Why create CBG Pathway?

There is an ongoing debate in the literature (see articles below) about the value and importance of grades in medical schools. In the international clinician educator blog, Dr. Robert Englander lays out a clear argument for why it is time to eliminate grading in medical education. He gives 4 main reasons (summarized below) for removing grades.

1. Grades are a norm-referenced assessment, meaning they compare one student to another. This is not congruent with the way we train and assess developing physicians since what matters most is not a comparison to other students but rather their ability to meet the competency thresholds set for their level of training and context. This paradigm for training is referred to as competency-based medical education and grading (or norm-referenced assessment) does not fit.
2. Grading has a direct effect on student well-being and burnout.
3. We know that bias exists throughout all forms of assessment and when this contributes to something as high-stakes as a grade, it contributes to inequity.
4. Grades incentivize students to focus on performance and how they are perceived rather than growth. This can result in them hiding their weaknesses or avoiding challenging situations that may impact their grade even though it results in less growth.

Clerkship Year

Quotes from different M3 students during their clerkship year

"Knowing you're being evaluated, in theory, changes how a student acts."

"l find myself trying to be a certain way for preceptors often"

"You have to be open to failing. You need to be able to try things, fail, readjust, and retry because that's the only way that you really can grow."