Pass-fail grading in medical education is a hot-button issue. Recent publications from the WSU Elson S. Floyd College of Medicine explore arguments for different grading systems in the United States, examining the evidence as well as student and physician perspectives.
The debate starts with medical students’ preclinical training. Fourth-year MD student Rhett Oellrich and Department of Medical Education and Clinical Sciences Professor Dawn DeWitt, MD, MSc, CMedEd, MACP, FRACP, contributed to a feature published in the New England Journal of Medicine debating the merits of pass-fail versus tiered (A, B, C, D, F) grading systems.
Expert commentators are invited to contribute to NEJM’s debate series and assigned a position to defend. Oellrich and DeWitt were assigned tiered grading, although the college’s MD program employs pass-fail grading for pre-clerkship education, or classroom-based learning.
“It was challenging,” DeWitt said, “but after talking to some of our students, I think there is room for potential benefits of both systems, especially now that we have pass-fail scoring for the United States Medical Licensing Examination (USMLE) Step 1 exams. I’m really looking forward to seeing what readers think about this challenging issue.”
Critics of the pass-fail system argue tiered grading is necessary to ensure competency and prepare students for their licensing exams, among other factors. Advocates argue pass-fail grading is sufficient for assessing medical knowledge, boosts student well-being and satisfaction, and helps remedy academic disparities.
Pass-fail grading is also a hot topic for clinical training, from undergraduate to graduate and continuing medical education. Vice Chair for Internal Medicine Lonika Sood, MBBS, MHPE, FACP, and collaborators at several institutions authored an article in the American Journal of Medicine synthesizing perspectives on clerkship assessment.
The article explores the complexities of evaluating clinical skills, from best practices to ensure core competencies to the unintended effects of grading variability on students’ competitiveness in residency applications.
Full access to both articles is available through the WSU Libraries.