The use of pass/fail grades to assess academic achievement and house staff performance

The advantages of a formal grading system in assessing a student's capability to practice medicine remain controversial. Students prefer the pass/fail method, while faculty lean toward the traditional approach. The efficacy of a modified pass/fail grading system in detecting superior academic achievement, as well as in predicting house staff performance, was evaluated. Mean scores on the examinations of the National Board of Medical Examiners of students selected fo Alpha Omega Alpha were significantly higher than those of other students, although the faculty was unaware of these results when selecting candidates. Chairmen in institutions where 125 students had served their first graduate year of training felt that 85 percent of the dean's letters summarizing the student's academic performance over a three-year period accurately indicated subsequent performance on the house staff. These results suggest that a modified pass/fail grading system can detect superior students as well as provide relevant information with respect to subsequent performance as a physician.