An ‘A’ I didn’t earn

a-big.jpgI don’t really like the way I feel right now. Before taking my exams, I’d heard that the class historically does poorly on these tests and this makes the cut-off for an A much lower. Knowing this, I decided not to push myself and to be comfortable with a lesser score. I got exactly what I asked for: two As just above the new cut-offs.


I’m not proud of what I’ve done and don’t feel much for celebrating. Worse, I think I saw this coming.

When they start us out in medicine, there’s a quote that gets thrown around to make each of us a little less nervous about our grades and a little more smug about getting by. Vitum Medicinus drew my attention to it once again:

Q: What do you call someone who graduated at the bottom of their med school class?
A: Doctor.

It’s funny, and it’s not.

Some schools are different, but it seems anecdotely that US medical schools grade on a Pass/Fail basis. What constitutes a passing grade is anyone’s guess, but it’s likely either 60% or 70%. This makes little sense to me. Medical students are possibly the most self-selecting group of overachievers and competitors that you’ll find. If you tell them that a failing grade is anything below 80%, then dammit, they’ll get that 80%. If you set the bar, they’ll jump it.

Pass/Fail screws with this. Lowering the bar to 60% and it might as well not be there for this group of people. If you have the academic discipline to get into medicine, a 60% is “mailing it in.” And what motivation is there to excel if it won’t matter? The desire to know so that you don’t kill patients isn’t in play since a) what you learn this early you forget and b) a-ketoglutarate dehydrogenase being an irreversible step of the Kreb’s cycle isn’t going to save anyone’s life (ok, so maybe you don’t forget all of it).

At SGU, we have ABC and F. We kill ourselves for those As, and when we’re reeling from a 12-hour day in the library, our asses sore from pressure atrophy, we look at each other and marvel at how early we would have gone home if we only had to ‘pass.’ The truth is that we don’t have to work any harder: a passing grade for us is the same, whether you call it a ‘C’ or a ‘P.’ But we do work harder because there’s recognition it it.

VM does a good job of making his point that regardless of the grading system, he’s learning the material. He realizes full well that the Boards are coming to level us all and that “cruising” through classes isn’t really an option. Still, maybe for most and at least for me, I perform to expectations and want them set as high as possible.

And this is why I feel like shit. I’ve taken away the meaning of my A. It used to mean that I had pushed until my eyes ached with my head hanging slack from my shoulders. It used to be the measure of my best effort and ability. Instead, I jumped the lower bar, am rewarded just the same, and feel so much worse.


3 Responses to An ‘A’ I didn’t earn

  1. groverjones says:

    I could leave it there, I suppose, but…

    Med school is not the be all and end all of learning life’s lessons. There are friends, lovers, family, hobbies, moments sitting on a beach doing nothing, jobs to earn your way through medicine and many other important things in your life.

    You do not need to kill yourself for an A to be a good (or great) doctor. Many of my colleagues who are good doctors did not achieve highly academically. They learnt the important stuff, they learnt the difference between ‘sick’ and ‘not sick’ and what to do with the ‘sick ones’ and then they went out and experienced life so that they could communicate with their patients. That is what makes a good clinician.

    So my advice; kick back, enjoy a drink, don’t let your mid 20s pass you by in a haze of exams and stress. Medical school is about learning but can also be about good times if you let it.

  2. fomamostly says:

    Your instincts are right, I think. Your fate is not to be hurtling just the low jumps, because you can see them for what they are. If you couldn’t see it, it would be easier to be satisfied. But you do see. Blessing. Curse. Damn.

  3. futuredrquinn says:

    I’m not sure about other US Med schools, but I know for a fact that the “Pass/Fail” system at University of Wisconsin-Madison is set at 80%. Anything below 80% is a fail. And the P/F system is only in place for the first year. After that, its all ABCF grades…so its not really the system you think it is.

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