Grade Inflation in Internal Medicine Clerkships: Results of a National Survey

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Abstract
There has been a discussion among medical educators concerning grade inflation; however, little has been written about it in the medical education literature. A survey was developed to determine if grade inflation exists by gathering data about grading practices and by gathering the opinions of course directors from Internal Medicine clerkships. The survey was administered during the 1996-1997 academic year to all 125 LCME accredited medical school Internal Medicine Clerkship Directors. Grading practices for 3 separate academic years were obtained plus responses to questions about causes of and solutions for grade inflation. Eighty-three surveys were returned for a 66% response rate. There was a trend towards higher grades across the 3 study years, with the 1995-1996 year being statistically significant. Forty-eight percent of the clerkship directors felt that grade inflation existed in their courses, and 43% felt that some students passed who should have failed. Statistically significant grade inflation exists in Internal Medicine clerkships. Most disturbingly, 43% feel we are unable appropriately to identify incompetent students.

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