UT Southwestern Changes Grading System

I think from a grading policy standpoint: This change will probably bring a LOT more students towards the UTSW side and I do think it is a step in the right direction with making the first semester strict Pass/Fail and numeric cutoffs at the beginning just like Baylor. With respect to curving grades in the basic sciences at UTSW, there are only 2 courses that I remember that were curved: Biochemistry and Genetics and in general you were helped by the curve, not hurt by it.

First semester courses at UTSW are Anatomy, Biochemistry, Genetics, and Embryology. So for incoming students I would say they will definitely like the change as those courses are memorization intensive courses.

Afterwards though, whether it is A/B+/B/C/F or Honors/High Pass/Pass/Marginal Pass/Fail or Jacket/Wallet/Coat/Pants/Shirt, it’s the same stratification over 5 intervals, it’s the alphabet vs. catchy labels. For naive medical students, the terms “Pass” and “High Pass” tends to give a greater sense of security (although a false sense of security) vs. getting a “C” makes someone feel worse. So with respect to grading scales Baylor and UTSW are equivalent. You call it “Honors”, and I call it an “A”. I liked the letter grade system, but I’m also very biased as I made an “A” in every basic science course I took. I would probably feel differently if I didn’t make all As.

For the purposes of true decrease in “stress” level and to decrease “competitive” feelings btw students (w/regards to not wanting other students to get an edge – hence not wanting to form study groups, hiding old tests or notes, not wanting to share study aids), the only grading interval that truly achieves this is strict Pass/Fail as is done at these institutions – many of which are top notch as well: http://services.aamc.org/currdir/section1/grading1.cfm (Select “Required Basic Sciences” and “2 intervals”)

The real reason for a more extended grading interval is for AOA selection. If, for example, we were to go to a strict Pass/Fail only system, the only thing AOA could stratify people on are USMLE Step 1 board scores (something I don’t mind at all actually, as it is a standardized exam and everyone is measured along a standardized yardstick). However, the hooting and hollering would be from students who did very well academically on professor-produced exams through 2 years, but did not do well on USMLE Step 1 a one day exam (those two are not necessarily equivalent as the emphasis both on material of what the professor thinks is important vs. what the USMLE test writers thinks is important AS WELL AS rote memorization vs. concept/critical thinking are very different).

There are students with stellar preclinical grades who had lackluster or average board scores. There are those with average or ordinary preclinical grades who had stellar board scores.

I know Baylor College of Medicine used to be, until very recently, strict Pass/Fail in the first year entirely and used H/HP/P/MP/F for the second year. I am very curious as to why that was changed. I highly doubt it had anything to do with straggling board scores or bad match lists or residency program director complaints. More likely it had to do with AOA selection as in reality when it comes to residency programs, they could give a two shits about your actual preclinical grades. It’s a lot easier to tell someone they missed getting into AOA marginally because they had a “High Pass” in Gross Anatomy, then not having ANY justification, no matter how ridiculous.

At any medical school, my personal opinion is I don’t think the grading system affects how much medical students study. I do think, however, it DOES affect as to WHAT medical students will study. For example, when a strict Pass/Fail system is instituted, students can really learn to master the information well and more importantly well for boards. However, any other system in which you have a variation of that like at UTSW or Baylor, you don’t really learn what you desire, you learn what the PROFESSOR wants you to know and HOW they want you to know it.

For example, in Pathology, the required textbook and the “Bible” of Pathology is usually Robbins Pathologic Basis of Disease, which if you actually read it is a very well written text. However, we knew better than to actually read the textbook as we knew the professors really did not test from there, but from their own syllabus notes/powerpoints.

Now if UTSW was strict Pass/Fail would I have comprehensively read Robbins? Of course! After all, there is no question I will be able to Pass the course, that’s not something I have to worry about. Thus, I can try to absorb as much knowledge and learn it the way I’m SUPPOSED to learn it rather than from a professor-made syllabus packet which may have extraneous info, may skip diseases, or not include all information that is in Robbins, such as seeing the connections through Pathophysiology. I know people that started studying from Robbins but would fail a professor-generated exam, and thus would have to go back to studying syllabus notes/powerpoints like the rest of us.

With the system of A/B+/B/C/F or H/HP/P/MP/F am I likely to read Robbins if the professor doesn’t really cover things they are supposed to in the chapter? Of course not. We are likely to do the study formula that brings the biggest dividends esp. in the short term, in which case the grade being one of them, so if a disease is not covered in the lecture notes, but is in Robbins, naturally I would skip it, and say oh well, as it wouldn’t help me get a question right on the exam coming up and I would be right. However, USMLE Step 1 is not a professor-biased exam, and you are expected to be able to answer questions not based on how a lecturer presented it, but based on what you SHOULD have learned.

One nice thing about UTSW is we take the NBME subject exams for the basic science in MS-2, which is actually written by the USMLE test writers. Thus, I am able to not only study for professor exams but also study well for a standardized exam and see how well I mastered it based on NBME/USMLE standards. I think the only NBME subject Exam that Baylor students take is the Comprehensive Basic Science Examination in order to promote: http://www.nbme.org/programs-services/medical-schools/subject-examinations/index.html