Call for Action: Undergraduate Medical Education Assessment—Advocating for a Transition From Tiered to Competency-Based Grading

Traditionally, undergraduate medical education (UME) grading has been based on a tiered system. Tier-based grading can cause anxiety as medical students are compared to their peers. Students then become overly driven by the pursuit of creating favorable impressions by supervisors as well as by high grades. Additionally, the emphasis on normative parameters appears to misalign with the goal of UME which is to not sort learners into different residency programs but to train future doctors to meet the needs of society. This commentary is a call for action to shift from utilizing a normative-based grading paradigm in UME to implementing one in which learners are being assessed on their ability to attain specific competencies. It is important that UME transitions to competency-based assessments as the graduate medical education (GME) realm has already adopted this framework.