I'm an undergrad in biology, long story short, I was looking a professor's CV (not in medicine) and he had indicated his GPA in his grad school (apparently he had the highest in his program). But what about medical school? I read somewhere that courses in med school are pass/fail and not graded. Not sure if that's true but if it is, how do good students distinguish themselves?

Secondly, same question in terms of getting into top specialties as indication of how good of a student someone is. On a medical school site I saw what seems to be labeled as "competitiveness" of various programs, with dermatology and plastic surgery being highly competitive and family practice and psychiatry being the least. I assumed this means that only most successful students get into these programs, and so this can be used to indicate how good someone is. But apparently not so. I'm not sure exactly how this works, but it seems med students, though they take the same exam (USMLE), they self-select into various specialties.

So how can you tell how good a student is in medical school if there is no GPA and if getting into a specialty also don't indicate that?


Gone are the days when course marks are the only metric against which medical students are assessed. This is one of the reasons for the institution of pass/fail modules of instruction. This issue is difficult for medical students to understand, given that entry into medical school is contingent on tough criteria involving grade-based metrics. All these questions you've asked are tied to this old way of thinking.

how do good students distinguish themselves?

Medical students distinguish themselves in ways other than course marks. They show compassion towards patients. They show creativity in their approach to problem solving. They demonstrate the ability to communicate effectively. They work well with their peers. They lead and follow, as is appropriate to achieve the best outcome for the patient.

It's not all about the marks. It's all about the patient.

same question in terms of getting into top specialties as indication of how good of a student someone is

I believe that you're looking at the question ass backwards. In logic terms, your applying the fallacy called confirming the consequent.

Competitive people get into dermatology. Sally got into dermatology. Therefore, Sally is competitive.

I suggest that you refrain from judging the "competitiveness" of a doctor on the basis of his or her specialty.

The choice of specialty has been long studied and the motivation to pursue a particular medical specialty is based on a number of factors, not the least of which is personal preference. I can think of no one in my professional life as a medical doctor -- professors, peers, students -- who've pursued a clinical specialty simply because it was the most competitive thing to get into.

The "competitive" label of some specialties is a function of supply of training posts against demand for the profession. There are relatively few positions available for dermatology compared to the need of the population. I promise you, if dermatology places were to triple overnight, the "competitive" label would be lost. The same is true at the other end. There are many places for family medicine, some not able to be filled.

So how can you tell how good a student is in medical school if there is no GPA and if getting into a specialty also don't indicate that?

There is no single metric. Rather, I suggest that you understand the mechanics against which you will be assessed. These will differ as you progress through your medical training. At each stage, the everyone resets to zero, any you start from scratch. There is no carry over of grades. Let me give you an example. In the program I head, we receive 400 applications for the 12 training places we possess. Once we select our trainees, everyone is treated the same. Effectively, the utility of your GPA, your medical school award for perfect attendance, your three letters of recommendation -- all of these have served their purpose and we chuck them out. We don't care whether you were top of your class or bottom of your class. You're now in our class and our rules apply. Do you know who has the hardest time figuring this out? Well, it's the people who are fixated about class and status.

Anyway, good luck to you.


I'm not a doctor, but I play one on TV.

What I mean is, I have zero personal experience with studying or teaching medicine. But I've read books about people going through medical training. So my answer will only be as good as those books (and my ability to imagine that world).

  1. How do good students distinguish themselves?

Judging by the context you gave, of reading a professor's CV, I think you're asking how one can tell who the rock stars are.

In academia: the length and the quality of the publications list, getting on the cover of an important journal, winning a prize, getting a prestigious fellowship, being an invited speaker, etc.

In medicine: here I'm less sure of my answer, but I think the items I mentioned for academia would apply as well. Also, when I hear one mental health professional speak of another one's credentials, they seem to know which are the really good training programs, so if someone has listed one of those on their CV, then that's a feather in their cap.

Perhaps you are asking, how do selection committees figure out which are the strongest candidates for a position. I imagine the reputation of the training program, and the recommendation letters, must be extremely important. Blue-blue-blue's answer gives an insider view of what a supervisor thinks about when preparing to give a reference (compassion, creativity, problem solving, communication, collaboration).

From my reading (which I will say once more, may have given me a totally wrong impression), here is what one has to do to be a successful medical student:

  • learn to do practical things like drawing blood, not necessarily with the benefit of step by step training in how to do it efficiently (in other words, this part of the job can be pretty sink or swim)

  • be respectful of nurses

  • respect the medical hierarchy

  • stay on top of an enormous amount of reading, so as to be able to answer impromptu verbal quizzes in front of fellow students, and also so as to be able to care for patients and do the creative problem solving mentioned by blue-blue

  • work incredibly long shifts, catching naps as catch can

  • navigate electronic records comfortably

  • be efficient

  • manage one's anxiety about appearing stupid, or about making a mistake

  • learn enormous amounts of material and figure out a way to catalog it all in one's brain

  1. I saw what seems to be labeled as "competitiveness" of various programs, with dermatology and plastic surgery being highly competitive and family practice and psychiatry being the least.

I think what you saw was a rating system indicating the relative ratios of #slots divided by #applicants. If that ratio is much higher in one specialty than another, then it is called "highly competitive."

If you are wondering how a student should use this information when choosing a specialty, my personal opinion is that one should be primarily guided by one's natural affinity for an area of medicine. (I can tell you that I was not very encouraged when I was in the hospital with a serious fracture, and the attending specialist who was overseeing my care, and checking on me from time to time, heard that my spouse is a physicist, and confided in me, "I always wanted to study physics, but my father said the only way he'd pay for my college was if I studied medicine.")

  1. So how can you tell how good a student is in medical school if there is no GPA and if getting into a specialty also don't indicate that?

See above. Also, when I was choosing a pediatrician for my first child, here are the qualities I valued in the one I chose:

  • She was able to connect with the child and with me

  • She listened to my point of view

  • She explained things clearly

  • She sometimes mentioned recent research results as they related to the issue the child was having, and sometimes on a subsequent visit I was able to see that she had done some reading in the interim (that really distinguished her from most doctors I had seen; maybe they all do that, but just don't talk about it....)

  • She gave us useful advice (sorry to have put that at the end, it's of course just as important as the other things)

And here are the reason I switched to someone different after some time:

  • We were having trouble getting child #2 diagnosed; I found an article I thought could give us some clues (it turned out, in fact, to provide the key to what was wrong), but when I mailed it to her and asked her to read it, and made an appointment for one month later, when we got there, she still hadn't read it.

  • She refused to use email or a patient portal or fax to communicate with me. It was very frustrating always to have to go through a semi-literate receptionist.

The current doctor of child #2 has some modern tech-related qualities that I really appreciate:

  • She checks frequently for messages that come in from patients through the receptionist and the patient portal.

  • She responds promptly through the patient portal, writes helpful letters explaining to the school what the child needs, and gets the letters to me directly through the patient portal. That gives me a chance to preview the letter and let her know if there's something the school is liable to misunderstand -- before the letter gets sent to the school.


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