Why the fuss about med school grading systems?

[janedoe4]

A dumb question, and probably best answered by current med students, but since I'm still an MS0 it would probably get moved from allo... Anyway:

Why are non-pass/fail grading systems seen as such a big detriment to a medical school and the experience students have there? Almost all of us have been dealing with grading scales more finely divided than that for ~16 years and been fine. Some developed competitive attitudes, some got stressed, some schools developed overall competitive/stressful atmospheres, and some didn't. I get that every level of education is more challenging than the last, so med school is reasonably expected to be harder than undergrad, but does one's ability to cope with being graded really drop off so dramatically at this point?

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[da8s0859q]

A dumb question, and probably best answered by current med students, but since I'm still an MS0 it would probably get moved from allo... Anyway:

Why are non-pass/fail grading systems seen as such a big detriment to a medical school and the experience students have there? Almost all of us have been dealing with grading scales more finely divided than that for ~16 years and been fine. Some developed competitive attitudes, some got stressed, some schools developed overall competitive/stressful atmospheres, and some didn't. I get that every level of education is more challenging than the last, so med school is reasonably expected to be harder than undergrad, but does one's ability to cope with being graded really drop off so dramatically at this point?

Also an MS0, so grain of salt theory applies, but:

Given the already-difficult (for most) nature of medical school, I would think that it is often seen as a good thing to have a grading system that provokes less competition amongst a group of people who are already fairly high achievers, statistically speaking.

And speaking personally, I think I would also enjoy a two- or three-tiered system more so than the usual grading scale.

 

[riceman04]

A dumb question, and probably best answered by current med students, but since I'm still an MS0 it would probably get moved from allo... Anyway:

Why are non-pass/fail grading systems seen as such a big detriment to a medical school and the experience students have there? Almost all of us have been dealing with grading scales more finely divided than that for ~16 years and been fine. Some developed competitive attitudes, some got stressed, some schools developed overall competitive/stressful atmospheres, and some didn't. I get that every level of education is more challenging than the last, so med school is reasonably expected to be harder than undergrad, but does one's ability to cope with being graded really drop off so dramatically at this point?

Of course not!!!! But why deal with it when you do not have to? Why do some schools still use that system whereas others do not.

I think some people may have some animosity towards the old grading scale b/c they look at it like this: The higher one progresses in education the more he/she has to lose...grades add that extra pressure in an environment that is naturally stressful due to intensity and volume of material (which you pretty much said). So the last thing someone wants to deal with is the idea of being "graded"

 

[riceman04]

And speaking personally, I think I would also enjoy a two- or three-tiered system more so than the usual grading scale.

What is interesting, though, is that in med school "fail" is usually the numerical equivalent to a 70 (or 69) and below...So, that two-three tiered system still has its drawbacks.

 

[MrBurns10]

A dumb question, and probably best answered by current med students, but since I'm still an MS0 it would probably get moved from allo... Anyway:

TRUST me, pass/fail is as good as it can get. Medical school involves memorizing so much information and so much studying (just to pass) that if you have to worry yourself with getting honors or whatnot, you're going to go insane. My school is H/P/F for the most part and I really wish we had stuck to the P/F system of first block.

 

[foofish]

Of course not!!!! But why deal with it when you do not have to? Why do some schools still use that system whereas others do not.

I think some people may have some animosity towards the old grading scale b/c they look at it like this: The higher one progresses in education the more he/she has to lose...grades add that extra pressure in an environment that is naturally stressful due to intensity and volume of material (which you pretty much said). So the last thing someone wants to deal with is the idea of being "graded"

...and since so many schools have switched to a pass/fail system, and some schools don't even internally track grades and still have no problem getting their students into great residencies, that would suggest that having letter grades at this stage really is unnecessary.

Some people "need" letter grades as motivation to learn, and that's fine, but for many others letter grades are an added layer of stress (and for some it then becomes a matter of learning for the test, as opposed to learning to actually acquire the knowledge).

All I can say is, picture what life would have been like if all of your premed requirements were pass/fail (and with no impact on your chances of getting into med school).

 

[Instatewaiter]

Even though you may be on a P/F system, your rank is still kept.

 

[soeagerun2or]

Even though you may be on a P/F system, your rank is still kept.

Not true. P/F & unranked is very much more stress free.

 

[searun]

Big Brother is still watching. Big Brother is always watching you. Big Brother knows what you are doing and Big Brother will report what you are doing....when you apply for residency. But if it makes you feel better to believe the illusion, then do so but it won't change anything. But sleep, my child, sleep well tonight.

 

[pcguy2]

How many schools are P/F and unranked. At UMN we have P/F but ranking still kept and honors are given to top students. I suspect that honors rankings will matter in matching.

Am I wrong?

 

[dbhvt]

A dumb question, and probably best answered by current med students, but since I'm still an MS0 it would probably get moved from allo... Anyway:

Why are non-pass/fail grading systems seen as such a big detriment to a medical school and the experience students have there? Almost all of us have been dealing with grading scales more finely divided than that for ~16 years and been fine. Some developed competitive attitudes, some got stressed, some schools developed overall competitive/stressful atmospheres, and some didn't. I get that every level of education is more challenging than the last, so med school is reasonably expected to be harder than undergrad, but does one's ability to cope with being graded really drop off so dramatically at this point?

The easy to understand answer: What is the average GPA for a matriculated medical student? OK, now does it make sense?

The real answer: Evaluations should reflect the purpose of the course. M1, for example, is meant to give you a base of information. There is no pedagogical use for discriminating between five tiers of understanding.

 

[dantt]

TRUST me, pass/fail is as good as it can get. Medical school involves memorizing so much information and so much studying (just to pass) that if you have to worry yourself with getting honors or whatnot, you're going to go insane. My school is H/P/F for the most part and I really wish we had stuck to the P/F system of first block.

Then there's Yale...pass/pass.

 

[Tired]

How many schools are P/F and unranked. At UMN we have P/F but ranking still kept and honors are given to top students. I suspect that honors rankings will matter in matching.

My school is P/F and unranked. Clinical years are graded on a P/F/honors basis, but no ranking is used. Yes, the honors in clinical years matter quite a bit because of this system.

 

[gary5]

When you take 100 students who have gotten straight As all their lives, and start handing out Cs and Fs, the environment becomes toxic very quickly. Some get slightly depressed, others have nervous breakdowns, and still others simply quit, deciding that a career of torture isn't a career worth pursuing. And, let's not forget the gunners who start slitting each others' throats (stealing text books, throwing away other peoples' notes, taking all the handouts so other people don't get one). Pass/fail is meant to reduce the excessive stress and competition that has been a problem in the past.

 

[Instatewaiter]

When you apply for residency, your school will either send out your rank or will send out your numerical scores with a histogram. So while it may seem like you are unranked, you are going to be ranked.

I am not saying that P/F is not more stress free. I am just saying that while it may seem like you are completely unranked, in almost all cases that is not the case. For instance, if no rankings were kept, who would get AOA? Do they just pick names out of a hat?

 

[njbmd]

When you take 100 students who have gotten straight As all their lives, and start handing out Cs and Fs, the environment becomes toxic very quickly. Some get slightly depressed, others have nervous breakdowns, and still others simply quit, deciding that a career of torture isn't a career worth pursuing. And, let's not forget the gunners who start slitting each others' throats (stealing text books, throwing away other peoples' notes, taking all the handouts so other people don't get one). Pass/fail is meant to reduce the excessive stress and competition that has been a problem in the past.

The above is gross exaggeration of the case. There is no "toxic environment". My school has the Honors, Pass or Fail grading system. One person decided that medical school was not for him two weeks into the first semester and quit. This action had nothing to do with the grading system but because he didn't want to do the work. Some people in my class failed a course. The pass/fail unranked system doesn't prevent failure of coursework nor does it prevent "gunners" who are present in every class. My class readily shared notes and texts and old exams and thus the grading system had little effect on individual behavior. People will deal with the curriculum in individual ways; some successful and some not so successful.

People who were prone to depression were depressed. No grading system will alleviate depression. The excessive "competition" from your classmates is largely a myth. The competition is from yourself and how you adjust (or don't adjust) to the curriculum that you must master. A grading scale won't change this adjustment period. Contrary to popular belief, medical school doesn't change people into something that they were not before they came to medical school. In my class, the age range was from 19 to 53 and thus all were adults and all had personalities set before medical school.

When you apply for residency, your school will either send out your rank or will send out your numerical scores with a histogram. So while it may seem like you are unranked, you are going to be ranked.

I am not saying that P/F is not more stress free. I am just saying that while it may seem like you are completely unranked, in almost all cases that is not the case. For instance, if no rankings were kept, who would get AOA? Do they just pick names out of a hat?

This is true. You will be "ranked" in some manner either by your school or by the residency program directors when they are evaluating your application to their program. These Pass/Fail "so-called unranked" systems are largely an attempt by the administration at some medical schools to "play with the heads of the uninitiated". You will be ranked and you will be singled out by your performance in medical school in some way whether it happens early by grade in pre-clinical coursework, board exams or clinical grades.

In the end, you do your best and change what isn't working for you. In the end, you will be judged by your performance one way or the other.

 

[pagemmapants]

I am not saying that P/F is not more stress free. I am just saying that while it may seem like you are completely unranked, in almost all cases that is not the case. For instance, if no rankings were kept, who would get AOA? Do they just pick names out of a hat?

From what I've heard, AOA at my school matters very little on first-year grades (which makes sense, given the curriculum) but a lot more on who you know who is also in AOA. Importance of basic sciences grades is minimized, but I'm sure our 2nd year rotations grades are given in a "print out" list version to the execs just to make sure that awesomely nice and smart-seeming cooperative person they like so much doesn't have straight Ps.

Also, as far as I know, the advisory dean letters go out with no more of a breakdown than "top half" or "bottom half" and the rest relies on words like "excelled in ______" and "performed extremely well in _______" versus "was sufficient in ______" and "performed acceptably in ________"

If you think this is bad for the students' chances because it makes the 89%ers look like the 98%ers, check out our match list. I like it because it takes into account the grades that actually matter; clinical rotation grades. It's not like memorizing every enzyme of the TCA cycle better than the guy next to you is going to make you a better doc, especially if that guy is spending 4 hours at the free clinic while you're holed up in the library.

 

[postbacker]

Right, but some schools *are* really unranked, and don't have AOA, and their students do just fine.

...off the top of your head, can you list some of these schools?

 

[MrBurns10]

Remember...your med school WANTS you to get into the best residency program you can get into, not only because they love you but because it makes them look good. The advisory deans at my school will only divulge your rank if it helps you. As far as I know, pagemmapants, only AOA rankings are divulged, not even top and bottom half. So even if you go to a ranked school, usually they will not divulge your rankings until it's something that enhances your application.

Okay so I guess I can't generalize, but this is how it's done at my school and it makes total sense. I don't see why any med school would want to hurt their students' chances at getting the residency they want...

 

[Tired]

When you apply for residency, your school will either send out your rank or will send out your numerical scores with a histogram. So while it may seem like you are unranked, you are going to be ranked.

You keep saying stuff like this, but you're simply wrong. Just because it happens at your school, it doesn't mean that it happens everywhere. I read my Dean's Letter from beginning to end. We were not ranked. There was no rank listed, no "top half/bottom half references", nothing.

 

[Law2Doc]

You keep saying stuff like this, but you're simply wrong. Just because it happens at your school, it doesn't mean that it happens everywhere. I read my Dean's Letter from beginning to end. We were not ranked. There was no rank listed, no "top half/bottom half references", nothing.

Some places use differently worded Deans letters for folks in different parts of the class ranking.

 

[Dookter]

You keep saying stuff like this, but you're simply wrong. Just because it happens at your school, it doesn't mean that it happens everywhere. I read my Dean's Letter from beginning to end. We were not ranked. There was no rank listed, no "top half/bottom half references", nothing.

I think this is a good point that people overlook. Different schools have different grading schemes, different ranking schemes [or lack thereof], etc. Look into these things people....they can affect your life. I personally know of some schools that have grading systems I would really not like. There are always the nay-sayers who get on SDN and say, "OH, it doesn't affect us" or "Well, you're ranked too and can't ACTUALLY enjoy P/F" etc. Don't ever listen to people who are in a crappy situation when they try to convince you that P/F or whatever isn't for you just b/c they didn't have it. Most people love it.

 

[Falco2525]

At U Chicago no ranking the first 2 years...straight P/F...and AOA is decided by how you do in the 3rd year clerkships

 

[Doctor Bagel]

As a student at a school with the traditional ABCDF grading, I do think it's more stressful because I'm always sweating over remembering those little insignificant differences that make the difference between an A and a B. Honestly, I think I might be better prepped for the boards and for life in general, if I could focus more on the big picture stuff that I'll actually retain instead of memorizing all these tiny details to get an A. And yes, I know I could set my mind free and not care about grades, but that's easier said than done for overachieving med students like me and most of you.

 

[psipsina]

My school is F/P/Hp/H (so basically grades except failing is <70-75) and it is not competitive at all. We get so many study guides and tips e-mailed to us from classmates that I frankly don't even get to look at them all. Everyone helped each other out during dissection, we have a student run free tutoring program etc. Its frustrating only to the extent that sometimes you miss a higher mark by a point or two and you kick yourself in the a$$ for watching tv as much as you did but no one is making suicide pacts over it or anything. Anyone who is truly deeply stressed is because they are borderline failing, which would be the same in a P/F system. We had a few drop outs but they were for personal reasons and I believe they are all coming back next year when they have their lives in better order.

 

[durfen]

At Stanford, it is pass/fail, unranked, and no record of your score is kept. Only aggregate score histograms for your class as a whole are kept, which is sent with your application to say that most passed with flying colors so the applicant probably did too. Just don't fail.

 

[Doctor Bagel]

Yeah, the competition with others isn't the downside of more traditional grading. I don't think that most students at my school are competitive to the point of not sharing their information or anything like that. I just feel like ABCDF grading makes me put more pressure on myself, so it still increases my stress.

 

[Dookter]

Yeah, the competition with others isn't the downside of more traditional grading. I don't think that most students at my school are competitive to the point of not sharing their information or anything like that. I just feel like ABCDF grading makes me put more pressure on myself, so it still increases my stress.

I agree with this. I REALLY agree if you have A-F with percentage cut-offs for who can get what grade...i.e. only X% gets an A, X% gets a B.

 

[durfen]

I guess it's a matter of personal preference. I find that grading hinders my overall learning. Although I'm not sure, it's probably because your learning is directly related to your enjoyment of the course. The two pass-fail courses I took last year were the most enjoyable of the lot, and I still remember a lot. For courses I didn't enjoy at all, I dont remember much. Grading just increases stress and lowers recall.