How professionalism grades hurt medical student professionalism

I love the profusion of new ways to teach and assess professionalism in medical school. It’s a huge advance from the days when people like me could still get in.


Yet, there are sharks in those waters. My friend and med ed collaborator Dr. Roshini Pinto-Powell of Dartmouth’s Geisel School of Medicine and I describe one of those sharks: numerical professionalism grades.

It starts with good intentions: we create a grading rubric on the thought that we should take professionalism AT LEAST as seriously as other topics in medical school. And the easiest way to grade is on a Likert scale.

Yet, we argue, boiling down something as complicated as professionalism into a simple, arguably meaningless professionalism grade is perilous. One reason why is that it imposes external incentives on a complex task, a combination known to sap students’ internal motivation.

That means we might begin with the intention of highlighting the importance of medical student professionalism, and end by undermining it.

Fortunately, there are better ways forward.

To read more, check out our full text publication at the Journal of General Internal Medicine, here.