Back in the 1980’s, my medical school  adopted  a Pass-Fail system of grading. The administration boasted of how they had reduced the pressure and competition of medical training by eliminating grades. But they added an additional grade of Honors for the top 10% of each course, thus negating the original intent. For many students, the presence of the rare and lofty “Honors” actually heightened the intensity and ruthlessness of competition to which doctors in training are prone.


MD or not MD, that is the quandary.
Whether ’tis easier on the butt to suffer
The hours and minutes of outrageous lecture.
Or to take a stand against a sea of schedules
And by leaving end them: to sit, to study
No more; and by no study, to say we end
The head-ache, and the thousand unnatural exams
This flesh is heir to – ’tis a vacation
Much to be admired. To sit, to study,
To study, perchance to learn; Aye there’s the rub.
For in this study of life, what learning may come,
When we have bubbled in this meager sheet,
Must give us Pass. There’s the respect
That makes Doctors out of B.A.’s,  B.S.’s.

For who would bear the classes of so long a time
The lecturer’s wrong, the proud Profs disdain,
The pangs of borrowed money, the sleep’s delay,
The insolence of course directors, and the stench
Of formaldehyde and rotten flesh,

While he himself his dissection make
On a bare cadaver? Who would gladly bear

To bleed and sweat under a weary light,
But for the hope of something here after;
The Doctorate of Medicine, with whose bestowal
All good things come. Piques the will,
And makes us rather bear those ills we have
Than to cast off eighteen years of education.

But compulsion makes cowards of a few,
And thus the nature of these students
Is sicklied o’er with the pale cast of concern,
And enterprises of little consequence,
With this regard, their meanings twist awry,
And lose all moderation.
I want you now, the fair Honors!
Nymph, in thy transcriptions
Be all my virtues remembered.

About Køt Biehl

I am a psychiatrist in private practice with 25 years experience in multiple settings including long-term inpatient, acute inpatient, partial hospitalization, outpatient, hospital consultation, long term psychodynamic psychotherapy, brief psychotherapy, and even electroconvulsive therapy. I am board certified in general psychiatry and psychosomatic medicine. My interests are many. I bore easily. I am fascinated by shamanic healing, particle physics, quantum theory, Schubert, Brahms, Schoenberg, Jung, Reik, Pynchon, Proust, Mark Strand, John Berryman, Richard Feinman, Wharhol, Pollock, Kandinsky, Miro, audiophile stereo reproduction, rocks on the beach, and small shiny objects.
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