any downsides to true P/F.

 

[Sephiroth]

Nevada uses this line when you're on the interview circuit. They claim letter grades are better because everybody could conceivably get an A and all get honors, whereas in those evil P/F schools only a small percentage of students can get honors.

Of course nothing prevents a P/F school from saying "All students with exam score averages above 90% get honors". Of course nothing prevents a letter grade school from saying "Only the top x% of our students by exam score will get honors, even if all of you get rounded off to an A". So it sounded like a pretty stupid argument to me.

Well sure, if you're gonna go outside the specific scenarios in question. H/P/F isn't the same as P/F, in which case it would make sense to ask if Honors was based on absolute score, or if class % was considered. However, a P/F system based on class % would seem absurd (a certain number of people must fail?). So yes, I'd say I'd prefer grades over H/P/F based on class%, but that's not really what we were talking about. And once you get into H/HP/P/F it's hardly any different than grades.

 

[BA11]

May I ask why? I don't see any downsides to true P/F.

Unless it has distinct honors levels associated with it pass/fail serves only to encourage mediocrity among those who are not naturally strong self-motivators. The gap in knowledge between one who scores a 95 on a test and one who scores a 70 is typically very large but in pass/fail courses this gap is not reflected. It doesnt encourage a mastery of the material and can create a false sense of mastery among those who do just well enough to pass.

Pre-clinical grades may not matter all that much when it comes to the residency match but the core knowledge they provide does because it is reflected in all other areas of your medical education.

 

[MT Headed]

Well sure, if you're gonna go outside the specific scenarios in question. H/P/F isn't the same as P/F, in which case it would make sense to ask if Honors was based on absolute score, or if class % was considered. However, a P/F system based on class % would seem absurd (a certain number of people must fail?). So yes, I'd say I'd prefer grades over H/P/F based on class%, but that's not really what we were talking about. And once you get into H/HP/P/F it's hardly any different than grades.

Her point was that Honors is this adjective that floats over the noun of your grade. She said that at a school with letter grades, the adjective Honors would go to the entire class if the entire class performed at an honorable level. She said that this was far superior to a P/F school where the adjective Honors would be applied to only a fixed percentage of students (presumably they all have a grade of P), and therefore any P/F school would be more cut-throat and a poorer student experience than the cooperative and supportive grading system at a letter grade institution.

My thinking was that this woman was an idiot, because a letter grade school could just as easily bestow an adjective on only a fixed percentage of their student body, and a P/F school could choose to bestow an adjective upon all of the students that achieved some internal curve-independent goal.

Students take tests and get numeric results back. Whether these numeric results are later rounded into two categories (P/F), five categories (ABCDF), or somewhere in between is orthogonal to how the school even later applies the adjective of Honors to some large or small portion of the student body. Her argument was without merit and a poor line of reasoning to justify Nevada's method of grading students vs. all P/F institutions.

I didn't argue with her of course, I just kept my mouth shut. They rejected me anyway.

 

[flatearth22]

Unless it has distinct honors levels associated with it pass/fail serves only to encourage mediocrity among those who are not naturally strong self-motivators. The gap in knowledge between one who scores a 95 on a test and one who scores a 70 is typically very large but in pass/fail courses this gap is not reflected. It doesnt encourage a mastery of the material and can create a false sense of mastery among those who do just well enough to pass.

Pre-clinical grades may not matter all that much when it comes to the residency match but the core knowledge they provide does because it is reflected in all other areas of your medical education.

But isn't that what the Step 1 is for? Wouldn't someone who worked their tail off during the pre-clinical years and got 95's have an easier time studying for Step 1 and doing well on it? Whereas someone who slacked off and barely scraped by with 70's would have a much tougher time?

On every PD survey the preclinical grades are among the lowest selection factors while the highest are always Step 1 score and grades in clinical rotations. Why cause undue stress by having grades, cut-offs, and tiers for something that is trivial for being selected by residencies? Why lie to your students by having a quasi P/F where some might not do as well as others only because they think that all P/F schools are created equally. Every school should be true P/F IMO.

 

[BA11]

But isn't that what the Step 1 is for? Wouldn't someone who worked their tail off during the pre-clinical years and got 95's have an easier time studying for Step 1 and doing well on it? Whereas someone who slacked off and barely scraped by with 70's would have a much tougher time?

If the only issue was weeding out "bad" medical students sure. The issue is preventing the poor development of these students altogether, not weeding them out after the fact. It is in both a school's and student's best interests to have every graduate hold the greatest depth of knowledge possible, and I don't believe P/F systems encourage that. Yes, I know that some of the top schools use P/F systems the first two years, however students who get into top schools are typically your academic overachievers who have no problem motivating themselves to learn as much as possible. A lot of students are ok with just doing enough to get by if that's all they have to do and there is no greater purpose to getting high pre-clinical grades outside of less studyig for step 1.

On every PD survey the preclinical grades are among the lowest selection factors while the highest are always Step 1 score and grades in clinical rotations. Why cause undue stress by having grades, cut-offs, and tiers for something that is trivial for being selected by residencies? Why lie to your students by having a quasi P/F where some might not do as well as others only because they think that all P/F schools are created equally. Every school should be true P/F IMO.

Like I said, I don't like quasi-P/F systems because it attempts to perpetuate the idea that pre-clinical grades have no real effect when in fact they do. I believe a normal grading system or honors system is always the ebst way to go. Again, just my opinion.

 

[catzzz88]

I don't know what everyone is complaining about... as long as everyone else is lulled into a false sense of security with these "pass/fail" scores, they won't see us gunners squatting in the far corner of the bar studying flash cards to get ahead while the rest of the class is getting drinks.

Well... that's how I see it at least! My motivation to do well comes from within. Maybe this is partly because I went to an undergrad school that does not allow anyone to talk about grades (it is against the honor code). Throughout undergrad, I never had a chance to compare myself to others so all of my motivation to study was based on how happy I was with my score, not how my score compared to a class average or my best friend. So... this SuperAwesomeMasterofMedicine/HighHonors/KindaHonorsButBarely/Pass/Fail/MajorFail/WTFare.u.doing.in.medical.school/GTFO scoring system makes no difference to me. I will do my best, and that's all.

Best,
C

 

[duress]

You guys confuse me. Mediocrity? The people who study 'just to pass' or scrape by are quite the rarity because they've likely already failed one exam and learned their lesson. Virtually everyone buckles down to do as well as they can for each exam.

The only thing difference the quasi P/F makes is that it rakes the emphasis off our actual pre-clinical grades. The promise of one sentence in our letter and the first (but not only) chance at AoA isn't really enough for most people to kill themselves for a 95, especially if the extra points were some kind of low-yield studying that has nothing to do with mastery, like memorizing everything said in lecture since the lecturer's tangential remark is choice B.

 

[SoundofSilver]

Either go true p/f or h/p/f.

 

[Hoya2009]

My school doesn't even give us our scores on assessments; we just get a pass or fail for the course, and encouragement to do more in areas if we did worse in them, but never a number score. It's pretty low stress and there's always a group to study with and notes/slides to look at. I like it a lot.

 

[Plue00]

Unless it has distinct honors levels associated with it pass/fail serves only to encourage mediocrity among those who are not naturally strong self-motivators. The gap in knowledge between one who scores a 95 on a test and one who scores a 70 is typically very large but in pass/fail courses this gap is not reflected. It doesnt encourage a mastery of the material and can create a false sense of mastery among those who do just well enough to pass.

Pre-clinical grades may not matter all that much when it comes to the residency match but the core knowledge they provide does because it is reflected in all other areas of your medical education.

Doesn't Harvard/Yale use it? Those students can't be mediocre. I guess only medical students can judge this. I wouldn't have a clue.

 

[gettheleadout]

Doesn't Harvard/Yale use it? Those students can't be mediocre. I guess only medical students can judge this. I wouldn't have a clue.

I think his point is that if you have mediocre students (unlike at top schools) you need grades to motivate them to succeed. I don't know how one can prove that though...

 

[Narmerguy]

Unless it has distinct honors levels associated with it pass/fail serves only to encourage mediocrity among those who are not naturally strong self-motivators. The gap in knowledge between one who scores a 95 on a test and one who scores a 70 is typically very large but in pass/fail courses this gap is not reflected. It doesnt encourage a mastery of the material and can create a false sense of mastery among those who do just well enough to pass.

Pre-clinical grades may not matter all that much when it comes to the residency match but the core knowledge they provide does because it is reflected in all other areas of your medical education.

You cannot assume that the gap in 95 vs a 70 will negatively impact physician quality without actual evidence to show this. Though it may seem intuitive, that does not simply make it true. If a school states that a 70 is sufficient, than a 70 is sufficient. What it takes to reach a 95 may not be useful for being an effective physician, and it is the school's discretion (and the accreditation committees') to decide at what points the benefits flatline.

However, an argument could be made that grading on p/f creates a culture of mediocrity that is not confined to the classroom but permeates other areas of their education as well. This could very easily result in Doctor's who lack drive and initiative in being as effective as possible. This is, again, reasonable but cannot be claimed and accepted without being proven. Further, there will be no grades once you become a doctor--schools could argue that if a doctor refuses to motivate himself/herself, an A/B/C curriculum is not going to change that.