Pass/fail grading in preclinical courses and differential attainment between racially/ethnically minoritized groups and non-minoritized groups

Many medical schools are transitioning to pass/fail grading from tiered grading systems which have been associated with increased competition, grade inflation, decreased wellness, and grading disparities along racial/ethnic lines. This retrospective cohort study followed two cohorts of students from one medical school for four years. One cohort was the last class to enter the school under a 5-point grading system for preclinical courses and the other was the first cohort to enter school under a pass/fail grading system for preclinical courses. Data was collected on various performance measures for the 501 students who comprised these two cohorts. Given the enduring problem of differential attainment between underrepresented in medicine (URiM) students to non-URiM students, we explored whether a change in grading systems impacted all students similarly. Overall students did as well or better in classroom performance, clerkship subject exams, and licensing exams following the change and the effect was essentially equal for URiM and non-URiM students alike. The most important finding was a decrease in differential attainment between URiM and non-URiM students after the change to pass/fail grading for the great majority of the performance measures studied.