You may be surprised to learn that medical students at many of the best schools in the country aren’t given grades during the first two years of their medical education. They either pass their coursework or they fail. And then, they take one high-stakes test that affects their medical future.

While the effort to allow medical students to take two years of course work on a pass-fail basis was driven by an effort to make the notoriously difficult life of medical students easier, the high-stakes testing consequence creates problems of its own.

In this post, Brenda Sirovich, a physician and professor at Dartmouth College’s medical school, writes about how this approach threatens to compromise both the community of medicine and the quality of patients’ care. She is a 2017 Public Voices Fellow with the OpEd Project, a social venture with both a nonprofit and for-profit arm that is aimed at increasing the range of voices and quality of ideas contributing to national and international debate.

News that a federal educational experiment failed to supply evidence in favor of  Education Secretary Betsy DeVos’s school choice agenda has undoubtedly elicited schadenfreude in some Democratic circles. Somewhat lost in the story, however, is scrutiny of how students’ educational success or failure ismeasured.

The trend toward near-exclusive reliance on standardized testing to measure educational achievement now extends all the way to medical school. Many may not realize that the readiness of aspiring doctors to enter the world of clinical medicine is now based overwhelmingly on a single, standardized, closed-book, multiple choice test.

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