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Clerkship Grading and the U.S. Economy

What Medical Education Can Learn From America’s Economic History

Bibliographic Data

ID21612869
AuthorsMichael S Ryan (0000-0003-3266-9289, M.S. Ryanis associate professor and assistant dean for clinical medical education, Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia; ORCID:., corresponding author), E Marshall Brooks (0000-0002-5918-0953, Virginia Commonwealth University), Komal Safdar (0000-0003-1024-2153, K. Safdaris a fourth-year medical student, Virginia Commonwealth University, Richmond, Virginia; ORCID:.), Sally A Santen (0000-0002-8327-8002, S.A. Santenis professor and senior associate dean, assessment, evaluation and scholarship, Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia; ORCID:.)
Year2021
Volume96
Issue2
Pages186-192
Publication date2021-02-01
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000003566
PMID33492834
OpenAlexW3041023464
LanguageEN
Citations received2
References cited40

Clerkship grades (like money) are a social construct that function as the currency through which value exchanges in medical education are negotiated between the system’s various stakeholders. They provide a widely recognizable and efficient medium through which learner development can be assessed, tracked, compared, and demonstrated and are commonly used to make decisions regarding progression, distinction, and selection for residency. However, substantial literature has demonstrated how grades imprecisely and unreliably reflect the value of learners. In this article, the authors suggest that challenges with clerkship grades are fundamentally tied to their role as currency in the medical education system. Associations are drawn between clerkship grades and the history of the U.S. economy; 2 major concepts are highlighted: regulation and stock prices. The authors describe the history of these economic concepts and how they relate to challenges in clerkship grading. Using lessons learned from the history of the U.S. economy, the authors then propose a 2-step solution to improve upon grading for future generations of medical students: (1) transition from grades to a federally regulated competency-based assessment model and (2) development of a departmental competency letter that incorporates competency-based assessments rather than letter grades and meets the needs of program directors

Currency · Economic growth · Economics · Higher education · Macroeconomics · Medical education · Clinical Reasoning and Diagnostic Skills · Computer Science · Innovations in Medical Education · Medical Education and Admissions · Medicine

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Citations per year0.4
Citation span2021 - 2025 (5)
Highly citedNo

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Open DOIOpen Access
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