No more P/F for Texas Med schools

4,383 Views | 32 Replies | Last: 12 days ago by BartInLA
HECUBUS
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Bill (H.B. 5294) in the Texas legislature that proposes to eliminate pass/fail grading in medical schools and require a standard A-F grading system. The bill also addresses admissions practices and prohibits preferential treatment based on race, sex, etc.

All the top med schools are P/F for the fist one to two years, depending on their classroom curriculum. A few students and MDs were able to argue and prevent '28 and '29 classes from adopting this retroactively before the Senate vote.

Sailed through the House. Looks like it might have died in the senate tonight. Hopefully.

Update- passed late last night
SA68AG
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Why is the standard A-F system bad ?
HECUBUS
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Good news
- Texas medical school entry will be more demographic blind
- P/F not retroactive thanks to current student/teacher efforts

Bad news
- Top Texas medical schools are less competitive for top students
- Research and extracurricular activities will be greatly reduced

Why? - Texas joining Florida and Indiana to eliminate diversity initiatives in medical schools
1Aggie99
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Make this make sense to me like I'm a 5YO. Why is the "bad news" bad news? Top students that bust their tails during undergrad should have tough competition with other top students. I read your comments like it's bad news they will not have competition based on the color of skin or birthplace any longer.

Oh and why/how does this impact research?

Legit questions, not trying to be an azz.
HECUBUS
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Top medical schools are generally P/F in the first year or two of the classwork portion of medical schools, through Step 1. It attracts top students, it's a perk. If grades during step 1 were stressed as top priority, it's likely first year students wouldn't participate in research.

Residencies don't care about the step 1 portion that is P/F which is why it can be offered. Residency is the goal of medical students. Out of touch politicians that may have earned an MD in the dark ages shouldn't be making any curriculum decisions ever.

You would need a med school applicant to get the real story. I only was aware of this through some current med students that would have been included in the retroactive part after completion of step 1 P/F. That was outrageous and I applaud their efforts to get that part removed.

Most of the class of 2029 med students probably didn't even know they almost lost their P/F perk.
bmks270
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Med school and students in general these days are getting soft.

Being graded is too scary and mean?
Ag9701
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As an MD who didn't graduate in the dark ages, the P/F system has gone too far imo. I do not think it was done mainly so med students will do research. Step 1 is now P/F….now Step 2 which is not P/F is what residencies are using. Grades and Step scores are not everything but they are important. TX med schools will still get great students b/c there are tons of smart kids in TX who want to take adv of living "near" their hometown and getting instate tuition.
Kool
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There is a massive push for making everything Pass/Fail because physicians don't always "look like" their patients, and we all know that the mark of a good physician is that they share your skin color, gender identity and sexual orientation. Our journals are full of the divisive rot known as DEI, and making Step 1 and Step 2 pass/fail is often proposed as one of many ways to rectify any discrepancies between the (especially) racial makeup of the top performing students and the population at large.

With regards to doing research and having other extracurricular activities during medical school, other than the summer months between the first and second years and during elective periods as a fourth year, there was essentially ZERO time available for a medical student to squeeze research into their schedule. As it should be.
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HECUBUS
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Where did you get your MD?
HECUBUS
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Dell is one year classroom and Baylor and UTSW are one and a half. Times have changed.
Ag9701
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What Kool said is what I was told.
Ag9701
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Basic sciences at BCM have been 1.5 yrs for at least 30 yrs now.

I am actually ok with a P/F system but raise the bar to at least 85% with the caveat that med schools focus on teaching useful info.

Most MDs in practice strive for 100% even though they know it is not reality.
HECUBUS
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UTSW ten years ago, Dell maybe since they started. McGovern claimed to be going to 1.5 on interviews a year ago. Most of the rest are still two years. I only have a class of '28 perspective.

I think the P/F deletion will only affect the out of state applicants which are typically the highest stat students. Since that acceptance rate is about 2%, and I would guess most don't end up in a Texas residency or practice, it's not a huge deal. The top in state will go out of state for bigger name med schools regardless.

The other part of the bill is great and should be applied to undergraduate as well. Demographic blind should be the only option. Education needs to be fixed in elementary school. What the heck are the politicians doing with all that Robinhood money that was supposed to have solved this issue?

P/F Step 1 isn't what most people appear to think. Everything is graded. it's just kept internal to the med school, because residencies don't care about it. It's another stupid political stunt to impress the uninformed.


HECUBUS
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Again, my opinion is worthless. I would value a class of '30 applicant's opinion. A lot of med schools offer P/F Step 1 and I expect most applicants prefer P/F for Step 1. Otherwise, it wouldn't be so widely offered. This seems like mostly misdirected DEI anger to me.
beatlesphan
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I like it. "Trainees" these days for the most part are terrible. They are coddled the moment they face any adversity. In reality what you need to become the best doc you can be is for someone to tell you that you're not cutting it when your effort and dedication is not sufficient.
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aggie93
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HECUBUS said:

UTSW ten years ago, Dell maybe since they started. McGovern claimed to be going to 1.5 on interviews a year ago. Most of the rest are still two years. I only have a class of '28 perspective.

I think the P/F deletion will only affect the out of state applicants which are typically the highest stat students. Since that acceptance rate is about 2%, and I would guess most don't end up in a Texas residency or practice, it's not a huge deal. The top in state will go out of state for bigger name med schools regardless.

The other part of the bill is great and should be applied to undergraduate as well. Demographic blind should be the only option. Education needs to be fixed in elementary school. What the heck are the politicians doing with all that Robinhood money that was supposed to have solved this issue?

P/F Step 1 isn't what most people appear to think. Everything is graded. it's just kept internal to the med school, because residencies don't care about it. It's another stupid political stunt to impress the uninformed.



Not really buying that top applicants, who obviously have the highest stats and strongest backgrounds, are the ones who would be intimidated by not being P/F. I can see how it would be stressful for students and that many wouldn't like it but I don't see that being the issue with the folks at the top of the scale.

I completely agree that demographic blind is the only sane policy for Med school. When you are talking about a doctor it should only be about merit, period.

Money will never fix this issue and it will never fix it at the lower levels either. Parents that support education and are involved with their kid's education will trounce money every time. Having a big and beautiful school and paying teachers more also has a very limited impact. The best teachers rarely do it for the money and they would take policy changes that allow they more freedom and less bureaucracy and students that want to learn over money almost every time. Typically when more money is thrown at education it goes to administration as well and special programs with minimal impact. That's why if you look at schools from the lowest level to the highest you have seen more money spent than ever in the last 50 years with a very small growth in teachers and an explosion in administration who are typically paid far better than teachers.

I also can understand that many who are supporting this bill don't really understand P/F's purpose and politics are involved but that's how things always work.
HECUBUS
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Pass fail is not intimidating. Given the choice, P/F step 1 is generally preferred. Most have been placing UTSW over Baylor in rankings since the Temple campus opened. Location is still a much bigger priority. I believe UTSW doesn't have P/F and Baylor does.

Correction: UTSW is pass fail also.
AggieCrew44
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Finished med school 2 years ago. First two years which was all preclinical stuff was pass/fail. I honestly appreciated it. Someone that made a 94 vs an 88 on a first year biochem test had zero bearing on how good of a doctor you will be

Rotations and stuff had pass/high pass/honors which is needed to differentiate

Made med school less stressful when first two years are just pass/fail and everyone still came out prepared for residency with the STEP exam being
BBRex
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The one thing I like about P/F is that it takes the focus off of grades. Our educational system already rewards students for grades, not learning, and students today are looking to maximize that number, not learn the material. Pass/fail, if done correctly, can change that.

Quote:

Money will never fix this issue and it will never fix it at the lower levels either. Parents that support education and are involved with their kid's education will trounce money every time. Having a big and beautiful school and paying teachers more also has a very limited impact. The best teachers rarely do it for the money and they would take policy changes that allow they more freedom and less bureaucracy and students that want to learn over money almost every time. Typically when more money is thrown at education it goes to administration as well and special programs with minimal impact. That's why if you look at schools from the lowest level to the highest you have seen more money spent than ever in the last 50 years with a very small growth in teachers and an explosion in administration who are typically paid far better than teachers.


Nowadays, money often comes into education in the form of grants or programs. Those require administration and accountability. Texas' Teacher Incentive Allotment is a prime example.
Medaggie
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Doc who did med school in Tx that was graded. Never heard of pass fail in med school. It is almost like giving everyone a ribbon for participating.

Almost everyone who gets into med school graduates unless. Taking away grades essentially makes everyone look the same. A student that made a 98 in basic science courses has magnitudes more knowledge than someone who made a 78. With pass fail, both could not be distinguished.

Glad grades are back. Reward those who put much more effort in to getting As vs someone who just skated by and made Cs.

Glad they are moving things back to when Med students were not coddled. Med students and residents are not as prepared to be docs as in the past. They are not as sharp or hardened but this is what society expects so I guess this is progress.
ReveilleBark
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Boomers here criticizing pass/fail aren't aware of the modern medical school curriculum. An 89 vs. a 91 can be the difference in your rank that severely hurts you for competitive specialities, yet means nothing in your actual competency to be a doctor. With that extra time you can volunteer, research, do things to make you look better. More and more students are taking research years during school to be competitive. 90% of you saying it's participation trophy behavior couldn't pass a first-year medical school physiology exam if your life depended on it.
beatlesphan
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I see your point but the problem is it's often not 89 vs 91...it's 69 vs 91. And someone who gets a 69 simply doesn't know the material as well as someone who got a 91.

Other docs can weigh in...but about 95% of the doctors out there are terrible. Like scary what on earth are you doing terrible. And I'm afraid with the increasing emphasis on wellness etc it will just get worse.
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SA68AG
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It's simply human nature that people don't put in as much effort into a pass/fail course as they do into a traditionally graded course.
Kool
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In addition to what the above two posters said, being pass/fail for the classroom portion of med school means that the clinical years are going to count for lots more. And the preclinical years don't have as much potential for a subjective assessment dragging your GPA down. At my med school (UTSWMC), Internal Medicine counted for a huge portion of your 3rd-year grades. I believe the rotation was 16 weeks. Even if you did great on your exam, one single Attending who didn't like you could give you a bad grade and crush your entire class ranking. That would be amplified significantly if the preclinical years were pass/fail.
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HECUBUS
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Status
Spectrum: Partisan Bill (Republican 2-0)
Status: Engrossed on May 10 2025 - 50% progression,
died in chamber
malenurse
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beatlesphan said:

I see your point but the problem is it's often not 89 vs 91...it's 69 vs 91. And someone who gets a 69 simply doesn't know the material as well as someone who got a 91.

Other docs can weigh in...but about 95% of the doctors out there are terrible. Like scary what on earth are you doing terrible. And I'm afraid with the increasing emphasis on wellness etc it will just get worse.
I think your 95% number is way off. But, even if it was 50% (which I would believe if you only looked at GPs) that is scary. Most Primary Care Docs I see are only adequate. Most are very lazy and just send their patients needing treatment to the ERs. No one practices medicine anymore. Most PCPs don't even admit their own patients.

Sorry, old burned out nurse rant.
The last thing I want to do is hurt you. But, it's still on the list.
BBRex
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Or the urgent care clinic. Calling your PCP because of a cold, only to be told the next available appointment is three months out isn't helpful. I see an NP now, who I like, but her job seems to be to review a questionnaire I fill out, review the notes from my urgent care visits, then ask if I have any questions. She did adjust some of my meds last visit, though, and she's been more proactive than my previous PCP.
TAMU1990
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Too many good candidates were left out of med or dental schools the past decade because they were White, Asian, and male. It's wrong. It's also dangerous.

It happens in vet and law schools too. Some of the stories you hear are flat out ridiculous. I will not go to younger doctors unless they are in the prohibited categories.
tamc93
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As a parent of a current M3, the P/F system earlier was good. I know how much effort she put into it, and still how high scores.

The volume and breadth that they are learning is the first 2-years is amazing. Every school would grade different and there would be no true comparisons going forward.

Once they start their rotations, let them be graded.
beatlesphan
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Your grades in the clinical years are FAR more subjective...
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HECUBUS
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Our kid's class '28 started rotations at MS2. Three already took and passed the step one exam before MS2 started. Most take the step one exam during rotations mid way through the MS2 year. MS3 is research or a masters degree and MS4 is MS2 minus exams plus applications for residencies. Most started research early MS1.

Politicians have no business messing with medical school curriculums or grading policies just because it's popular with constituents who are equally uninformed. Glad the bill died.
Ag9701
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You state 89 vs 91 has nothing to do with how good of a doctor you will be. True but of course you pick a narrow range. What about the people who consistently make 90 or above vs people who usually sit in the 70s. There are usually characteristics in those high achievers that are desirable.

You then make the point that P/F allows them to volunteer, do research, etc to be more competitive. Those definitely have nothing to do with how good of a doctor you will be esp since they are being done just to look competitive.

Are you an MD or currently in med school?
BartInLA
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I'm a PhD and not an MD but when I overheard med students doing rotations at Parkland Hospital (UTSW) psychiatric ER, they talked about passing a test etc… but not a word about grades. This was 1996. Wonder if they were pass/fall back then? They were doing rotations.
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