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Medical School Pass Fail Grading System

I’ve just finished writing my first medical school exam and though the material wasn’t overly difficult, I’m glad it’s done with. A pass is a pass. On to more interesting topics and relevant topics.  It’s safe to say that the honeymoon of medical school is officially over. No more medical school is a “walk in the park.” The sheer amount of memorization is beginning and it doesn’t seem to be stopping anytime soon, if ever.

At first, I was a skeptic of the pass/fail system. The common saying is “What do you call a student who graduates at the bottom of their medical class?” The Answer: “A Doctor!” Wouldn’t a pass fail grading system breed mediocrity. Why would anyone want a surgeon that only answered 75% his medical exam questions correctly? But I’m finding that’s not the case. The type of people that make it into medicine aren’t just motivated by marks alone. We like to learn, tackle challenging problems and push ourselves. The more interesting the materials covered in class, they more inclined we are to study.

The pass fail system ultimately is a good thing for medical students. It reduces competition (backstabbing) in the classroom, unnecessary stress  and reduces an examsmanship approach to learning, where people study with the sole purpose of scoring points. It creates a partnership of trust between classmates and teachers; there is a common goal of quality education. Studies have shown that schools with the pass fail system have better class dynamics and that has been no significant difference found in board scores.

I believe the AMSA sums it up quite nicely when they say, “The type of student who makes it to medical school in the first place—a successful, motivated achiever—will learn in any kind of system; will learn despite the system.”

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  1. Bobo
    Bobo June 5, 2009

    Out of curiosity, do P/F med schools still have some kind of ranking system?

  2. medaholic
    medaholic June 7, 2009

    No. At least not one that counts. People more or less know where they stand in the class though. (Class average, median, highest and lowest mark are still known)

  3. resident
    resident June 9, 2011

    this fixation on p/f is one of the problems with med education. what is wrong with failing a student? what is wrong with a grading system that lets students know how proficient they are? barely passing and not knowing it seems worse than knowing percentiles.

    • medaholic
      medaholic June 9, 2011

      @resident – for the record we do know our percentages. We are given a breakdown of our marks, and we know where we rank in our class. There are students who fail.

      The problem with grading system is when it’s used to determined residency matching, etc. This fosters an environment where your classmates is not your colleague but the competition. People will gravitate to not sharing notes/information, not helping each other out, etc etc because it lessens their chance of succeeding.

      I have nothing against knowing my marks and knowing where I am deficient. Our school fails students who are not proficient. I am just against the idea of making a big deal between an 80% on a test, an 85% and a 90%. Especially for a 70 MCQ test, that’s a difference of a few questions. And if it wasn’t a pass/fail system, people would be overreacting and overstressing to those few marks unnecessarily.

  4. Robert
    Robert July 15, 2011

    I agree, pass / fail seems like a better system for medical school. They need to mix in some more business classes as well. I know plenty of doctors who excel in medicine, but struggle in running the business side of their practice.

  5. Nancyshanice
    Nancyshanice November 8, 2011

    i think it is good system of grading if many organizations will adapt the pass fail system then many will be encouraged to learn. i really like it . thanks for sharing. it is great information that needs to be implemented.

  6. Rosa
    Rosa March 24, 2014

    Thanks for this info. I totally agree with the P/F grading. I think it s a great way to make people work more like a team. And Im a team player.

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