A CHANGE TO PASS/FAIL GRADING IN THE FIRST TWO YEARS OF MEDICAL SCHOOL RESULTS IN IMPROVED PSYCHOLOGICAL WELL-BEING WITH NO DECLINE IN ACADEMIC PERFORMANCE, ATTENDANCE, USMLE SCORES, OR SUCCESS IN THE RESIDENCY MATCH.

 

Robert A. Bloodgood1*, Jerry Short2, John M. Jackson2, and James R. Martindale2. Department of Cell Biology1 and the Office of Medical Education2

University of Virginia School of Medicine, Charlottesville, Virginia 22908 U.S.A.

 

PURPOSE

This study measured the impact of a change in grading system in the 1st two years of medical school, from graded (A, B, C, D, F) to pass/fail (P/F), on medical students’ academic performance, attendance, residency match, satisfaction and psychological well-being.

 

METHODS

The last graded class (2006) was compared with the first P/F class (2007).  Objective data were collected on academic performance in the 1st and 2nd year courses, the clerkships, USMLE Steps 1 and 2CK, and residency placement.  Self-report data were collected using a web survey (which included The General Well-being Schedule of Dupuy) administered each of the 1st four semesters of medical school.

 

RESULTS

The P/F class exhibited a significant increase in well-being during each of the first 3 semesters of medical school relative to the graded class, greater satisfaction with the quality of their medical education during the 1st four semesters of medical school and greater satisfaction with their personal life during the 1st three semesters of medical school.  The graded and pass/fail classes showed no significant differences in performance in 1st and 2nd year courses, grades in clerkships, scores on USMLE Steps I and 2CK, success in residency placement and attendance at scheduled academic activities.

 

CONCLUSION

A change in grading from letter grades (A, B, C, D, F) to pass/fail in the first two years of medical school conferred distinct advantages to medical students, in terms of improved psychological well-being and satisfaction, without any reduction in performance in courses or clerkships, USMLE test scores, success in residency placement, or attendance.