Grading Doctors

LAST SPRING the Med School faculty approved a four-point grading plan to replace a pass-fail system for the first year and a half of Medical School. The new system met its first test in late October at a midterm exam in Histology taken by all first-year students.

The results showed that a system that had been proffered as a variation of pass-fail grading had been abused. Instructors allotted only an eight-point region for passing marks. Furthermore, 16 per cent of the class fell within a "marginal" designation and were required to perform remedial work. Ostensibly conceived as a warning to those few students bordering on failure, this designation was stretched.

The first year students response, a plan to number but not sign blue books at a subsequent midterm in Physiology, was carried out by over 90 per cent of the class. This measure allowed a coordinating committee of the students to make sure that the faculty learned the names of only those who failed and thus could record only pass or fail grades.

This plan is ingenious and admirable and deserves support. While it lacks the immediate force of a strike, shutdown or demonstration, it has handcuffed the faculty and effectively reintroduced pass-fail grading.

However, the release to the administration of a sealed list of code numbers and names from a Microbiology final earlier this week may only have given the faculty a hostage it will be impossible to reclaim.

Medical students enjoy an enviable position. They have all finished their pre-med training and its fabled cut-throat competition, to reach a plateau where, barring failure, they are assured internships and M.D.s. Any attempt to rank them at this level is meaningless; it only introduces the unnatural and ugly clamor for grades.

Proponents of a structured grading system argue that without grades, better students would have no assurance of acceptance as interns by prestigious hospitals. This argument rests on shaky premises.

First, even without students' transcripts, prestigious hospitals will no doubt be able to cull what they consider the cream of the cream.

Second, it is not clear that these hospitals, usually the best equipped and most sophisticated, should get the better students. Every one of the poorer students will receive an internship and those who choose to will ultimately treat people. To conclude that the better student nonetheless deserves a place in the better hospital does not follow.

Even leaving aside this question, it is clear that the Harvard Med School faculty should restore pass-fail grading. It has received an overwhelming mandate from its students, a fact that must override other considerations.

The faculty should reinstate pass-fail grading now.

The faculty should also try to gauge student feeling at the clinical level, the last two-and-a-half years of Med School, years which have always been graded.