The Alpert Medical School MD Curriculum Committee passed a motion last month to grade all preclinical courses — the entirety of the first two years of medical study — solely Satisfactory/No Credit, beginning with the MD class of 2017.
The school’s previous policy graded all preclinical courses S/NC but also allowed students to earn honors distinction in select courses following their first semester.
Med School administrators and students said there has long been widespread interest in eliminating honors grading for preclinical classes.
Med School Student Senate members of the class of 2017 raised the issue to the rest of the Student Senate, which unanimously voted for the change prior to the motion’s adoption by the MDCC. A survey of first-year medical students found that 65 percent of students favored the change, wrote Dan Ebner MD’17, Class of 2017 MDCC student representative, in an email to The Herald.
This strong student support prompted Luba Dumenco, chair of the subcommittee on years one and two of the MDCC, to conduct extensive research on the issue, which showed that solely S/NC preclinical grades are very common. The majority of the U.S. News and World Report’s top 20 medical schools have pass/fail grades without honors for preclinical classes.
A 2011 Mayo Clinic College of Medicine study designed to evaluate the effects of grading on preclinical medical students concluded that the way students are evaluated “has a greater impact than other aspects of curriculum structure on their well-being. Curricular reform intended to enhance student well-being should incorporate pass/fail grading.”
A 2011 University of Massachusetts study reached a similar conclusion.
“I went into this in a very unbiased fashion,” Dumenco said. “Increasingly, as people saw the data, they became more interested in it, and that’s because the data were strong.”
But some expressed doubt about the extent of the studies’ conclusions.
“I don’t think the absence of honors would have affected my stress levels tremendously during years one and two,” wrote Greg Elia MD’15 in an email to The Herald, though he added that he supported the change on the whole.
The UMass study found that pass/fail, compared to tiered grading, resulted in “no significant difference” in students’ residency placements or academic performance.
“Med students are highly self-motivated regardless of the honors distinction,” Elia wrote.
Though “the absence of preclinical honors grades on a student’s transcript” would not be harmful, honors distinction could slightly bolster a student’s application for residency placement, Elia wrote.
But a 2012 survey of the national resident matching program found that honors status in preclinical grading was relatively unimportant in evaluating residency candidates.
“There is no evidence that changing to pass/fail will hurt anyone’s application,” said Dick Dollase, director of the office of medical education.
Dollase dismissed the notion that preclinical S/NC would deprive students of a chance to distinguish themselves from their peers, citing scholarship and research opportunities as well as the availability of an honors distinction in the clinical years, “where it counts.”
After the evidence was presented to the MDCC, and members of the Student Senate in the class of 2017 discussed the issue with their peers, the Office of Medical Education conducted a survey indicating that 87 percent of students supported the motion to restrict preclinical grades to S/NC.
PLME student Nikki Haddad ’16 said she was “pleasantly surprised by the news,” adding that the change may reduce competition among students and promote collaboration.
“There were still people who dissented, some feeling as though the data for other schools may not apply to Brown or them personally, and others noting that they felt honors would motivate them to work harder,” Ebner wrote.
But administrators said they were interested in hearing what all students had to say, and dissenting students were offered the opportunity to speak at Student Senate and MDCC meetings.
“There had been an adequate opportunity for everyone to discuss this in a non-emotional way,” Dumenco said.
Though the MDCC was aware the proposal did not have universal support, the committee passed the motion regardless due to vast majority approval and the preponderance of evidence in its favor, she said.
ADVERTISEMENT
