Marking a new era, Hopkins drops grades

Medical school: A pass-fail system is replacing the traditional letters in doctors' education.

October 11, 2002|By Erika Niedowski | Erika Niedowski,SUN STAFF

There are no more A students at the Johns Hopkins School of Medicine. But that has nothing to do with the caliber of future doctors who are training there.

The medical school has dropped its traditional letter grades and replaced them with a pass-fail system - a step that most other elite medical schools have taken.

"This sort of ties in to a national trend and wave of trying to figure out how to assess very bright people and do so in a way that encourages them rather than discourages them," said Dr. David Nichols, vice dean for education at Hopkins.

Medical school officials began discussing the change last year, in part because they worried that the letter-grade system was turning off potential students as well as fostering an unhealthy competitive climate. A survey of students who were accepted to Hopkins but decided to go elsewhere showed that the grading system was one of the main reasons.

Walter Cheng, 26, a third-year Hopkins medical student and self-described "classic B student," called the new pass-fail system a "nice cosmetic change" to a school with a reputation for being overly intense.

"People who are applying to the school, it kind of reassures them that it really isn't as cut-throat as its reputation may seem," said Cheng, who sits on the education policy committee that first debated the change.

Medical school is hard enough without the pressure of grades, faculty members say. The first two years, spent largely in the classroom, are packed with basic science courses such as molecular biology and biochemistry.

Students have to memorize the name of every bone, organ and muscle in the human body and be able to explain, for example, the difference between a chromosome and a chromatid.

The new grading policy, instituted schoolwide beginning this semester, is designed in part to help change the mindset of those obsessed with getting an A.

"Because medical students come from this high-pressure, pre-med world, it's very important in medical school to do everything we can to get that out of their system, and get them to just not worry about grades and worry only about learning and caring about people and caring about patients," said Dr. Solomon Snyder, head of the neuroscience department and a member of Hopkins' advisory board.

Gone are the 13 possible letter grades ranging from A+ to F. Students will now receive one of four marks: honors, high pass, pass or fail.

An expanded pass-fail system will enable outstanding work to be recognized as such - and for residency directors to draw distinctions among large pools of applicants.

Many top-tier medical schools, including Harvard, Yale, Duke and Stanford, use some form of a pass-fail system.

Dr. William B. Guggino, a professor of physiology at Hopkins who also sits on the education policy committee, said it was hard under the old system to differentiate levels of excellence.

The difference in the quality of work between, say, a student who got an A and a student who got an A- wasn't always clear.

Guggino also ended up counseling his share of students who had trouble accepting that C's on their transcripts wouldn't prematurely end their medical careers.

"There's plenty of examples of people who were in the middle of the class, [or] near the bottom of the class, who ended up being great doctors," he said.

Not everyone supported the new four-level grading system. Some wanted to continue using letter grades, believing that it was a professor's job to draw out differences in student performance and that classroom competition was healthy. Some preferred a system that was strictly pass-fail, to measure only mastery.

Student reaction has been mixed. Nichols, the vice dean, said first-year students seem to like the simplified system. But other students who are used to the letter-grade system - and thrived under it - aren't so sure.

Some members of Cheng's class are worried that the switch could hurt their chances of landing a highly competitive residency.

"We're just a little bit worried that perhaps people might not understand what the change is all about," he said. "There's a little bit of anxiety there, but I think those are things that will pass with time as all the kinks get worked out."

As always, students will have written recommendations from faculty members to support residency applications - which can be more telling than even letter grades.

"I have more things to back me up besides just saying, I did this class and I got a `high pass,'" Cheng said. "It's not as if my grades are the sole basis for judgment."

Faculty members stress that even with the new grading system, the academic standards at Hopkins haven't changed - and students know that.

"Students don't sit around watching television and say, `All I have to do is pass,'" said Snyder. "They actually are diligent and motivated."

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