Why Medical School Grades Don’t Matter

Medical school grades don’t matter. They’re not a reflection of how well (or badly) you know the material. But I do remember stressing out a lot about them in my first couple of years of medicine. Before I realised the truth.

That’s not to say don’t keep an eye on them however — they’re still important in terms of helping you progress through the years. But the amount of precedent they take, at least in your average medical students eyes, is usually way too much. Here’s why.

Medical School Grades Don’t Matter; They’re Not a Reflection of Your Self Worth

The first reason I think an overly-centred approach on grades is bad is because it often creeps into the idea of how you see yourself. A lot of students at med school? Define themselves by how they score on a test.

The reason I think this is potentially unhelpful is two-fold. First it gets people into thinking they’re only as “good” as their last exam score. Second it gets them in an unhelpful competitive mindset that leads to resentment and secrecy, rather than collaboration and helpfulness.

Your score in a test doesn’t determine who you are. You are not graded for your conscientiousness, discipline, ability to empathise or work in a team. These are the more important abilities, I’d argue, of gauging progress in healthcare. Critical aspects that help you succeed.

Jerad Gardner, MD, reminds us of this in the video below. Likening learning in medical school to the familiar analogy of “drinking from a firehose”, he reminds us of the huge amount information we’re expected to know. Telling us to take it easy on ourselves in the process.

One key thing to take away here? Jerad reminds us that even he, himself, barely remembers what he scored on most of his tests in school. Given the complete irrelevance it bears now in as career as a pathologist.

That’s why you shouldn’t worry. You’re so much more than a number (or letter) in a book. And the soft skills you’re developing by working hard, staying focused and helping those around you? Pay much greater dividends in the long-run.

Grades Don’t Reflect You’ve Mastered the Subject

One thing I’ve noticed from my time in med school watching students panic and look for short-cuts to pass tests? Grades have no reflection on whether they actually understand a subject or not.

Case in point: the way most students at my University approach tests. Rote-learning all the answers from the exams of previous years and praying the same questions come up again; this is hardly an efficient strategy. And, as I’ve argued before, it only derails your progress in the long-run. Making future tests — that build on that knowledge — all the more difficult when you don’t understand the core concepts in the first place.

This is why I’m so passionate about students re-thinking how they study. Recognising that most of what they do is highly inefficient (read my article “how to study more effectively“), they’d save themselves so much stress worrying about their grades. And only with a small amount of course correction too.

Another reason grades don’t reflect how well you know a subject? The fact there’s a whole bunch of different grading systems out there too.

In Bulgaria, for example, we’re graded on a 1-6 scale (1 being a fail, 3 being a pass and 6 being the equivalent to an A). America dishes out A, B, C etc that’s converted into a number that’s reflected in an overall grade point average (GPA). And in the UK, from what I understand (had to look it up), each University has their own criteria; ultimately scoring people within a year so that they get prioritised in choosing Foundation (junior year) placements.

My point is it’s all different. So depending on where you choose to work — assuming you work in a country different to your place of study — your grades will barely be relevant in that system anyway. As it will all come down to your final performance on medical licencing exams (UKMLA, USMLE, PLAB etc).

This is another reason why I’m for standardised testing. It makes everything you did at med school, internally at least, irrelevant. Except for your independent dedication to learning and mastering the material as you see fit. And making the system fairer for everyone.

Grades Should Be an Afterthought

Hopefully if you’ve read this far, you’re already beginning to change your mind about the importance of grades. But here’s where I want to things one step further. To suggest to you to treat whatever grades you get as a simple afterthought.

Let be more careful here. I’m not saying “don’t work and study hard in med school.” I think that’s entirely necessary. I’m just saying don’t worry so much about what you score on internal tests. Because most of the time they’re written by what a professor or lecturer thinks is important. Not what a licencing board or specialist college thinks instead.

I think this is also a key thing to bear in mind for people just about to start medical school too. The exams they had to do before? Definitely do count — making or breaking whether they make it into medicine in the first place. But they shouldn’t continue with the same mentality in their first few years at least. The stress that would bring? Just not sustainable to balancing the more important factors; mental health etc, that helps them survive in school in the long-run.

Exceptions: When Medical School Grades Matter

Of course there are exceptions to the rule. As mentioned before, in regards to UK medical Universities, grades can determine your career placement (if only by location) in your junior years. In the US also, they help determine what medical specialisms you have access to.

What I think the right message is here? There’s always time to turn it around. Time to experiment with strategies, improve your skills and better your understanding before times get real.

It’s not just me that says this either. One of my favourite (and realist) medical YouTubers, Antonio J. Webb, also suggests this too. And, as you can see, he’s not doing too bad by the looks of it!

For the majority of us then, a better strategy to approach medical school grades is to have your own individual way of looking at them. Recognise the limitations of putting them first in your life. But acknowledge their utility as rough placeholders for your progress.


What I hope to have outlined in this article, besides from maybe helping you relax when it comes to being anxious about your grades, is when and where to apply your max effort.

Your first years at least? Should be a broad experiment. A learning experience you tinker with to see which of the principles of active recall work best. Then, hopefully having settled on a best approach, you can maybe start thinking about grades more seriously later.

To summarise though, here’s why I feel medical school grades don’t matter:

  • They don’t accurately suggest you know or understand the material
  • A lot of course examinations include things from lecturers/teachers that are wholly irrelevant (minutiae detracting from the big picture)
  • Sometimes your performance can be solely down to luck or circumstance
  • Exam grades have no bearing (for the most part) on deciding your future career
  • Focusing on them too much can breed an unhealthy competition between colleagues that misses the broader point of medicine (i.e. being cooperative)
  • Obsession can cause greater mental health problems; anxiety, depression etc. further down the line (medical school is hard enough)

So don’t sweat it too much if you think you’re coming up shorter than you deserve!