Outcome measurement in postgraduate year one of graduates from a medical school with a pass fail grading system

Purpose. To measure the performances of first-year residents who had gradua ted from a medical school with a pass/fail grading system and to compare th e preparedness of these graduates with that of their peers. Method. All 169 graduates of Stanford University School of Medicine's class es of 1993 and 1994 were included in this study. First-year program directo rs rated the performance of each Stanford graduate in II areas, compared th e graduate's clinical preparedness with that of his or her peer group, and rated the accuracy of the dean's letter in presenting the graduate's capabi lities. Results. Responses were obtained for 144 of the 169 graduates (85%). The pr ogram directors rated the overall clinical competencies of most of the grad uates as "superior" (76%) or "good" (22%); they rated very few as "unsatisf actory" (2%). When the Stanford graduates were compared with their peers, t heir clinical preparedness was judged "outstanding" (33%), "excellent" (44% ), and "good" (20%); very few were judged "poor" (3%). Stratification of pr ograms by either hospital or medical specialty did not reveal significant d ifferences in overall clinical competence. Ninety-one percent of the respon ses reported that the dean's letters had accurately presented the capabilit ies of the graduates. Conclusion. Graduates from a medical school with a two-interval, pass/fail system successfully matched with strong, highly-sought-after postgraduate t raining programs, performed in a satisfactory to superior manner, and compa red favorably with their peer group.