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True Pass-Fail Curriculums: Key to Learning and Collegiality

Being a premedical student is largely about the numbers — your MCAT score, your rank in your graduating college class, whether that subpar performance in organic chemistry will lethally impact your medical school application. If you’re anything like me, your time as a premed was spent encapsulated in a crippling and disorienting world of anxiety. I remember scanning Internet posts to confirm just how underwhelming my application to medical school was in comparison to those of other “more qualified” students. I read of students who had managed to attain a 4.0 grade point average in all their prerequisite classes while achieving a perfect score on the MCAT and maintaining an enviable balance of humility and self-confidence, and I was understandably daunted. 

Stepping outside of traditional grades

Tired of the consequences of having to numerically perform, whether that meant comparing my score on a test to the class average or simply calculating (and recalculating) what grade I’d need to be “good enough” for medical school, I began to focus exclusively on medical schools with true pass-fail curriculums during my medical school application cycle. To me, the pass-fail curriculum meant liberation from studying to compete and an opportunity to study to learn.

Of course, studying to compete doesn’t mean that I didn’t learn the definition of work in my premed physics class or that I missed the steps of glycolysis in biology, but it does mean that how I studied for those classes was defined not by what information I thought would be useful for my academic career moving forward, but rather by what information I thought would be “high yield” — meaning that which I thought would end up on the test.

By contrast, as a student now enrolled in a true pass-fail medical school curriculum, I find that my studying is more often than not driven by curiosity and a willingness to move outside of the material presented in class. I find myself looking up clinical correlations, delving into minor topics that I find interesting and, ultimately, exploring medicine through my preclinical curriculum in a way that might help decide my professional interests later on as I apply to residency.

Teamwork to learn

I also find that the pass-fail curriculum comes with a measure of humility absent in a graded system or in a pass-fail curriculum that embraces a “high pass, pass, low pass” hierarchy. With numerical competition largely removed between classmates, I have observed a shift in social divisions typically created between “good” and “bad” students. No one asks about specific scores, and thus study groups are formed not based upon whether someone got an 80 percent or a 95 percent on the last assessment, but rather upon whether a prospective group member is invested in team learning and has a valuable perspective to contribute.

I often found myself intimidated by my premed classmates who seemed perennially more “on top” of the material than I ever could be, thus leading me to shy away from group learning. In medical school, I find that the intimidation factor has been eliminated and that, as a consequence, I’d feel comfortable approaching any given classmate for academic collaboration.

Looking ahead

The pass-fail curriculum does have drawbacks in that it may not give you a fantastic measure of how well you are mastering your course material — is 70 percent on an assessment really good enough to say “I know this?” But in my experience both as a student in this kind of curriculum and observing my classmates adjust to these new standards, I can’t imagine that the additional pressure of alphabetic or numerical grades would add much to our learning. If anything, having grades seems cause for the divisiveness and feelings of inferiority endemic in premedical courses, which compromise the kind of collegiality and curiosity necessary to perform effectively as a physician.

Cassie Kosarek Cassie Kosarek (2 Posts)

Contributing Writer

Geisel School of Medicine at Dartmouth

Cassie is a student at the Geisel School of Medicine at Dartmouth. She graduated in 2012 from Bryn Mawr College with a BA in English and a minor in psychology and completed the Bryn Mawr College Post-Baccalaureate Program for career changers in 2015. She has been on the editorial team at the Annals of Thoracic Surgery and regularly contributes to US News and Student Doctor Network.