[Should we keep the graduation with distinction in medical school?]

Historically, medical students can graduate medical school with distinction if they have a high mark on average or excellent performance on a number of rubrics. Recently, one of the Dutch medical schools abolished marks during the clerkships, based on the decision to introduce programmatic assessment. This led to an internal debate about whether or not to keep the option of graduating with distinction. The authors believe firstly that it is difficult to derive a mark from narrative feedback. Secondly, more theoretically, without receiving marks or distinctions, we enable students to focus their attention to the process of learning, allowing mistakes, and uncertainties, instead of showing how good they are in meeting expectations.