What do you call the dude who comes in last in his medical school class?

Answer: Doctor!

I was told this joke when I was preparing for postbac. It’s funny, right? Because no one wants their doctor to be that guy. We all hope we’re getting treated by a genius who never misses a needle stick and can diagnose you as soon as you walk in the door. We don’t want to think about our doctors missing questions on exams or struggling to understand the basic concepts of disease.

I think that’s part of the reason I get a funny look when I tell people that medical schools are pass/fail for the most part. (The first two years, anyway.) No one wants to think about their doctor as someone who just barely scraped by with a 70; we’d at least like to think of them striving for that A.

source: Yoga Retreats.

There are good reasons for the pass/fail system, though. By and large we medical students are competitive bunch, and that particular quality is only reinforced though extreme curves and weed-out classes in pre-med. That kind of competition has an ugly side. There is a pretty significant difference between a doctor who made it to the top of her class because she is intelligent and hardworking, versus one who made it by being vicious. (Although, I won’t lie, it makes for great television.)

Beyond that, most of the medical schools I seriously considered attending seemed to take the attitude that, by virtue of being accepted into their program, we had proven ourselves. We all had the capacity to become physicians, and there was no need to put us through the wringer just for the sake of establishing our right to be there. Once you’ve made it to medical school, you’re clearly a smart, driven person. Now it’s just a matter of making sure you’re a smart, driven person who knows how to practice medicine.

Of course. there are degrees of excellence, so in case you’re worried that all doctors are considered equal, keep in mind that the second two years of medical school are graded, and students must pass  two numerically graded board exams before they can be considered for residency. There is another board exam after the first year of residency, and regular board certifications throughout a doctor’s career.

And, if I might just add, having just clawed my way through my first real medical school examination, passing medical school is nothing to sneeze at. It isn’t the same thing as passing high school or a college course. These tests are designed to challenge us, we who fought our way to the top of the undergrad heap.

So to the dude who came in last in his medical school class? I will most certainly call you Doctor. I know very well that you earned it.