pass/fail in medical school

i just read an article from medscape..
the system we use here is pass/fail system with grade which are good,very good and excellent..
i just want to share the impact of this system in our life later..

A Change to Pass/Fail Grading in the First Two Years at One Medical School Results in Improved Psychological Well-Being

Abstract

Purpose: To measure the impact of a change in grading system in the first two years of medical school, from graded (A, B, C, D, F) to pass/fail, on medical students' academic performance, attendance, residency match, satisfaction, and psychological well-being.
Method: For both the graded and pass/fail classes, objective data were collected on academic performance in the first- and second-year courses, the clerkships, United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK), and residency placement. Self-report data were collected using a Web survey (which included the Dupuy General Well-Being Schedule) administered each of the first four semesters of medical school. The study was conducted from 2002 to 2007 at the University of Virginia School of Medicine.
Results: The pass/fail class exhibited a significant increase in well-being during each of the first three semesters of medical school relative to the graded class, greater satisfaction with the quality of their medical education during the first four semesters of medical school, and greater satisfaction with their personal lives during the first three semesters of medical school. The graded and pass/fail classes showed no significant differences in performance in first- and second-year courses, grades in clerkships, scores on USMLE Step 1 and Step 2CK, success in residency placement, and attendance at academic activities.
Conclusions: A change in grading from letter grades to pass/fail in the first two years of medical school conferred distinct advantages to medical students, in terms of improved psychological well-being and satisfaction, without any reduction in performance in courses or clerkships, USMLE test scores, success in residency placement, or level of attendance.
Introduction

In recent years, U.S. medical schools have used a variety of grading systems, particularly in the first two years of medical school. The most recent data available from the Association of American Medical Colleges Web site (http://services.aamc.org/currdir/section1/grading1.cfm) show the following breakdown of the grading systems used by medical schools for the required basic sciences portion of the curriculum: two intervals (usually pass/fail) = 40 schools, three intervals (usually pass/fail/honors) = 35 schools, four intervals (usually pass/fail/honors/high honors) = 32 schools, and five intervals (usually A, B, C, D, F) = 26 schools. These data suggest that there is currently no consensus on the most appropriate grading system in the early years of medical school. In addition, there are few useful data available to guide decision making in this area.[1-5]

Medical school is inherently stressful.[6-8] The principal attraction in moving toward a pass/fail grading system lies in the expectation that it will improve students' psychological well-being (reduce stress and anxiety), decrease competitiveness, and promote cooperative learning. However, for medical schools contemplating a change from a traditional graded (A, B, C, D, F) system to a pass/fail system, concerns may include (1) a decline in attendance at scheduled educational activities, (2) a decline in academic performance, (3) a decline in United States Medical Licensing Examination (USMLE) Step 1 scores, and (4) reduced success in residency placement.

A University of Virginia School of Medicine faculty committee examined the literature on medical student grading systems (and its relationship to academic performance), medical student well-being, and residency placement. The committee surveyed current medical students and faculty regarding their preferences for grading systems and gathered data on grading policies at other medical schools. Based on these preliminary measures, in the spring of 2002, the decision was made to switch from a five-interval (A, B, C, D, F) to a two-interval (pass/fail) grading system for each individual course in the first two years of medical school. The change in grading system was introduced with the class of 2007 (the class entering medical school in the fall of 2003).

The faculty committee that recommended the switch to pass/fail grading hypothesized that the change from a graded to a pass/fail system would result in no change in attendance at scheduled academic activities, no change in academic performance in courses and clerkships, no change in performance on USMLE Step 1 and Step 2 Clinical Knowledge (CK) exams, and no change in residency placement success. However, it was predicted that this change in grading system would improve students' well-being, increase satisfaction with their medical education, and affect their time utilization (e.g., allow more risk taking in terms of time allocation to activities not directly related to the medical curriculum). A comprehensive assessment of the impact of the change in the grading system at the University of Virginia School of Medicine has been conducted, the results of which we report here. R.A.B. cochaired the grading study committee, designed the study, collected the data, and wrote the paper. J.G.S. was a member of the grading study committee and assisted in study design and data analysis. J.M.J. designed the online survey tool and assisted in data collection and processing. J.R.M. did all of the statistical analysis of the data.

by:Robert A. Bloodgood, PhD; Jerry G. Short, PhD; John M. Jackson, MS; James R. Martindale, PhD
Published: 06/29/2009