I just read Dr. Shapiro's Practice Perfect article, "Should Podiatry Schools Change to Pass/Fail?", in which he advocates for pass/fail grading at podiatry colleges. The main structure of the argument is that student stress is greatly reduced and it would be easier to evaluate students more evenly from the colleges at residency application time.The research he used to base his conclusion and his personal experiences caused him to outline a very cogent argument as to the benefits of a pass/fail system, which I can find no reason to dispute.
HOWEVER - my personal experience, (and older age) concludes this: When I am in a motor vehicle accident and I have multiple fractures, internal bleeding, etc. and I make it alive to the ER, I want Joe Traumasurgeon MD, to be one who was trained in the most stressful environment starting from day one of medical school including residency and fellowship. I want him or her not to have been protected by ridiculous work load limitations that may have allowed him to be at home sipping a latte while he or she could have been learning one more time how to put my pelvis back together. I also would prefer that he or she had not been trained in an environment where when the watch said 4PM he or she could snap off their gloves and point to the clock and go home whether they wanted to or not. And I don't want anyone who if during training set a finger fracture at 1AM in the ER got the next day off.
I am not insensitive to overworked and tired trainees and their increased chance of making serious mistakes and causing harm to come to patients. But in my opinion, the backlash to prevent this from happening has been way overdone and should be turned back a little.
Not all stress is bad....indeed there is real science proving that absence of stress leads to failure to thrive.
Bryan Markinson, DPM
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