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.

Just sayin'

Bryan Markinson, DPM 

  • Comments (2)
  • Dieter,

    The pass-fail argument has been around podiatry colleges for 40+ years.  We tried it in Iowa 30 years ago and it was a failure.  We dumped it after a few years and went to a numerical grading system.  P/F unmotivates students.  How is a student evaluated as to how well they are learning the materials by the teachers or those post-graduate programs?  Now it is one thing for the National Boards to be P/F because that is a test to demonstrate minimal competence for licensure.  However is that what we really want for students?  I can promise you that the so-called enlightened ones who currently are using the system will be dumping it too after a few years, just like we did at the Iowa school.

    Best wishes,


  • I also read the article. The key argument, it seems to me, that a pass/fail structure is the standard for the MD, already, and that Podiatry is unecessarily caught up and lagging behind, invested in the one upmanship of competetive grading with a dubious value, for all the reasons argued in the article.

    There are very many additional stressors applied to the podiatry student and this will usually include a residency which in of itself can and does provide many of the extra stressors required to hone the practitioner's temperament.

    The suggestion made, in this article, seems a very reasonable one.