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Q. In medical schools with pass/fail system, how do residencies discriminate the good candidates from the bad ones?A2A:Can a Pass/Fail Grading System Adequately Reflect Student Progress?Selection criteria for emergency medicine residency applicants.Effect of USMLE on US Medical Education (aamc.org).Pass-fail is here to stay in medical schools. And that's a good thing.Grading Systems in Medical School: Pass/Fail or A-F Scale?A Medical School goes Pass/Fail only: Why this is an Excellent Change!Can a Pass/Fail Grading System Adequately Reflect Student Progress?At Vanderbilt University because we maintained four grading intervals in the clinical years, we experienced no measurable change in the outcomes of our residency match. For schools that use a pass/fail only system throughout the 4-year curriculum, program directors rely more on qualitative measures, such as the comments recorded on clerkships assessment forms, letters of recommendation, and the nature of student leadership and scholarship accomplishments. With a sense that these subjective measures are less reliable than the objectivity of grades, program directors also tend to rely more heavily on Step 1 scores and the reputation of the medical school.Selection criteria for emergency medicine residency applicants.Acad Emerg Med. 2000 Jan;7(1):54-60.Survey of program directors in Emergency Medicine.Most important: EM rotation grade, interview, clinical grades, and recommendations.Moderate emphasis: elective done at program director's institution (USMLE) step II, interest expressed in program director's institution, USMLE step I, and awards/achievements.Less emphasis: (AOA) status, medical school attended, extracurricular activities, basic science grades, publications, and personal statement .Of the 94 respondents, 37 (39.4%) had minimum requirements for USMLE step I (195.11 +/- 13.10), while 30 (31.9%) replied they had minimum requirements for USMLE step II (194.27 +/- 14.96).Results are compared with those from previous multispecialty studies.Curriculum Inventory in ContextJuly 2016 Volume 3, Issue 7Click to view complete chart onlineEffect of USMLE on US Medical Education (aamc.org)Pre-clerkship curricular enhancements in medical education are undermined by medical students’ focus on their USMLE Step 1 scores and the threat of not acquiring a residency position. Fears of the licensure examination also thwart medical school efforts to created patient-centered care from day one.Medical educators are challenged continuously on issues around enhancing student learning, providing them with support throughout medical school, preventing and addressing burnout, and much more. We struggle with how much content to expect students to master in medical school, how to balance new content with foundational content, and how to help students become self-directed learners for life. The Curriculum Inventory reveals that over 90% of US medical schools have changed their curricula recently or currently are planning or implementing change. These curricular and pedagogical changes require a large investment of resources on the part of medical schools and their faculties. We hope the returns on those investments are medical students who acquire the knowledge, skills and behaviors necessary to ease seamlessly into their clerkships and graduates who are prepared to transition into residency and the supervised practice of medicine.For decades, schools have focused attention on reducing the competitiveness that the pre-medical system required of students in order to get into medical school. We recognize that these behaviors are unhealthy for student wellness, for their learning and for patient care. We know that the best learning, patient care, research and administrative leadership emerges from high functioning and diverse teams— the antithesis of the “cut-throat pre-med.” According to the Curriculum Inventory, dichotomousPass/Fail grading has been implemented at 60% of medical schools as an effort to encourage collaboration and teamwork among students. It largely has been effective. When our school converted to P/F grading in 2003, we realized a more collaborative and supportive learning environment with no statistically significant change in performance on assessments and no change in USMLE Step 1 scores. We did see a statistically significant improvement in student well-being until the semester prior to the taking of USMLE Step 1 when that improvement fell off. (Bloodgood, et al.)A recent conversation on the Dr-ED list serve highlighted the conundrum currently facing students and medical educators. It seems that no matter how we change the learning environment to support our students’ well-being and their professional development, the threat posed by the score a student achieves on USMLE Step 1 is more harmful and powerful than anything we can do to mitigate its negative impact. Students now enter medical school believing that nothing in the pre-clerkship phase of medical education matters other than their performance on USMLE Step 1 as it will determine not only where they will obtain a residency but IF they will obtain a residency.We try to engage them in active learning but they prefer the efficiency of lectures on what they need to memorize. We try to help them learn about ethics, human development, interviewing skills, and they reject us saying those topics are “common sense” and “fluff” and not highly represented on USMLE Step 1 so we’re wasting their time. Carry this to the logical conclusion, and medical schools are producing students who are well-prepared for Step 1 but ill-prepared for the clinical learning environment of clerkships. All of the time, effort and money invested in improving medical education may be for naught. Why? Medical students focus their efforts on memorizing facts for Step 1—not because it’s necessary for licensure but in order to get a premier residency. But medical students are bright and insightful and display cognitive dissonance regarding their medical education. Students will say they know that active learning, problem solving and a focus on clinical reasoning will make them better doctors, but despite this cognition they behave in a way that focuses on memorizing for Step 1.The simple solution to this worsening problem is to score USMLE Step 1 as pass or fail or delay the release of numerical scores until after residency interviews are completed. Anxiety about the numerical scores compromises the education of our medical students.About the author:R. J. Canterbury, M.D., M.S., DLFAPA, is the Senior Associate Dean for Education and Wilford W. Spradlin Professor of Psychiatry and Neurobehavioral Sciences at the University of Virginia School of Medicine. His research interests include substance abuse, epidemiology of substance abuse and AIDS, and health services research.References:Bloodgood, Robert A, Short, Jerry G, Jackson, John M, Martindale, James R. A Change to Pass/Fail Grading in the First Two Years at One Medical School Results in Improved Psychological Well-Being, Academic Medicine, 84(5), May 2009, pp 655-662.Pass-fail is here to stay in medical schools. And that's a good thing.FRANCIS DENG, MD AND AUSTIN WESEVICH | EDUCATION | AUGUST 3, 2016Starting this fall, second-year students will no longer have the stress of grades at our medical school, Washington University in St. Louis (WashU). In extending the pass-fail system from the first year to the second preclinical year, WashU joins the other 18 of the top 20 research medical schools on U.S. News and World Report that grade the entire preclinical curriculum on a pass-fail basis. (The sole holdout is Penn, which maintains a graded system for two of three preclinical semesters.)Locally, the change caps an evolving, years-long conversation between students, instructors, and administrators. But we are just one of the many medical schools lately to catch onto a national movement that started long ago.Turbulent sixtiesSome schools such as Harvard, Stanford, and Yale have maintained preclinical pass-fail for decades. Many other schools dabbled in curricular reform in the 1960s. Opponents hoped the storm would pass. A provocative article published in the New England Journal of Medicine in 1978 blamed the “transient sociopolitical turmoil” of the preceding decade for causing a revolution in medical education with digressions such as “social medicine,” “primary care,” “elective scheduling,” and especially “the experiment in pass/fail grading.” The authors decried the subversion of traditions and erosion of standards, pleading for maintaining “elitism in education.”It’s important to note that these authors’ beliefs came from the perspective of resident selection rather than of medical education. They believed that “it is impossible to prevent a bright student in a good environment from becoming an excellent physician by manipulating such inconsequentials as the curriculum and the grading system,” but they saw evidence that inferior residents were selected in the absence of a class ranking based on grades.Preclinical pass-fail trendNow, the storm has settled somewhat. Though the politics have changed, pass-fail grading is no fad. Schools are now increasingly reaching a stable compromise: grades for clinical clerkships, pass-fail for preclinical courses. In fact, more than half of the aforementioned medical schools changed to all-pass-fail preclinical curricula in the past decade, and none have reverted back to multi-tier grading.The current trend for preclinical pass-fail is driven by two major factors: 1) decreased relative importance of preclinical grades in residency applications, and 2) increased focus on student wellness and mental health.Emory University Match DayLow importance in residency applicationsA dwindling minority of residency programs place value on performance in basic science courses. Practically speaking, the data are often uninterpretable. Grade distributions vary dramatically between schools or even within a single institution. These days, preclinical curricula differ in length, course naming, degree integration, and grading scales. In contrast, the USMLE Step 1 exam provides a commonly understood measure of basic science knowledge for all MD students. With the availability of standardized assessment, it is no wonder that surveys of program directors rank basic science honors among the least commonly considered factors for interviewing and ranking applicants. Step 1 scores rank among the most common.Given the importance of Step 1 scores to residency applications, some have worried about the effect of changing grading policies on Step 1 performance. We now know from the experience of several schools that changed to pass-fail that students perform just as well as before. Moreover, schools that switched did not find significant differences in residency match quality.Focus on student wellnessEven though preclinical grades do not greatly affect residency applications, they still appear on transcripts and factor into class rank and AOA medical honor society selection. Chronic pressure to get the best grades can lead to significant distress. In recent years, academic leaders have increasingly recognized the importance of mitigating unnecessary stress during medical training.We found that an overwhelming majority of students at all stages at our medical school thought they would be somewhat or much less stressed during the preclinical years if they were evaluated on a pass-fail basis. Multiple peer-reviewed studies verify these beliefs.In a multi-institutional study, students in 3+-interval graded schools had significantly higher stress, emotional exhaustion, and depersonalization and were more likely to have burnout or considered dropping out compared to students in schools with pass-fail grading. Grading scale was more strongly associated with student well-being than the number of contact days or tests.When the University of Virginia changed to pass-fail, preclinical students had higher well-being and vitality and reduced anxiety and depression. When Mayo Medical School switched part of its curriculum to pass-fail, students had less stress, improved mood, and even greater group cohesion. When Saint Louis University changed to pass-fail as part of a multifaceted preclinical curricular reform, students had lower levels of moderate or severe depression symptoms, anxiety symptoms, and stress. We believe a simple change in grading systems can lead to a clinically significant change in student wellness and mental health.National organization endorsementThe alarming levels of burnout among physicians, residents, and medical students demand greater national attention to wellness. The American Medical Student Association passed policy in 2012 stating that it “STRONGLY URGES all medical schools to adopt the use of a strictly pass/fail grading policy during the preclinical years of medical school” to reduce the risk of poor student health and wellness and to promote teamwork and collaboration rather than competition. In 2012, the American Medical Association (AMA) approved policy entitled “Supporting Two-Interval Grading Systems for Medical Education,” which acknowledged the benefits of a pass-fail system for the non-clinical curriculum. By 2013, as tabulated by the AMA and published in JAMA, pure pass-fail was the most common preclinical grading system across the country, found at 41 percent of allopathic schools.We believe the so-called “pass/fail experiment” has finally proven itself and will continue to propagate, not as a reaction to “transient sociopolitical turmoil,” but as an enduring curricular reform that prevents unnecessary mental turmoil during training.Francis Deng is a resident physician and can be reached on Twitter @francisdeng. Austin Wesevich is a medical student.AMA Journal of Ethics®Illuminating the art of medicineVirtual Mentor. November 2009, Volume 11, Number 11: 842-851.Can a Pass/Fail Grading System Adequately Reflect Student Progress?Commentary by Bonnie M. Miller, MD, Adina Kalet, MD, MPH, Ryan C. VanWoerkom, Nicholas Zorko and Julia HalseyAs David, a second-year medical student, made his way into the lecture hall, he was surprised to see how packed the room was. A group of 25 third-year students, or one-fifth of the class, had recently petitioned to switch from a traditional letter-grade system to one that was pass/fail at their school, and the medical student government organized a townhall meeting for students to discuss the matter. Unable to find a place to sit, David stood against the wall alongside his good friend Beth, a fellow second-year. In the room he saw students of all levels, from first-years to fourth-years, engaged in excited chatter.LEARNING OBJECTIVE: Identify the objectives of effective medical school grading systems and how medical schools can design them.The third-year class president, Sam, stood up. “Okay everyone, quiet down so that we can begin the discussion. We had not expected a turnout of this magnitude; it’s clear that this is an issue many of you feel quite passionately about. The administration has informed us that adopting a pass/fail system will require a majority vote from the student body.”The volume level in the room suddenly increased.He continued, “So, we hope that this meeting will serve as a lively debate where students on either side of this issue can share their arguments with the voting body.”“Pass/fail is such a great idea,” David whispered to Beth.To his surprise, she disagreed. “I don’t think so,” Beth replied. “I personally work harder and perform better when I am graded.”One of the third-year petitioners stood up to argue, “Our medical school is known for being one of the most intensely competitive programs in the country. We are already so stressed out—becoming pass/fail would remove an atmosphere of hypercompetition, and that will be a good change for our mental, emotional, and physical well-being.” His words were met with applause from some students in the hall.Another third-year petitioner presented a counterargument. “The majority of our graduating students match with residency programs each year, and most of those match at one of the programs they ranked in their top three. We’ve done very well with grades—would the same be true if we became pass/fail? Also, those of us interested in matching into very competitive specialties, such as dermatology, ophthalmology, and surgical specialties are put at a disadvantage since class rank and academic performance are highly regarded by residency directors in these specialties.”David, who himself had a particular interest in going into surgery, looked around the hall and saw a number of students nodding their heads in agreement. Beth nudged him playfully and whispered, “See what I mean?”Commentary 1by Bonnie M. Miller, MDThe primary purpose of any grading system is to measure student achievement of established learning objectives. Performance data let individual students know where they stand in the development of needed competencies. Aggregated performance data supply faculty and medical school administration with information about the effectiveness of teaching. A traditional grade stratifies students according to level of achievement and can motivate students, reward effort, and perhaps signify suitability for a potential area of study. A pass/fail grade indicates simply that a student has achieved an expected level of competence, information that is critically important if medical education is to fulfill its obligation to the public.The ideal grading system would also encourage the development of desirable professional behaviors. Does a traditional grading system encourage students to constantly strive for excellence, a habit that, theoretically, they would maintain when they no longer receive grades? Does a pass/fail system encourage collegiality, collaboration, and teamwork, since no one is disadvantaged by another’s success, and mutual benefit can result from sharing. In the case scenario we are commenting on, is Beth correct in fearing a lack of motivation in the absence of grades, or is David justified in his concern about grade-induced hyper-competitiveness?I believe that concerns about both consequences are justified, but my experience with grading systems suggests that neither is inevitable. Based on our grade-system change at Vanderbilt University earlier in the decade, I believe that elements such as faculty role modeling, selection of teaching strategies, careful and inclusive selection of the qualities that are being assessed, and use of criteria-based grading systems are more important contributors to student evaluation than whether or not letter grades are used.Faculty RoleGrading systems exist within the larger context of an educational environment that can powerfully mold the professional development of students. If students are hypercompetitive, it is unlikely that the grading system alone creates that behavior. Similarly, if students consistently aim their efforts at minimal passing performance, the environment might lack the ingredients needed to inspire excellence. Regardless of the grading system, medical school faculty and administration should be aware of the environments they create and monitor them with vigilance to assure that they support the attitudes and behaviors expected of the profession.In any grading system, faculty members should serve as role models who demonstrate a passion for excellence and a quest for improvement, both in their teaching efforts and their patient-care responsibilities. Role models who strive for excellence, not because of grades but for the good of those they serve, help students move beyond the external rewards that motivated them in their previous endeavors. Whether in teaching teams or in clinical teams, faculty members can also model the collaboration and collegiality that are important for effective, high-quality patient care. Finally, when faculty members care for the well-being and professional growth of their students, they model the compassionate and nurturing attitudes we hope those students will adopt.Teaching and Course-Management StrategiesTeaching strategies can also ameliorate the potentially negative side effects of a grading system. Many students study best in groups or learn most deeply when they are challenged to teach their peers, and schools with traditional grading systems can actively promote these approaches. Faculty can use course-management systems that allow all students to see the answers to all questions asked, and students can be encouraged to post helpful articles and learning tips. Team-based learning rewards group performance as opposed to individual effort, while creating pressure not to let one’s peers down, which discourages the slacking that a pass/fail system might encourage.Choosing What to MeasurePerhaps the grading system a school uses is less important than the qualities it chooses to grade. Assessment indeed drives learning, and if we feel that the professional development of our students is critical, we should demonstrate that by assessing it. In both science-based and clinical courses, students should be evaluated on their initiative, engagement with and concern for their own learning, interpersonal skills, teamwork skills and collegiality. Schools can devise grading policies, whether pass/fail or traditional, in which failure to demonstrate one of these key attributes can lead to failure in the course, regardless of cognitive achievement.Criteria-Based GradingFinally, the use of a normative versus a criteria-based grading system can influence student behaviors. In the former, the grade distribution is determined by comparative student performance, limiting the number of highest grades and creating an atmosphere in which one student’s performance can influence the grade of another. This is more likely to induce competition. In a criteria-based system, the requirements for each grade interval are predetermined, and any student who meets the designated requirements receives the designated grade, even if an entire class qualifies for an A. While this model could lead to grade inflation, it does recognize all students who achieve a certain level of excellence. And shouldn’t all medical teachers aspire to the goal of having all students excel?The Vanderbilt Grading ExperienceIn 2002, Vanderbilt University reexamined its traditional letter grading system. Like students at David and Beth’s school, our students performed very well in the residency match, and we were leery of changes that would make it more difficult for program directors to evaluate students. Unlike students at David and Beth’s school, ours did not complain of an overly competitive atmosphere. I’d like to think that this was because of our collegial educational environment, but a criteria-based system probably helped. Our greatest concern at that time was for the fairness of grades in the first year of medical school. Because of the wide variation in our students’ undergraduate preparation and the difficulties of adjusting to medical school, we felt that letter grades reflected not only effort and ability, but also the strength of the undergraduate program, the major a student had selected, and the ease of social transition. Most of our students who received marginal grades in the first year subsequently performed at very high levels, but were left with transcripts that marred their overall records.To balance our concern for first-year grades with our concern for the impact of a pure pass/fail system on the residency application process, we decided upon a hybrid system with pass/fail in the first year only; honors/pass/fail in the second year; and honors/high pass/pass/fail in the third and fourth years. We hoped that the noncompetitive culture of collaboration established in the first year would continue throughout the remaining 3 years, even as more grade intervals were introduced.Some faculty feared, like Beth, that first-year students would lack the motivation to put forth their strongest efforts. Fortunately, this fear never became a significant reality. Our curriculum remains rigorous and demands hard work, and the environment still encourages our students to reach for excellence. Occasionally a student’s performance slips on the last exam in a course if he or she is easily within the passing range, but this has not been a large enough effect to diminish overall class performance from year to year. Student performance in the subsequent years of medical school and on Step 1 of the United States Medical Licensing Examination (USMLE) has actually improved, relieving anxieties about the grading system’s long-term negative impacts on the learning habits.Paradoxically, in the first year of the transition, students and faculty sensed an increase in student competitiveness in the second-year class, even though this class entered with a traditionally graded system. We quickly realized that this resulted from a concurrent switch to a normative-based system that limited the number of honors grades to 25 percent of the class. In the following year, we reverted to a criteria-based system that set the honors bar extremely high to combat grade inflation but allowed all students who cleared that bar to receive an honors grade. Many students in that second-year class were also unhappy with the change and reported that they had selected Vanderbilt because of its traditional grading system. We learned from this experience that whenever possible, major policy and curriculum changes should be phased in with the entering classes. I have also become a strong believer in a criteria-based system that sets high standards but proudly recognizes all students who meet them.Because we maintained four grading intervals in the clinical years, we experienced no measurable change in the outcomes of our residency match. For schools that use a pass/fail only system throughout the 4-year curriculum, program directors rely more on qualitative measures, such as the comments recorded on clerkships assessment forms, letters of recommendation, and the nature of student leadership and scholarship accomplishments. With a sense that these subjective measures are less reliable than the objectivity of grades, program directors also tend to rely more heavily on Step 1 scores and the reputation of the medical school.No grading system is perfect in its ability to assess learners accurately, promote professional behaviors, and predict future accomplishments. Regardless of the system selected, a school must be aware of the potential for unintended consequences and should strive for an educational environment that counters these and encourages students to excel for the right reason, which is that their excellence will someday improve the lives of others.Bonnie M. Miller, MD, is the senior associate dean for health sciences education at Vanderbilt University School of Medicine in Nashville.Commentary 2by Adina Kalet, MD, MPHAs medical educators, our responsibility to society is to ensure that all physicians are competent to practice medicine. Ideally, both faculty and students should enthusiastically engage in an evaluation system that facilitates our fulfilling this responsibility. I am a strong believer in a grading system that is ultimately pass/fail—but is at the same time rich in confidential, formative feedback that helps students identify their strengths and weaknesses. To be meaningful, the “pass” thresholds must be competency- and criterion-based, not arbitrary or norm-referenced, i.e., predetermined percentages of students pass and fail.Competitive residency programs choose residents based on whatever evidence of their abilities exists. Residencies are looking for students who are a good fit for their program, well prepared, and capable of handling the work. The absence of letter grades on the formal transcript, without evidence of a rigorous, reliable assessment process is problematic for two reasons. First, it places enormous, undeserved pressure on students to do well on National Board Exams. Second, this approach overemphasizes the reputation of the medical school and its admissions policies.The debate presented in the case scenario focuses on the wrong outcomes. For example, students often defend pass/fail systems as more conducive to a relaxed learning environment because there is less interpersonal competition. I am not certain that this reflects reality. All medical students are highly achievement-oriented and many are competitive by nature. To be successful and competent physicians they must learn to manage the negative impact of these otherwise valuable personal traits in complex and competitive environments. On the other side of the argument, pass/fail systems disadvantage students who are consistently struggling because it allows them to squeak by without being identified for special attention early. In addition, even in schools like mine, NYU Medical Center, that operate with a pass/fail preclinical system, numeric grades are generated and followed for certain purposes (e.g., AOA determination), and students are well aware of this contradictory policy.In saying that the grades debate often focuses on the wrong outcome, I also mean that scores on exams are only useful if the exams themselves are reliable and valid measures of what they are meant to measure. Ideally, competency exams would provide students with detailed information to help determine whether they had the minimum competency to serve as physicians. We would overcome current weaknesses in measuring the remarkable capacities some students have in areas such as interdisciplinary teamwork and complex critical thinking. Once we have decided on fair, criterion-based measures that assess critical competencies, there is no way we could ethically, morally, or professionally argue against using such measures. Since most of our exams or grading systems do not reach this level of evidence, however, we use them as blunt instruments rather than sources of meaningful information.In sum, I don’t care as much as many students do about whether we use pass/fail or other systems. I care that we measure what is important and act on those measures to ensure excellence in our graduates.Adina Kalet, MD, MPH, is the Arnold P. Gold Professor of humanism and professionalism and an associate professor of medicine and surgery at New York University School of Medicine. She has a long-standing research interest in assessment of clinical competence and the relationship between medical education and patient outcomes. She has mentored three cohorts of NYU SOM Virtual Mentor student editors.Commentary 3by Ryan C. VanWoerkom, Nicholas Zorko, and Julia HalseyDuring the late 1960s and early 1970s, medical schools moved away from traditional grading systems and began adopting pass/fail or honors/pass/fail evaluation [1]. It is thought that the impetus for these changes originated with the concern that grade-based learning did not prepare for lifelong learning outside of the academic world and that it suppressed creativity and increased stress [1, 2]. On the other hand, it is well-known that residency directors hold the dean’s letter in high regard and favor the more discriminative letter-grade evaluation report [1, 3, 4].The ultimate quick test in medicine is applying the principle of primum non nocere (first do no harm). Is there a possibility that by changing the grading system to a less rigorous, more comfortable pass/fail system we may be harming patients? This would occur indirectly by allowing some students to slip through the cracks of a low-demand education and evaluation system. Gonnella et al. noted that students in need of remediation (not meeting basic standards set for competence in medical education) often went unidentified under a pass/fail system. “Failure to identify students who pass only narrowly results in the suppression of information that is critical to the future development of the students, and is important in the prevention of problems in professional practice” [5]. This does not bode well for patients, even if only a few sub-par students slip through the system without undergoing appropriate remediation.One example of a problem in professional practice could occur while a student or resident is caring for patients on a hospital team. The extra effort spent by one student studying for an “A” may trigger a memory for the correct tests needed to arrive at a diagnosis and implement an alleviating treatment, a connection that another student who only wanted to pass may not have made. The use of pass/fail grading has been correlated by some groups with poorer performance on exams [8, 9]. Additional information supporting this view was found in a study of surgery residents trained under different grading systems in medical school. Moss et al. found that residents who attended medical schools that assigned grades performed better than those who attended schools that used pass/fail systems [6]. Proponents of pass/fail grading argue that students working in such systems report a greater sense of satisfaction and well-being, but there is evidence refuting this reduction in anxiety upon implementation of a pass/fail grading system [7]. This perceived decrease in anxiety, regardless of validity, may not be worth the decrease in knowledge acquisition that may occur with less rigorous study habits.Students’ personal characteristics and attributes may influence their behavior and attitudes as strongly as a strictly graded traditional system with its intense pressure to perform well—the extrinsic factors—but the two are not easily separated. As one comes closer to measuring an extrinsic factor in medical education, he or she inadvertently affects the intrinsic. Consider, for example, the competitiveness that is said to infect medical students. A student who is willing to pull ahead at the risk of alienating classmates may be innately achievement-oriented, so the cause for his or her behavior is independent of the medical school environment and its pressure to compete.Kaitlyn died by suicide in medical schoolMany schools have opted for the honors/pass/fail grading system, which does not eliminate the pressure or incentive for students who wish to compete for honors grades. Honors/pass/fail may have the paradoxical effect of placing additional pressure on competitive students to perform even better simply because their grading system fails to discriminate adequately.A survey of surgery clerkship directors revealed consensus that a three-tiered system did not do enough to differentiate students appropriately. Pass/fail programs, this Ravelli et al. study concluded, “produced little reliable discrimination” between the quality of students and their peers [2]. With this in mind, it is more just to acknowledge a continuum of grades properly than to differentiate only between pass/fail. Consider a student who received the all-time top score for a medical school exam and was given the same grade as a student who passed by one question. This system results in general statements of evaluation for a majority of students without providing a means of recognition for outstanding efforts.Although many medical schools tout their pass/fail grading system as a means of attracting prospective medical students, these same schools, in truth, rank their students because they know that residency programs want them to distinguish among students. If students are not ranked in a traditional numerical order (e.g., 1/125), they are lumped in quartiles. In order for medical schools to maintain clout in placing their students in competitive residencies, the Medical Student Performance Evaluations (MSPEs) that they send to residency programs must rank students in some useful way. This may even lead to confusion among students regarding their own rank systems.Turning to the other side of the debate—the argument for pass/fail grading—students have more compelling motivators than grades. Having made it through the weeding process in high school and college classes and even the application process where grades were the most important criteria, medical students need to acquire the knowledge necessary to pass the national boards, obtain residencies and fellowship, and establish a satisfying career. At this point in their medical education, they have greater motivators to learn than simply to get an A on a test.The letter-grading system also suffers from grade-inflation, which has caused distress in admissions committees and employers of various disciplines. Grade inflation has placed a greater significance on standardized testing as the most objective way for schools to compare candidates from different programs. This in turn, may make the medical board exams a more stressful experience.While much of this discussion may not seem to be directly related to ethics, in the grand scheme of things, performing at a level which is anything less than one’s best has the potential to be detrimental to a patient’s well-being and is therefore unethical. The AMA Code of Medical Ethics states,Incompetence, corruption, or dishonest or unethical conduct on the part of members of the medical profession is reprehensible. In addition to posing a real or potential threat to patients, such conduct undermines the public’s confidence in the profession [10].Therefore, medical students’ ethical obligation encompasses the duty to prevent incompetence within their profession.Steve Prefontaine put it best: “To give anything less than your best is to sacrifice the gift.” As physicians or future physicians, we owe it to our patients and society to give our absolute best effort in exchange for the trust and responsibility for their lives they have given over to our care. We have been given a gift and privilege to study and practice medicine and should thus handle it appropriately regardless of the method used to evaluate us.ReferencesDietrick JA, Weaver MT, Merrick HW. Pass/fail grading: a disadvantage for students applying for residency. Am J Surg. 1991;162:(1)63-66.Ravelli C, Wolfson P. What is the “ideal” grading system for the junior surgery clerkship? Am J Surg. 1999;177(2):140-144.Lurie SJ, Lambert DR, Grady-Weliky TA. Relationship between dean’s letter rankings and later evaluations by residency program directors. Teach Learn Med. 2007:19(3):251-256.Provan JL, Cuttress L. Preferences of program directors for evaluation of candidates for postgraduate training. CMAJ. 1995;153(7):919-923.Gonnella JS, Erdmann JB, Hojat M. An empirical study of the predictive validity of number grades in medical school using 3 decades of longitudinal data: implications for a grading system. Med Educ. 2004;38(4):425-434.Moss TJ, Deland EC, Maloney JV Jr. Selection of medical students for graduate training: pass/fail versus grades. N Engl J Med. 1978;299(1):25-27.Yarbro RC. A comparison of anxiety levels of students taking pass/fail versus grade in student teaching. Tenn Educ. 1982;12(2):33-36.Weller LD. The grading nemesis: an historical overview and a current look at pass/fail grading. J Res Devel Educ. 1983;17:39-45.Suddick DE, Kelly RE. Effects of transition from pass/no credit to traditional letter grade system. J Exp Educ. 1981;50:88-90.American Medical Association. Opinion 9.04. Discipline and medicine. Code of Medical Ethics. Chicago, IL: American Medical Association. 1994. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion904.shtml. Accessed October 12, 2009.Ryan C. VanWoerkomis a fourth-year medical student at the University of Utah in Salt Lake City, with plans to enter a career in internal medicine. He serves as the chair of the Committee on Bioethics and Humanities for the American Medical Association-Medical Student Section as well as being the Midwest representative to the American College of Physicians Council of Student Members.Nicholas Zorkois a fourth-year MD/PhD student at The Ohio State University in Columbus. He graduated from Ohio State with a bachelor’s degree in biology in 2006, and is currently the vice chair for the Committee on Bioethics and Humanities for the American Medical Association-Medical Student Section.Julia Halseyis a third-year medical student at the University of Missouri in Columbia. She graduated from Truman State University in Kirksville, Missouri, with a bachelor’s degree in biology and from Trinity International University in Deerfield, Illinois, with a master’s degree in bioethics. She currently serves as the student representative to the AMA’s Council on Ethical and Judicial Affairs.Related in VMNurturing Leaders for an Environment of Change, November 2009Is There More to Medical School than Grades? December 2003The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.© 2009 American Medical Association. All Rights Reserved.Grading Systems in Medical School: Pass/Fail or A-F Scale?Author: Veronica Reina Mar 25, 2014Up until medical school, the majority of your classes used the traditional A-F grading scale to rate your academic achievement. Everyone loves to get an A, and receiving an F is a sure sign that you blew it. When you begin your research for medical school, you’ll want to think about the importance of whether a school uses a traditional grading system or relies on Pass/Fail ratings. There are a number of factors to consider, and each medical school grading system has both advantages and disadvantages.In a more conventional A-F medical school grading system, future residency options are greatly increased based on that graded performance. The clear competitive benefit of a conventional grading system is that it can distinguish candidates based on how they performed as compared to their peers. Unfortunately, according to the National Institutes of Health (NIH), being ranked in an A-F medical school grading system raises anxiety levels and heightens depression as medical students compete for the most coveted residencies and other post medical career paths. Medical students must decide whether a coveted residency is worth the added stress inherent in a highly competitive A-F medical school grading system. These factors increasingly lead more medical schools to adapt the Pass/Fail system.The simplicity and non-competitive nature of the Pass/Fail medical school grading system depends on the intensity of the medical school curriculum and the degree of the Pass/Fail system. More schools are implementing a hybrid medical school grading system, wherecoursework completed during the first two years is evaluated as Pass/Fail and the final two years are graded using the conventional A-F scale. More widely used is the High Pass-Pass-Fail medical school grading system, which allows for students to distinguish themselves particularly by receiving a High Pass rating. The Pass/Fail medical school grading system places a critical amount of importance on letters of recommendation and national board testing as predictors of your future success in your residency.At a number of elite medical schools, including both the Yale School of Medicine and Stanford Medical School, the vetting process to gain acceptance to these institutions is so thorough that the grading system is secondary to the prestige of the medical school. Studies often show that attendance at elite medical schools leads to the most sought after residencies. A better predictor of student success during medical school and in applying to residency programs is your benchmark performance on the US Medical Licensing Examination. Ultimately, this exam is the most important gauge of a student’s success in medical school.Residency programs sets their own standards pertaining to acceptance and success. Acceptance in these programs is based on a number of factors. One of those is whether your medical school employs a conventional A-F grading system or Pass/Fail system. Medical school grades are not the only criteria for matching to your ideal residency program, but they are significant enough that you will want to do some research and be informed about the criteria by which you will eventually be evaluated. The road to becoming a medical professional is fraught with choices. Making well advised and thoroughly researched decisions, like the grading system used by your medical school, is critical to your success. — Post by Madeliane Kingsbury.A Medical School goes Pass/Fail only: Why this is an Excellent Change!september 17, 2016 by lifeofamedstudent, posted in med student adviceWell I’m officially THAT old, bitter resident. I had to walk uphill to medical school 10 miles there and back. “In my day” medical school was fail, pass, high pass, or honors. I just found out that the medical school I graduated from has changed the first 2 years of science courses to simply pass/fail (while retaining the honors/high pass grades in clinical rotations). I am so annoyed! Why does this bother me? Because that’s not how it was when I was there! Because having the extra high pass and honors adds a great deal of unnecessary stress to students as they are adjusting to the brutal workload of medical school. BUT BECAUSE I HAD TO GO THROUGH IT, SO SHOULD EVERYONE ELSE, DAMMIT!In all seriousness, I am in complete agreement and happy for the change.The first year of medical school was the absolute hardest of my life. The stress was monumental. The coursework is overwhelming. The absolute competition, while often among friends, is real. With the high pass/honors in place, it wasn’t good enough to just pass. It wasn’t good enough to even high pass! Everyone, admit it or not, felt the pressure of having those staggered “grades.”My first semester I had a hard time adjusting to the rigors of medical school. The study habits that had suited me so well in undergrad, were completely failing me. As a result, my grades that semester were also struggling. After one particularly bad exam result in anatomy, the idea of failing a class for the first time was unbelievably depressing. I had graduated high school and then even undergrad with a 4.0. I had never even had a “B” before. Yet, by November of that first semester, failing was a reality that I had to live with every day. The effect that had on my psyche was truly significant. Luckily, and with some serious hard work, I passed that anatomy class and all my classes that semester.By second semester, I began to find my study groove and was getting my confidence back. Even early in that semester, I no longer had to question whether I would pass or not. I was doing fine in all my courses. However, that did not take the pressure off. Once I realized, passing wasn’t the issue, it quickly became whether or not I would “high pass.” I’ve always been the type to push myself but in medical school the looming issue is always the competition. What residency you can realistically apply to is greatly affected by the scores you receive. So once I knew I could pass my classes, I felt I had to high pass them. Just like that first semester trying to pass, I was now only happy with a “high pass.” That second semester I ended up with a “high pass” in three of my courses, and I was honestly less happy about it than when I’d found out I’d barely “passed” that first semester.This trend would continue and by 3rd year, I wasn’t even happy with a high pass and downright disappointed when I only passed a rotation. Then my 4th year of medical school I managed to receive an honors grade in 6 of my 9 courses. Yet I still was probably not as emotionally satisfied or happy as the day I found out I passed that first anatomy class I was so worried about.My actual medical school transcript.While some might look at my story and feel I’m an example for why staggered grades HELPS students push to achieve more and more, I disagree. The added stress of always having the next higher grade to achieve is unnecessary and even harmful. Medical school IS stressful. It’s stressful no matter how you are graded. The goal IS to pass and be sufficiently trained to enter a residency, where only then are you actually trained to take care of patients. This isn’t 1960 and people are not practicing medicine unboarded straight from medical school. Medical school is now just a hoop to jump and likewise should simply be a course to pass.I consider myself a fairly emotionally robust person. I have entered a speciality (anesthesia) where the choices I make can have an instantaneous life or death consequence. I have always handled pressure well and may even enjoy it a little bit. Not everyone is like that. Fewer still enjoy or thrive under it. The staggered honors-high pass grades tends to adversely affect these people the most. It takes good passing students, who will become good doctors, and crushes them under the added pressure. Deflates them with the unstopping competition. Eventually, burning them out toward medicine. And horrifically, every year a few of them decide to commit suicide.Will a pass/fail only curriculum make medical school easy? Not even close. But it definitely could take unnecessary stress off students. That first two years of medical school were the hardest of my life. If had a pass/fail curriculum been in place maybe I wouldn’t be saying that today, at least after the second semester. And just maybe, there would be a lot of other great doctors out there that hadn’t been eventually burned out by the same system. If you are in a program that still uses a staggered honors grading system, I’ll give you the same advice that was given to me during those years: P = M.D, baby. Because you know what they call the person that graduates without a single honors grade? DOCTOR.What do you think? Is Pass/Fail a way to improve student wellness? Or is there benefit to having a staggered grading system? Add your thoughts in the comment section below!

As per the latest news, new IIMs plan to replace Group Discussion (GD) with written test (WAT) and they may use the older scores of IIMs for admissions. The new Indian Institutes of Management (IIMs) started since 2010, following some of the older IIM’s like IIM-A, B, L, etc. will replace the group discussion (GD) stage of their admissions with a written essay test.They also plan to use the score of WAT taken by older IIM’s, i.e. if a student has already appeared for the written tests of some of the older IIMs, he or she will not need to take the written test separately for the new IIMs. Either way, the personal interview will still be taken by the new IIMs.Over the years, GD is gradually getting shunned by the IIMs and WAT is being conducted before PI.Writing ability and time constrainNow that essay writing is gaining importance in the admission criteria of IIMs’ the main concern is the time limit. While writing an essay for admission to a top B-school, the focus should be on the time. IIM Bangalore gives 30 minutes to write the essay, while IIM Lucknow gives 15 minutes and the time for writing the essay is as little as 10 minutes in IIM Ahmedabad.Here, the key will be to write as fast as possible in order to finish the essay. Don’t waste much time on thinking and planning the structure of the essay, else you will not be able to complete it. For this, you will need sufficient practice.According to a student of IIM Ahmedabad, the best way to practice is by picking up one current-affairs topic every day and writing as much as you can for 10 minutes. Your focus should be on starting the essay and putting in as many important points as possible. There is no compulsion to present the matter in impressive or flowery language. Instead, accuracy and correctness of spelling and grammar take precedence. The essay’s evaluation is based on the number of new ideas or points you can produce in the given time, the different angles from which you can analyze the topic and the logic behind each argument.It is important to develop the ability to think and articulate quickly. For B-school panelists, essays are tools to see how you structure your thoughts and produce them in the least amount of time. Apart from IIMs, other prominent B-schools like XLRI and IIFT also use Essay Writing to assess candidates.Read More Written Ability Topics (WAT)Weightage for GD, PI and WATThe weightage to the PI and Written Ability Test at IIM Lucknow will be as follows:ComponentsWeightsWritten Ability Test10Personal Interview40Total50(The minimum requirement for getting a pass in Personal Interview is 12 out of 40 marks.)Weightage for CAT score, Class XII, graduation and work experience for PGPThe weightages are as follows:ComponentsWeightsAggregate CAT - 201538Class - XII Marks2Graduation Marks3Work Experience2Diversity Factor : Academic Discipline(D Fa)3Diversity Factor: Gender (DFb)2Total50Final Merit ListIIM-L’s admission policy document states: “The sum of the scores in all the eight components will be taken as the final score of a candidate for arriving at the merit list(s) for final selection to the PGP / PGP-ABM of IIML.Top 10 Business School Essay Writing Tips1.Don't Use Company Jargon:As a prospective business student, you have probably spent the past few years in a corporate environment with its own in-house terminology. Remember that you are writing for a reader who hasn't attended your company's meetings or contributed to its products. You should certainly describe various aspects of your professional life--your leadership skills, your career trajectory, your triumph in the face of obstacles, and so on--but do so in language that is as accessible to your reader as it is to you. Imagine that you are composing a document for a customer who must decide whether to buy a particular product: you. Write clearly and personably.And if you are a fresher, go for the common language you have been using in your school days rather than the jargons you came across while a conversation with your friend who is corporate now or any of your relative.2. Don't Bore the Reader. Be Interesting.Admissions officers have to read hundreds of essays, and they must often skim. Abstract rumination has no place in an admission process essay. Admissions officers aren't looking for a new way to view the world; they're looking for a new way to view you, the prospective student.The best way to grip your reader is to begin the essay with a captivating snapshot. Notice how the blunt, jarring "after" sentence creates intrigue and keeps the reader's interest.Before: I am a compilation of many years of experiences gained from overcoming the relentless struggles of life.After: I was six years old, the eldest of six children in the Bronx, when my father was murdered.3. Do Use Personal Detail. Show, Don't Tell!Good essays are concrete and grounded in personal detail. They do not merely assert "I learned my lesson" or that "these lessons are useful both on and off the field." They show it through personal detail. "Show, don't tell" means that if you want to relate a personal quality, do so through your experiences without merely asserting it.Before: If it were not for a strong support system which instilled into me strong family values and morals, I would not be where I am today.After: Although my grandmother and I didn't have a car or running water, we still lived far more comfortably than did the other families I knew. I learned an important lesson: My grandmother made the most of what little she had, and she was known and respected for her generosity. Even at that age, I recognized the value she placed on maximizing her resources and helping those around her.The first example is vague and could have been written by anybody. But the second sentence evokes a vivid image of something that actually happened, placing the reader in the experience of the student.4.Be Concise. Don't Be Wordy.Wordiness not only takes up valuable space, but also confuses the important ideas you're trying to convey. Short sentences are more forceful because they are direct and to the point. Certain phrases, such as "the fact that," are usually unnecessary. Notice how the revised version focuses on active verbs rather than forms of "to be" and adverbs and adjectives.Before: My recognition of the fact that the project was finally over was a deeply satisfying moment that will forever linger in my memory.After: Completing the project at last gave me an enduring sense of fulfillment.5.Do Address Your Weaknesses. Don't Dwell on Them.At some point while writing the essay on personal topic, you will have an opportunity to explain deficiencies in your record, and you should take advantage of it. Be sure to explain them adequately: "I partied too much to do well on tests" will not help your reputation. The best tactic is to spin the negatives into positives by stressing your attempts to improve; for example, mention your poor first-quarter grades briefly, and then describe what you did to bring them up.Before: My grade point average provides an incomplete evaluation of my potential and of the person I am today, since it fails to reveal my passion and determined spirit which make me unique and an asset to the _______ School of Business.After: Though my overall grade point average was disappointing, I am confident that the upward trend in my academic transcript will continue in business school. Furthermore, my success on the CAT/XAT/etc and in the corporate world since graduation reinforces my conviction that I have a keen business sense--one that I hope to develop at the _______ School of Business.6.Do Vary Your Sentences and Use Transitions.The best essays contain a variety of sentence lengths mixed within any given paragraph. Also, remember that transition is not limited to words like nevertheless, furthermore or consequently. Good transition flows from the natural thought progression of your argument.Before: I started playing piano when I was eight years old. I worked hard to learn difficult pieces. I began to love music.After: I started playing the piano at the age of eight. As I learned to play more difficult pieces, my appreciation for music deepened.7.Do Use Active Voice Verbs.Passive-voice expressions are verb phrases in which the subject receives the action expressed in the verb. Passive voice employs a form of the word to be, such as was or were. Overuse of the passive voice makes prose seem flat and uninteresting.Before: The lessons that have prepared me for my career as an executive were taught to me by my mother.After: My mother taught me lessons that will prove invaluable in my career as an executive.8.Do Seek Multiple Opinions.Ask your friends and family to keep these questions in mind:Does my essay have one central theme?Does my introduction engage the reader? Does my conclusion provide closure?Do my introduction and conclusion avoid summary?Do I use concrete experiences as supporting details?Have I used active-voice verbs wherever possible?Is my sentence structure varied, or do I use all long or short sentences?Are there any clichés, such as "cutting-edge" or "learned my lesson"?Do I use transitions appropriately?What about the essay is memorable?What's the worst part of the essay?What parts of the essay need elaboration or are unclear?What parts of the essay do not support my main argument?Is every single sentence crucial to the essay? This must be the case.What does the essay reveal about my personality?9.Don't Wander. Do Stay Focused.Many students try to turn the personal essay into a complete autobiography. Not surprisingly, they find it difficult to pack so much information into such a short essay, and their essays end up sounding more like a list of experiences than a coherent, well-organized thought. Make sure that every sentence in your essay exists solely to support one central theme.10. Do Revise, Revise And Revise.The first step in an improving any essay is to cut, cut, and cut some more.Some important sample essays are as follows, although they are only indicative and not to be considered as the only way of writing on those topics. One should exercise his or her own thoughts as well. To help you understand and co-relate, the ending of some topics are not what it should be. We hope you can identify and complete them in your words.Values ChallengedOne has to understand sub-continental culture regarding marriage in order to understand this particular crisis. Marriages are classified into two groups: 'settled' marriage and 'love' marriage. In a 'settled' marriage, the groom's family chooses the bride, and if bride's family accepts the groom, the two families get together and fix the marriage. The bride and the groom may or may not meet each other before the marriage.In a 'love' marriage, two persons fall in love and get married, with or without the permission of their families. This is considered a social crime, and the newlyweds are forced to leave their families.After I came back from the US, I met my sweetheart who was attending medical school. We courted each other for years, and when she graduated we figured it was time to marry. I asked my family to select the woman of my choice so as to marry the woman I love without upsetting social norms.When my mother proposed my fiancée's family, her mother wanted to see me personally. I assumed she would consider me a suitable candidate for her daughter's husband since I come from a good family and since I am qualified to maintain a family.However, rather than looking for qualities in me that might make her daughter happy, she demanded that I posses an MBA degree before I marry her daughter. Apparently, all of her relatives' and friends' daughters got married to either MBAs or Ph.D.'s.I was dumbfounded. I would have gladly given the moon to her daughter, but I was not about to earn an MBA to satisfy this woman's irrational craving. How would an MBA help me to become a better husband? Even though I intended to pursue an MBA anyway, I could not agree to her demand. I told her that I would never earn an MBA. As a result, I couldn't marry the woman of my dreams.I stayed true to my personal values, and it cost me the woman I love.Media InfluenceCRITICALLY ASSESS THE WAYS IN WHICH THE MEDIA CAN BE SAID TO INFLUENCE OR HAVE EFFECTS ON SOCIETY.The Mass Media is a unique feature of modern society; its development has accompanied an increase in the magnitude and complexity of societal actions and engagements, rapid social change, technological innovation, rising personal income and standard of life and the decline of some traditional forms of control and authority.There is an association between the development of mass media and social change, although the degree and direction of this association is still debated upon even after years of study into media influence. Many of the consequences, either detrimental or beneficial, which have been attributed to the mass media, are almost undoubtedly due to other tendencies within society.Few sociologists would refute the importance of the mass media, and mass communications as a whole, as being a major factor in the construction and circulation of social understanding and social imagery in modern societies. Therefore it is argued that the mass media is used as “an instrument”, both more powerful and more flexible than anything in previous existence, for influencing people into certain modes of belief and understanding within society.The question of media’s influence on society and its cultural framework has often been debated upon from leading theorists to anyone with any form of media connections, but to contemplate that the character of Chulbul Pandey from Dabang or student group of Rang De Basanti can have an influence on an audience members attitude, beliefs or interpretations of society is a very simplistic and debatable version of the truth.The media does influence, but using more diverse and subtle roles of impact. Some theorists suggest that it is even a case of society influencing the media and not the more widespread and presumed version.Presidential Vs. Parliamentary Democracy: A DebateTwo of the most popular types of democracy are the presidential and parliamentary government systems.A nation's type of government refers to how that state's executive, legislative, and judicial organs are organized. All nations need some sort of government to avoid anarchy. Democratic governments are those that permit the nation's citizens to manage their government either directly or through elected representatives. This is opposed to authoritarian governments that limit or prohibit the direct participation of its citizens. Two of the most popular types of democratic governments are the presidential and parliamentary systems.The office of President characterizes the presidential system. The President is both the chief executive and the head of state. The President is unique in that he or she is elected independently of the legislature. The powers invested in the President are usually balanced against those vested in the legislature. In the American presidential system, the legislature must debate and pass various bills. The President has the power to veto the bill, preventing its adoption. However, the legislature may override the President's veto if they can muster enough votes. The American President's broadest powers rest in foreign affairs. The President has the right to deploy the military in most situations, but does not have the right to officially declare war. More recently the American President requested the right to approve treaties without the consent of the legislature. The American Congress denied this bill and was able to override the President's veto.In parliamentary governments the head of state and the chief executive are two separate offices. Many times the head of state functions in a primarily ceremonial role, while the chief executive is the head of the nation's legislature. The most striking difference between presidential and parliamentary systems is in the election of the chief executive. In parliament systems, the chief executive is not chosen by the people but by the legislature. Typically the majority party in the parliament chooses the chief executive, known as the Prime Minister. However, in some parliaments there are so many parties represented that none hold a majority. Parliament members must decide among themselves whom to elect as Prime Minister. The fusion of the legislative and executive branches in the parliamentary system tends to lead to more discipline among political party members. Party members in parliaments almost always vote strictly along party lines. Presidential systems, on the contrary, are less disciplined and legislators are free to vote their conscious with fewer repercussions from their party. Debate styles also differ between the two systems. Presidential system legislators make use of a filibuster, or the right to prolong speeches to delay legislative action. Parliamentary systems will call for cloture or an end to debate so voting can begin.Most European nations follow the parliamentary system of government. Britain is the most well known parliamentary system. Because Great Britain was once a pure monarchy, the function of the head of state was given to the royal family, while the role of chief executive was established with Parliament. Some parliaments, however, do not have a history of monarchy. Israel is a parliamentary system with a president. The president, however, does not hold the same power as a president in a presidential system, but functions as the head of state. In both presidential and parliamentary systems, the chief executive can be removed from office by the legislature. Parliamentary systems use a "˜vote of no confidence' where a majority of parliament members vote to remove the Prime Minister from office. A new election is then called. In presidential systems, a similar process is used where legislators vote to impeach the President from office.Since the fall of the Soviet Union, democracy has begun to flourish around the world. As emerging nations struggle to identify themselves, they are also debating which form of democracy is best for them. Depending on the nation and its citizens, they may choose the more classic parliamentary system or the less rigid presidential system. They could also blend to two popular systems together to create the hybrid government that works best for them.Corruption in India“Corruption is Social Evil - Power tends to corrupt, and absolute power corrupts absolutely.”In its simplest sense, corruption may be defined as an act of bribery or misuse of public position or power for the fulfillment of selfish motives or to gain personal gratifications. It has also been defined as "Misuse of authority as a result of consideration of personal gain which need not be monetary".In recent Centuries India has earned a place among the THREE most corrupt countries in the world. Corruption in India is a consequence of the nexus between Bureaucracy, politics and criminals. India is now no longer considered a soft state. It has now become a consideration state where everything can be had for a consideration. Today, the number of ministers with an honest image can be counted on fingers. At one time, bribe was paid for getting wrong things done but now bribe is paid for getting right things done at right time.It is well established that politicians are extremely corrupt the world over. In fact, people are surprised to find an honest politician. These corrupt politicians go scot-free, unharmed and unpunished. Leaders like Lal Bahadur Shastri or Sardar Vallabh Bhai Patel are a rare breed now who had very little bank balance at the time of death.The list of scams and scandals in the country is endless. Now recently before the start of 2010 Common Wealth Games, Corruption played major role in common wealth games organisation. The Bofors payoff scandal of 1986 involved a total amount of Rs 1750 crore in purchase of guns from a Swedish firm for the Army. The Cement scandal of 1982 involved the Chief Minister of Maharashtra, the Sugar Scandal of 1994 involved a Union Minister of State for food, the Urea Scam and of course no one can forget Hawala Scandal of 1991, the Coffin-gate, fodder scam in Bihar or the Stamp scandal which shocked not only the political arena but the entire society.Is it possible to contain corruption in our society? Corruption is a cancer, which every Indian must strive to cure. Many new leaders when come into power declare their determination to eradicate corruption but soon they themselves become corrupt and start amassing huge wealth.There are many myths about corruption, which have to be exploded if we really want to combat it. Some of these myths are: Corruption is a way of life and nothing can be done about it. Only people from underdeveloped or developing countries are prone to corruption. We will have to guard against all these crude fallacies while planning measures to fight corruption.It is not possible to kill or remove the corruption by improving the Social-economic conditions of the country. Because we all know that the most of the people who are corrupted are not economically or socially backward, surely they will be having a notable social status."Despite a decade of progress in establishing anti-corruption laws and regulations, these results indicate that much remains to be done before we see meaningful improvements in the lives of the world's poorest citizens."The following steps should be considered to eradicate corruption:Greedy business people and unscrupulous investors should stop bribing the political elites. Don’t be either at the receiving or at the bribing end. Political elites should stop putting their private gains before the welfare of citizens and economic development of their regions. Government should include a chapter in text books related to corruption and its desire consequences.We all need to stop talking about Corruption only and start taking initiatives and be brave in ourselves. Corruption is going to end only when people like us stand up and speak out.If we do not take step forward to remove corruption from root, the word developing country will always be attached with our country INDIA. So we, the common man, should find some solution for removing corruption from our INDIA and hence we will also prove ourselves helpful in making our country developed.And it is possible - today’s generation is willing to change this system. And soon corruption will be out from our country. Every person should consider this as his or her own responsibility to avoid and defeat corruption“A strong youth movement in the country only can remove corruption and each student should take a vow to begin this exercise courageously within the family” - Former President- Dr.A.P.J.Abdul KalamHow Do You Measure Success In Life?Reaching the top of the tree in one's chosen occupation or profession is the usual standard by which success in life is measured, at least in the Western world. However many Asians would reject this criterion. The contemplative religions assert that success is only measurable in terms of religious advancement and of the acquisition of the virtues. Thus, success would be in inverse ratio to material advancement.Most of the world accepts the definition of material advancement, its objectives being affluence and perhaps power over others, both being the most important means of self-expression. Some are born into positions which already confer affluence and power, so success to them might lie merely in the preservation of the family business or estate and perhaps its enhancement for the benefit of the next generation. Most people have to work hard to achieve success.The western concept of success is not always satisfying and some people, at the height of their affluence and power, reject it in favor of the simple life. This happens for a variety of reasons. Beyond a certain point the acquisition of money proves unsatisfactory. The difference between the lifestyle available to a millionaire and that available to a billionaire is marginal. Unhappily money making can become an obsession, and some very wealthy people become very mean. Money also creates anxiety since it usually has to be put at risk if more is to be made. Other anxieties may be created when a large number of people become dependent on a financial empire.Money confers power which may corrupt. It is often made at the disadvantage of others, and it may damage a business man's relationships both with his peers and with his subordinates. These pressures and anxieties often have a detrimental effect on health and on family life. One's wife and children are inevitably neglected and unhappy. The children of successful capitalists or career workaholics sometimes reject everything the father offers and want to start a life of their own where they could get and give that love and care they always missed and which was replaced by materialistic things.You can complete this essay in your own words…..Let us now cover some essay topics that have appeared in the past in B-schools entrances. These topics are very popular and have a high chance of getting repeated:-National affairs:India has the largest pool of talented manpower but very few innovations and patented productsAllowing Foreign Universities in India is bad for India's education systemIndia versus Bharat: a divided nationHow should women empower themselves?More than one billion Indians: A gigantic problem or a sea of opportunitiesPolitical Issues:Voting should be made compulsoryBanning politicians with criminal records from contesting elections is against their rightFight against corruptionWomen's Reservation BillUnion Budget is useless and recession puts it off trackEconomy/ Business Issues:Recession is the mother of innovationShould Petroleum Subsidy go away?Discuss the role of Public Private Partnership in India's Economic GrowthForeign direct investment will revitalize the education systemBusinesses should concentrate on making profits and not address social and environmental IssuesInternational Issues:India to become a superpower in near futureChina's relations with India vis-a-vis PakistanDoes India have a role in Afghanistan? DiscussThis list of past Essay Topics above will help you understand what are the areas to study, the topics asked are and how to go about preparations. It is recommended that you read newspaper and listen to news so that you're well tuned with current affairs.Essay as a precursor to PI:The essay you wrote in the first half of the personal assessment round can generate some questions in the interview round. The panel could ask you questions about the essay and you have to defend it. Questions on the topic can also be asked, which means you will need to know a lot about the topic. If you don’t know something, simply admit it.This was a complete module on WAT which is the latest buzz-word in town for MBA aspirants. MBA Entrance Exams 2016/17 has especially made this module to throw sufficient light on this topic. We are very hopeful that once you go through all the topics discussed in the module, you will be well prepared to face the WAT of any institute or college.

White privilege - Wikipedia“United StatesWealthAccording to Roderick Harrison "wealth is a measure of cumulative advantage or disadvantage" and "the fact that black and Hispanic wealth is a fraction of white wealth also reflects a history of discrimination".[109]Whites have historically had more opportunities to accumulate wealth.[110]Some of the institutions of wealth creation amongst American citizens were open exclusively to whites.[110]Similar differentials applied to the Social Security Act (which excluded agricultural and domestic workers, sectors that then included most black workers),[111]rewards to military officers, and the educational benefits offered to returning soldiers after World War II.[112]An analyst of the phenomenon, Thomas Shapiro, professor of law and social policy at Brandeis University, says, "The wealth gap is not just a story of merit and achievement, it's also a story of the historical legacy of race in the United States."[113]Over the past 40 years, there has been less formal discrimination in America; the inequality in wealth between racial groups however, is still extant.[110]George Lipsitz asserts that because wealthy whites were able to pass along their wealth in the form of inheritances and transformative assets (inherited wealth which lifts a family beyond their own achievements), white Americans on average continually accrue advantages.[114]:107–8Pre-existing disparities in wealth are exacerbated by tax policies that reward investment over waged income, subsidize mortgages, and subsidize private sector developers.[115]Thomas Shapiro wrote that wealth is passed along from generation to generation, giving whites a better "starting point" in life than other races. According to Shapiro, many whites receive financial assistance from their parents allowing them to live beyond their income. This, in turn, enables them to buy houses and major assets which aid in the accumulation of wealth. Since houses in white neighborhoods appreciate faster, even African Americans who are able to overcome their "starting point" are unlikely to accumulate wealth as fast as whites. Shapiro asserts this is a continual cycle from which whites consistently benefit.[116]These benefits also have effects on schooling and other life opportunities.[114]:32–3Employment and economicsFurther information: Racial wage gap in the United StatesMedian weekly earnings of full-time wage and salary workers, by sex, race, and ethnicity, U.S., 2009.[117]Racialized employment networks can benefit whites at the expense of non-white minorities.[118]Asian-Americans, for example, although lauded as a "model minority", rarely rise to positions high in the workplace: only 8 of the Fortune 500 companies have Asian-American CEOs, making up 1.6% of CEO positions while Asian-Americans are 4.8% of the population.[119]In a study published in 2003, sociologist Deirdre A. Royster compared black and white males who graduated from the same school with the same skills. In looking at their success with school-to-work transition and working experiences, she found that white graduates were more often employed in skilled trades, earned more, held higher status positions, received more promotions and experienced shorter periods of unemployment. Since all other factors were similar, the differences in employment experiences were attributed to race. Royster concluded that the primary cause of these racial differences was due to social networking. The concept of "who you know" seemed just as important to these graduates as "what you know".According to the distinctiveness theory, posited by University of Kentucky professor Ajay Mehra and colleagues, people identify with other people who share similar characteristics which are otherwise rare in their environment; women identify more with women, whites with other whites. Because of this, Mehra finds that white males tend to be highly central in their social networks due to their numbers.[120]Royster says that this assistance, disproportionately available to whites, is an advantage that often puts black men at a disadvantage in the employment sector. According to Royster, "these ideologies provide a contemporary deathblow to working-class black men's chances of establishing a foothold in the traditional trades."[118]This concept is similar to the theory created by Mark Granovetter which analyzes the importance of social networking and interpersonal ties with his paper "The Strength of Weak Ties" and his other economic sociology work.Other research shows that there is a correlation between a person's name and his or her likelihood of receiving a call back for a job interview. Marianne Bertrand and Sendhil Mullainathan found in field experiment in Boston and Chicago that people with "white-sounding" names are 50% more likely to receive a call back than people with "black-sounding" names, despite equal résumé quality between the two racial groups.[121]White Americans are more likely than black Americans to have their business loan applications approved, even when other factors such as credit records are comparable.[122]Black and Latino college graduates are less likely than white graduates to end up in a management position even when other factors such as age, experience, and academic records are similar.[123][124][125]Cheryl Harris relates whiteness to the idea of "racialized privilege" in the article "Whiteness as Property": she describes it as "a type of status in which white racial identity provided the basis for allocating societal benefits both private and public and character".[126]Daniel Furber and Suzanne Sherry argue that the proportion of Jews and Asians who are successful relative to the white male population poses an intractable puzzle for proponents of what they call "radical multiculturism", who they say overemphasize the role of sex and race in American society.[127]:57–58EducationSome studies have claimed that minority students are less likely to be placed in honors classes, even when justified by test scores.[147][148][149]Various studies have also claimed that visible minority students are more likely than white students to be suspended or expelled from school, even though rates of serious school rule violations do not differ significantly by race.[150][151]Adult education specialist Elaine Manglitz says the educational system in America has deeply entrenched biases in favor of the white majority in evaluation, curricula, and power relations.[152]In discussing unequal test scores between public school students, opinion columnist Matt Rosenberg laments the Seattle Public Schools' emphasis on "institutional racism" and "white privilege":The disparity is not simply a matter of color: School District data indicate income, English-language proficiency and home stability are also important correlates to achievement ... By promoting the "white privilege" canard and by designing a student indoctrination plan, the Seattle School District is putting retrograde, leftist politics ahead of academics, while the perpetrators of "white privilege" are minimizing the capabilities of minorities.[153]Conservative author Shelby Steele believes that the effects of white privilege are exaggerated, saying that blacks may incorrectly blame their personal failures on white oppression, and that there are many "minority privileges": "If I'm a black high school student today ... there are white American institutions, universities, hovering over me to offer me opportunities: Almost every institution has a diversity committee ... There is a hunger in this society to do right racially, to not be racist."[154][155]”Bamboo ceiling - Wikipedia “A survey that was taken revealed that while 83% of Asian Americans felt loyal to their jobs, only 49% felt as though they belonged in the American workforce.[32]According to researchers that study diversity and talent management, 25% of Asians surveyed said "they had felt workplace discrimination because of their ethnicity."[33]Asian American men, more than any other demographic, said they felt stalled in their careers and were more likely to quit their current jobs to search for advancement elsewhere.[33]In another survey, 66% of Asian American men and 44–50% of Asian American women said they felt their careers had stalled, showing that not only do Asian Americans face large amounts of workplace discrimination, but also that Asian American men are discriminated against more than Asian American women by a wide margin, revealing a significant gender disparity.[34]Differentiating Asian American subgroups[edit]In 2020, a series of studies conducted by researchers at MIT Sloan School of Management (Jackson G. Lu), University of Michigan (Richard E. Nisbett), and Columbia Business School (Michael W. Morris), re-investigated the Bamboo-ceiling issue in the United States. Published in PNAS, the research highlighted the importance of differentiating Americans of East Asian and South Asian descent.[45]The research found that South Asian Americans' leadership attainment in US is significantly higher than that of East Asians. In addition, South Asians are more likely than Whites to attain leadership positions, as shown by data on the ethnicities of S&P 500 companies' CEOs and senior leadership positions. All findings controlled for demographics factors including English fluency, age, gender, education, tenure at company, personality, home country, and GDP per capita of cultural origin.Moreover, according to the research, cultural differences in assertiveness is the main reason why East Asian Americans hit the bamboo ceiling, while South Asian Americans are able to transcend it. Compared to South Asians, East Asians are less likely to speak up, engage in constructive debates, and stand their own grounds in conflicts. The difference in culture mediated the leadership attainment gap between East Asians and South Asians in the United States. Thus, the researchers suggest that Bamboo Ceiling is not an "Asian issue", but an issue of cultural fit with the US prototype of leadership.”https://www.ussc.gov/research/research-reports/demographic-differences-sentencingBlack male offenders continued to receive longer sentences than similarly situated White male offenders. Black male offenders received sentences on average 19.1 percent longer than similarly situated White male offenders during the Post-Report period (fiscal years 2012-2016), as they had for the prior four periods studied. The differences in sentence length remained relatively unchanged compared to the Post-Gall period.Non-government sponsored departures and variances appear to contribute significantly to the difference in sentence length between Black male and White male offenders. Black male offenders were 21.2 percent less likely than White male offenders to receive a non-government sponsored downward departure or variance during the Post-Report period. Furthermore, when Black male offenders did receive a non-government sponsored departure or variance, they received sentences 16.8 percent longer than White male offenders who received a non-government sponsored departure or variance. In contrast, there was a 7.9 percent difference in sentence length between Black male and White male offenders who received sentences within the applicable sentencing guidelines range, and there was no statistically significant difference in sentence length between Black male and White male offenders who received a substantial assistance departure.Violence in an offender’s criminal history does not appear to account for any of the demographic differences in sentencing. Black male offenders received sentences on average 20.4 percent longer than similarly situated White male offenders, accounting for violence in an offender’s past in fiscal year 2016, the only year for which such data is available. This figure is almost the same as the 20.7 percent difference without accounting for past violence. Thus, violence in an offender’s criminal history does not appear to contribute to the sentence imposed to any extent beyond its contribution to the offender’s criminal history score determined under the sentencing guidelines.Female offenders of all races received shorter sentences than White male offenders during the Post-Report period, as they had for the prior four periods. The differences in sentence length decreased slightly during the five-year period after the 2012 Booker Report for most offenders. The differences in sentence length fluctuated across all time periods studied for White females, Black females, Hispanic females, and Other Race female offenders.”