Why aren't all medical schools P/F?

[DevinBookerMD]

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I'm lucky enough to have some interviews lined up at the moment but not all of them are P/F. Actually its almost split down the middle. This is a big deal for me as I don't want to stress about getting 90% each class. I have friends in both and let's just say, they are in completely different mental states rn. So what's the benefit of non P/F? And how do I get some of these schools I really like to switch hahahahaha

 

[Goro]

I'm lucky enough to have some interviews lined up at the moment but not all of them are P/F. Actually its almost split down the middle. This is a big deal for me as I don't want to stress about getting 90% each class. I have friends in both and let's just say, they are in completely different mental states rn. So what's the benefit of non P/F? And how do I get some of these schools I really like to switch hahahahaha

Getting a grade provides a motivation for students to do well.

 

[Kardio]

I'm lucky enough to have some interviews lined up at the moment but not all of them are P/F. Actually its almost split down the middle. This is a big deal for me as I don't want to stress about getting 90% each class. I have friends in both and let's just say, they are in completely different mental states rn. So what's the benefit of non P/F? And how do I get some of these schools I really like to switch hahahahaha

Even at the P/F schools, you will likely be ranked relative to your peers for purposes of residency applications (or so I’ve been told).

 

[907914]

Getting a grade provides a motivation for students to arbitrarily compete for literally no reason.

FTFY.

 

[Goro]

FTFY.

Maybe at the UG level.

 

[907914]

Maybe at the UG level.

Getting a ‘good enough grade’ seems to be a major source of stress among my peers. Does that not translate to medical school?

 

[choks]

Maybe at the UG level.

Definitely at the UG level! Always tried to a standard deviation above the mean. Are medical school courses graded in the same way, curved to a normal distribution meaning a good chunk of the class is destined to fail? Doesn't seem right since they're already very stringent on who they accept. Sounds like it would be 10 times worse since you're competing with others who are on your caliber?

 

[Goro]

Getting a ‘good enough grade’ seems to be a major source of stress among my peers. Does that not translate to medical school?

Well, why do you think there's been such a huge switch to P/F? The stress is not the gunner comparison to each other, it's the fear of not matching.

Despite the stress, in a graded system you have a reliable predictor of student performance on Boards. I'd much prefer to see Boards go P/F like they used to, but only if some mechanism would be put into place to prevent lazy PDs from only lusting after grads of Really Top Schools. But that's a whole 'nuther thread.

BTW, The pF system is an odd duck. Schools that institute them have had a tendency to want to reward and acknowledge their best students, so they mutate the system into H(onors)/P/F...which then further mutates into H(onors) HP P F...and you're right back at A/B/C/F grading!

 

[Goro]

Definitely at the UG level! Always tried to a standard deviation above the mean. Are medical school courses graded in the same way, curved to a normal distribution meaning a good chunk of the class is destined to fail? Doesn't seem right since they're already very stringent on who they accept. Sounds like it would be 10 times worse since you're competing with others who are on your caliber?

Curved??????? CURVED?????????

This is medical school. Our job is to train clinicians, not fail people out.

 

[choks]

Curved??????? CURVED?????????

This is medical school. Our job is to train clinicians, not fail people out.

Makes sense! I can understand universities failing students to weed out a major, but can't imagine medical schools doing the same. Thank you Goro, I guess I'm just afraid after being away from school for a couple years.

 

[ciestar]

Curved??????? CURVED?????????

This is medical school. Our job is to train clinicians, not fail people out.

My school has curved exams before. But, this isn’t common at all. And by curved exams, I mean by a question or two.

 

[ciestar]

Even at the P/F schools, you will likely be ranked relative to your peers for purposes of residency applications (or so I’ve been told).

Found out my school does it quartiles.

 

[u_raptor]

I'm lucky enough to have some interviews lined up at the moment but not all of them are P/F. Actually its almost split down the middle. This is a big deal for me as I don't want to stress about getting 90% each class. I have friends in both and let's just say, they are in completely different mental states rn. So what's the benefit of non P/F? And how do I get some of these schools I really like to switch hahahahaha

I interviewed at Brody ECU last month and asked this exact question basically. The student I was talking to said it allows their school and residency directors looking at them to have some sort of metric to compare them with bigger schools that use P/F. For instance, if a Brody student was compared to a T30 student with similar step score and ECs, and both were P/F, the T30 is likely to get picked. However, with a grading system, it *might* make the Brody student look better by having an A next to their class transcript. Their school justified it as a way of helping their students when compared to bigger schools.

Although I agree very much, I would rather be at a P/F school in terms of mental state. The schools that used P/F seemed much more relaxed about their classes comparatively.

 

[LizzyM]

You have to be sure that you are learning enough to do well on the boards. For some people, grades help them in that regard. Some P/F schools will alert students who barely passed that they fell into that category just so they know and can take that into account when preparing for boards. At one T20 school, there used to be the saying C=MD meaning don't sweat it, as long as you earned a passing grade, you'd be fine in the match. Not sure if that holds true or if it was better for everyone if it was just P/F and P=MD.

 

[Tenk]

People who barely pass their classes don’t magically wind up with a 260 on step 1. Having grades definitely helped me study harder and score higher. I honestly don’t see what all the fuss is about this either. You’ve been getting grades in school for the last 16 years. Why fuss about another two.

I’d be far more concerned about cost, location, available departments and match lists than p/f. It would be one of the last things I would consider.

 

[DevinBookerMD]

People who barely pass their classes don’t magically wind up with a 260 on step 1. Having grades definitely helped me study harder and score higher. I honestly don’t see what all the fuss is about this either. You’ve been getting grades in school for the last 16 years. Why fuss about another two.

I’d be far more concerned about cost, location, available departments and match lists than p/f. It would be one of the last things I would consider.

ok that’s interesting to hear you say that. i’ve got some schools on my list of interviews rn that are cheaper than the P/F ones. I was thinking about what matters more to me and was having a hard time. if location was approximately on equal grounds, how much more would you pay for P/F, if any?

 

[Medic741]

Because medical schools are bad at what they do and don’t want to change?

 

[Tenk]

ok that’s interesting to hear you say that. i’ve got some schools on my list of interviews rn that are cheaper than the P/F ones. I was thinking about what matters more to me and was having a hard time. if location was approximately on equal grounds, how much more would you pay for P/F, if any?

I wouldn’t pay anything more for p/f because money makes me far happier than p/f ever could.

 

[Tgfu34]

I'm lucky enough to have some interviews lined up at the moment but not all of them are P/F. Actually its almost split down the middle. This is a big deal for me as I don't want to stress about getting 90% each class. I have friends in both and let's just say, they are in completely different mental states rn. So what's the benefit of non P/F? And how do I get some of these schools I really like to switch hahahahaha

My school is not P/F, a GPA is computed by our “percent grades” in our classes (ex. I got a 94% in gross anatomy). It’s definitely stressful thinking about that number but I know that I would work harder in this system rather than a P/F system, which is going to lay a better foundation for me when studying for boards. Also, like the above posters have said, the grading scale could be a component on your CV that sets you apart from another applicant that had P/F, especially if you killed your first two years. Hard chance that the schools will switch their grading unless they’re getting hard data/anecdotal evidence from students that say otherwise. Regardless of grading system, just put in the hard work and prepare yourself as well as you can for boards during those first two years.

 

[Engrailed]

Does your med school ranking/grade follow you beyond residency applications?

 

[AnatomyGrey12]

For the same reason there are still college football teams that run the triple option.

Are medical school courses graded in the same way, curved to a normal distribution meaning a good chunk of the class is destined to fail? Doesn't seem right since they're already very stringent on who they accept. Sounds like it would be 10 times worse since you're competing with others who are on your caliber?

Hell no. The only time a test was "curved" was when the average was a little lower than the profs liked so they would give a few points back to bump the average up. I've had test where the average was an 89 and the low score was like an 81. Medical schools don't exist to try and fail people out.

Does your med school ranking/grade follow you beyond residency applications?

No. But your board scores matter for fellowships a lot of times, but a lot less so than residency.

 

[AnatomyGrey12]

Well, why do you think there's been such a huge switch to P/F? The stress is not the gunner comparison to each other, it's the fear of not matching.

Despite the stress, in a graded system you have a reliable predictor of student performance on Boards. I'd much prefer to see Boards go P/F like they used to, but only if some mechanism would be put into place to prevent lazy PDs from only lusting after grads of Really Top Schools. But that's a whole 'nuther thread.

BTW, The pF system is an odd duck. Schools that institute them have had a tendency to want to reward and acknowledge their best students, so they mutate the system into H(onors)/P/F...which then further mutates into H(onors) HP P F...and you're right back at A/B/C/F grading!

The only way I could support a mass return to P/F grading in medical schools is if there were a standardized curriculum with everyone taking the same NBME subject exams as their tests. No more school prof designed exams.

 

[Hi_I'mPaul]

Definitely at the UG level! Always tried to a standard deviation above the mean. Are medical school courses graded in the same way, curved to a normal distribution meaning a good chunk of the class is destined to fail? Doesn't seem right since they're already very stringent on who they accept. Sounds like it would be 10 times worse since you're competing with others who are on your caliber?

My school is graded NOT on a bell curve system. Technically everyone in the class could get an A. So, you're really not competing against anyone... Historically averages are in the mid-80s so as long as you do your work, then you're more than fine. Plus I enjoy the incentive to do well. Again, this is just for my school though

 

[Tenk]

Does your med school ranking/grade follow you beyond residency applications?

The only thing that patients care about is if your medical school taught you how to prescribe Percocet or not.

Like 9/10 people would prefer a Caribbean grad who prescribes Percocet over a Harvard grad who prescribes Motrin for their chronic back pain.

 

[907914]

a Harvard grad who prescribes Motrin for their chronic back pain

Are you trying to tell me that military docs are Harvard grads?

 

[Tenk]

Are you trying to tell me that military docs are Harvard grads?

That is literally, 100%, word for word what I am saying.

 

[AnatomyGrey12]

The only thing that patients care about is if your medical school taught you how to prescribe Percocet or not.

Like 9/10 people would prefer a Caribbean grad who prescribes Percocet over a Harvard grad who prescribes Motrin for their chronic back pain.

Nah doc! I need that one that starts with a D. I can't remember the name very well but it's the ONLY one that works. Dilah something.

 

[Laradd]

Just my impression but I can't imagine going to a school that isn't pass fail. The headache of having grades and all that again would drive me crazy

 

[choks]

After thinking on it all night, if I had the option, I'd likely go to a graded school just because I believe it would motivate me to do the best my abilities allow. Also, it would help me figure out things I would need more support with since there is a clear grade and percentage of how I did. Of course there will be less stress with the P/F system, but I think to be the best physician I can be, the graded system would encourage me to succeed best. Thank you everyone for the information, really helps!

Now to nail these interviews and actually have some options 🙂

 

[Lucca]

After thinking on it all night, if I had the option, I'd likely go to a graded school just because I believe it would motivate me to do the best my abilities allow. Also, it would help me figure out things I would need more support with since there is a clear grade and percentage of how I did. Of course there will be less stress with the P/F system, but I think to be the best physician I can be, the graded system would encourage me to succeed best. Thank you everyone for the information, really helps!

Now to nail these interviews and actually have some options 🙂

Don’t pick ur school because of the curriculum it’s not likely to be the most salient differentiating factor. Even if you did trust me P/F is the best thing to ever happen to education. Maxing out grades requires exponentially more effort as the grade gets higher, especially in med school where the volume of information is so high. It’s made even worse if grades are factored into your class ranking (if the school ranks its students, as most do) or AOA because then u are penalized for *not* grinding out those extra points.

If you want to be the best physician you can be it’s definitely not because you have the most detailed understanding of all of the human body’s metabolic pathways. You would be better served by studying enough to feel you have a good grasp on the major concepts / step1 and clinically relevant information and then volunteering in the med schools free clinic and starting to learn the basics from patients, residents, attending physicians; or even just shadowing a few specialties and figuring out how hard u have to grind to match what u like.

 

[choks]

Thank you! Unfortunately, the schools I will be interviewing at are letter-graded. Hopefully, I get some more good news later in the cycle. Great information and makes total sense. Sort of like this application process, not all about the numbers, although it is still a significant component.

 

[Matthew9Thirtyfive]

My school is P/F for some modules and H/P/F for most. Not having A/B/C/F grading is amazing. Even having the H thrown in there isn’t a big deal because most people don’t get it so you’re not standing out in a bad way if you don’t have it.

Guess what. People still know how they’re doing because they give us our grades on exams and we use NBME exams in every module. So we get to track our progress without having to worry about not getting a good enough grade. What a concept.

And lol at curved exams.

 

[907914]

So we get to track our progress without having to worry about not getting a good enough grade. What a concept.

BIG BIG MOOD, BRUH.

 

[sparkysparkyboomman]

My school does P/F but our grades in 1st and 2nd year account for a portion of our ranking at the end of school.


BUT, 3rd and 4th year account for a total of 70% of our class ranking. This emphasizes clinical skills over clinical knowledge which I find interesting but also reasonable. Knowing the information is important but knowing how to apply it is more important.

 

[deleted1006988]

My school does P/F for the first 2 years and class ranking is only determined by clerkships. I like it a lot and so far it doesn’t make us any less motivated to do well, especially since doing really well on earlier exams gives you some margin of error in later ones in a class. I could see people not caring about the last exam of a class if they already have enough accumulated points to pass the class... Not that it matters since we have to know stuff for step anyway

 

[RNthenDoc]

Because earning high Bs at Harvard should not be seen as less than earning As at For Profit Osteopathic School Number 77.

So we do P/F and then utilize a series of well made standardized tests to actually show the academic performance of students instead of who is the best at remembering low-yield facts from a professor’s research.

I thought everyone knew this already...

 

[Matthew9Thirtyfive]

Because earning high Bs at Harvard should not be seen as less than earning As at For Profit Osteopathic School Number 77.

I mean I’m all for P/F but I seriously doubt anyone would view a B at Harvard as less than an A at BFCOM. No offense to my DO student colleagues of course, since the same would hold true for many MD schools.

 

[Goro]

Because earning high Bs at Harvard should not be seen as less than earning As at For Profit Osteopathic School Number 77.

So we do P/F and then utilize a series of well made standardized tests to actually show the academic performance of students instead of who is the best at remembering low-yield facts from a professor’s research.

I thought everyone knew this already...

I mean I’m all for P/F but I seriously doubt anyone would view a B at Harvard as less than an A at BCOM. No offense to my DO student colleagues of course, since the same would hold true for many MD schools.

Oh, stop thinking like pre-meds. It simply doesn't work this way.

Medical school material is rather homogeneous, only how the material is delivered varies. A B Harvard is not the same or "better" than an A at BCOM.

HMS is not more rigorous than any other med school in terms of classwork. I could take the entire med school class at BCOM and plop them into HMS and their performance will be pretty much the same. The only thing the HMS students have is more "firepower", meaning, the effort they have to give to handle med school will be less, and thier recall will probably be faster.

And, I hope you're sitting down for this, but PDs don't care about pre-clinical grades.

 

[Matthew9Thirtyfive]

Oh, stop thinking like pre-meds. It simply doesn't work this way.

Medical school material is rather homogeneous, only how the material is delivered varies. A B Harvard is not the same or "better" than an A at BCOM.

HMS is not more rigorous than any other med school in terms of classwork. I could take the entire med school class at BCOM and plop them into HMS and their performance will be pretty much the same. The only thing the HMS students have is more "firepower", meaning, the effort they have to give to handle med school will be less, and thier recall will probably be faster.

And, I hope you're sitting down for this, but PDs don't care about pre-clinical grades.

Oh I know. But extremely top residencies tend to get students from the top med schools. There’s some data that school name plays a part when we are talking about the top 5 or so. I didn’t mean that they necessarily teach better material, just that name plays a part.

Also that preclinical grades don’t matter. Thank God.

 

[deleted804295]

Ew @ graded curriculum. Imagine having to work hard for class material while also trying to grind for step.

 

[u_raptor]

Ew @ graded curriculum. Imagine having to work hard for class material while also trying to grind for step.

Lol I was talking to my dad recently (Ob/Gyn) and he asked how students have time for research, step studying, etc. I told him the curriculum for most schools are Pass/Fail and he was dumbfounded

 

[RNthenDoc]

Medical school material is rather homogeneous, only how the material is delivered varies. A B Harvard is not the same or "better" than an A at BCOM.

HMS is not more rigorous than any other med school in terms of classwork. I could take the entire med school class at BCOM and plop them into HMS and their performance will be pretty much the same. The only thing the HMS students have is more "firepower", meaning, the effort they have to give to handle med school will be less, and thier recall will probably be faster.

I disagree completely. Having spoken to someone who transferred medical schools (from a big name private school to a state school) for personal reasons, this individual holds that there is variance in the rigor with which schools train their medical students.

Speaking with my colleagues from other medical schools currently, I can *definitely* say that some courses are harder at certain institutions than others. I thought this was obvious, and should be intuitive:

If Harvard's lowest quartile ("a C student") had a 3.8 and a 515 MCAT, intrinsically you should know that candidate will do better at ICOM, and would likely be one of their top students. Why is a C (Harvard) student suddenly an A (ICOM) student? This intrinsically implies variance in academic rigor.

And, I hope you're sitting down for this, but PDs don't care about pre-clinical grades.

Getting a grade provides a motivation for students to do well.

If PDs don't care about preclinical grades then it isn't really much of a motivator for students, since medical school's actual function is to match into a residency and not to inflate egos, right?

 

[Goro]

Oh I know. But extremely top residencies tend to get students from the top med schools. There’s some data that school name plays a part when we are talking about the top 5 or so. I didn’t mean that they necessarily teach better material, just that name plays a part.

This is a completely separate issue from the subject of this thread.

 

[Goro]

I disagree completely. Having spoken to someone who transferred medical schools (from a big name private school to a state school) for personal reasons, this individual holds that there is variance in the rigor with which schools train their medical students.

Speaking with my colleagues from other medical schools currently, I can *definitely* say that some courses are harder at certain institutions than others. I thought this was obvious, and should be intuitive:

If Harvard's lowest quartile ("a C student") had a 3.8 and a 515 MCAT, intrinsically you should know that candidate will do better at ICOM, and would likely be one of their top students. Why is a C (Harvard) student suddenly an A (ICOM) student? This intrinsically implies variance in academic rigor.




If PDs don't care about preclinical grades then it isn't really much of a motivator for students, since medical school's actual function is to match into a residency and not to inflate egos, right?

There are various reasons why students underperform in medical, but the academic rigor and performance of the student is not what you're trying to make it out to be.

I'll match your anecdata with my own, taken from medical Educators at Medical Education conferences. And that is the problem students are the same no matter where they go to medical school

Stop trying to equivalize undergraduate performance with medical school performance

 

[RNthenDoc]

There are various reasons why students underperform in medical, but the academic rigor and performance of the student is not what you're trying to make it out to be.

I'll match your anecdata with my own, taken from medical Educators at Medical Education conferences. And that is the problem students are the same no matter where they go to medical school

Stop trying to equivalize undergraduate performance with medical school performance

The entirety of medical school admissions “equivalizes” UG performance with medical school performance. You’ve stated on this site hundreds of times that certain GPAs are “lethal” for your school. If there isn’t a correlate between UG performance and medical school performance, why do you screen low GPAs or MCATS?

You actually didn’t address any of my points at all, other than to tell me “performance isn’t what I think it is.”

Do you believe someone who can pass at HMS but is near the bottom of the class would be the bottom of the class at a bottom-tier school?

That’s the crux of my argument. I believe that student would have higher grades at a lower-ranked school. Seems like common sense.

 

[907914]

There are various reasons why students underperform in medical, but the academic rigor and performance of the student is not what you're trying to make it out to be.

I'll match your anecdata with my own, taken from medical Educators at Medical Education conferences. And that is the problem students are the same no matter where they go to medical school

Stop trying to equivalize undergraduate performance with medical school performance

I think there might be some accuracy in the “same student performs differently at different medical schools” argument.

The curriculum would be the same, and the student would be the same, but the students surrounding them would be the same. Say someone has an acceptance to both Harvard and ICOM (weird ass student, but let’s roll with it). The kinds of students that surround this theoretical applicant would either make this guy the middle to bottom of his class at Harvard, but the top of his class at ICOM. If the content is the same, Harvard students are more likely to perform better than ICOM students. However, if the applicant is at the top of his class at ICOM, the confidence boost may give him better results on step or clinicals. Conversely, if you are bottom of your class at Harvard you will be more stressed, have lower self confidence, and overall perform much worse

 

[Matthew9Thirtyfive]

This is a completely separate issue from the subject of this thread.

We are discussing the benefits of P/F and someone brought up that it equalizes grades between schools and that Harvard students shouldn’t have to worry about having their Bs looked at as worse than As from podunk schools. That’s what prompted my response. Seems like a pretty linear train of thought to me.