Differences in Medical Students' Academic Performance between a Pass/Fail and Tiered Grading System.

OBJECTIVES

Medical school implementation of a pass/fail grading system offers the opportunity for a reduction in student stress and anxiety and the creation of a less competitive environment, leading to an improvement in overall well-being. Some critics of a pass/fail system have raised concerns of a decrement in academic performance. The purpose of this research project was to determine whether medical students at the Medical College of Georgia experienced a significant change in academic performance when graded using a pass/fail grading system rather than a tiered grading system in the year 1 curriculum.

METHODS

This retrospective cohort study included a convenience sample of two cohorts of students: the first had tiered grading in the first year of medical school (classes of 2015 and 2016; n = 389) and the second cohort had pass/fail grading in the first year of medical school (classes of 2017 and 2018; n=385). Students' undergraduate grade point average and Medical College Admission Test scores in the two cohorts were compared. The first- and second-year averages and comprehensive finals, and the US Medical Licensing Examination step 1 scores were compared. Mann-Whitney tests were calculated to compare the cohorts' grades.

RESULTS

Overall, both cohorts performed similarly in the first and second year of medical school and on US Medical Licensing Examination step 1; however, there were a few unimportant but statistically significant differences of 1 to 2 points on a 100-point scale. In a few instances, the pass/fail cohort performed slightly better and in others, slightly worse.

CONCLUSIONS

Overall academic performance was similar. The potential for an enhanced learning environment associated with pass/fail grading does not create an important decrement in academic performance.