“It is really great that 100% of our students are in the top 50%.” I work in a medical school and I recently said this to a clerkship director. She didn't like it.
Satisfactory: adequate, suitable, fulfilling all the requirements. Imagine a largely subjective evaluation with a 5 point scale on which 1 is Outstanding, 2 Above Average, 3 Average, 4 Below Average, and 5 Unsatisfactory, and using multiple evaluations to calculate an average for the final grade expressed as Honors (overall average of 1.0 to 1.74), or Commendation (overall average of 1.75 to 2.30), or Satisfactory (overall average of 2.31 to 3.50), or Unsatisfactory (average greater than 3.5). So, with 3.0 as the defined average, mathematically 100% of our students on clinical assignments are in the top 50%. In my three-plus years in this position, (more than 5,000 evaluations requiring more than 20,000 reminders for more than 700 students), no one has averaged more than 3.0, much less more than the 3.5 necessary for remediation; (or at least I assume some form of remediation would be required for Unsatisfactory, but since I have never seen it, I guess I don't really know).
The fact that 100% of our students are in the top 50% is a tribute to and a reflection of our priorities and processes. Yet it works very hard to come out the other end as a tribute to the excellence of our students, which is misleading; and for the faculty it justifies their self-importance and their belief in their own excellence in teaching, which is also likely misleading. Medical school, (as I believe is true for much of higher education), is no longer the formal education advertised; it has become an apprenticeship.
Maybe it has always been so? And maybe this is okay? But if it is, why the charade? Why not admit it is pass/fail? (Or for all intents and purposes, pass/fail-pass?) Is it so the University can justify its existence and continue to charge exorbitant fees for an education that is not what it is supposed to be? If so, it is consistent. Maintain that status quo! Go America!
Some would argue that the first two years of medical school are largely classroom learning, thus formal education. And these same Pollyannas would argue the same about most of traditional higher education. I would argue that the college experience has more and more become on the job training teaching the social skills necessary for many of the jobs requiring a college degree. My argument is supported by research on grade inflation and the student as customer; (look it up). Our priorities, (graduation rates, placement rates, more students, more tuition), guide and encourage our processes. In my experience, documented quality formative feedback is nearly nonexistent.
There is another factor at play here: because medical school is so expensive and so exclusive only to those who can afford the time and effort required both in preparation and attendance, equal opportunity is absent. The first question (though a bit rhetorical) is, “Is this purposeful?” The next question is, “Does this contribute to our priority-led process?” I believe it does. Not only must we work to justify our existence, we also tend toward easy and status quo is much easier (and less expensive In the short term) than change.
100% of our students on clinical rotations are in the top 50%. It aligns with our priorities, it is easier, and it is the way everyone does it. This is not only a condemnation of the medical school I am attached to, but (I believe) also of all medical schools, all higher education, our culture and our country.
Go America!
Our priorities need to change. Instead of today, tomorrow. Instead of hard currency, an open exchange. Instead of an accomplishment, a gift. Instead of a statement, an ellipsis. An acknowledgement that I am an adumbration; a mere foreshadow of those to follow. So what will I choose to portend? Am I a champion for Beauty, Truth, Wisdom, Justice? Or am I a Harbinger of Doom?
Pretty heavy conclusion for a mathematical aberration. But we have to start somewhere.