All medical degrees are equal, but some are more equal than others: An analysis of medical degree classifications

BackgroundInequity in assessment can lead to differential attainment. Degree classifications, such as 'Honours', are an assessment outcome used to differentiate students after graduation. However, there are no standardised criteria used to determine what constitutes these awards. MethodsWe contacted all medical schools in the UK and collected data relating to classifications awarded, criteria used and percentage of students receiving classifications across the 5-year period prior to the 2019/2020 academic year. ResultsAll 42 UK medical schools responded, and 36 universities provided usable data. Of these 36 universities, 30 (83%) awarded classifications above a 'Pass'. We identified four classifications above a 'Pass', and these were 'Commendation', 'Merit', 'Distinction' and 'Honours'. Sixteen (44%) universities awarded a single additional classification, and 14 (39%) universities awarded two or more. There was considerable variation in the criteria used by each university to award classifications. For example, 30 (67%) out of 45 classifications were dependent on all examined years, 9 (20%) for a combination of years and 6 (13%) for final year alone. Twenty-five of 30 universities that awarded classifications provided data on the percentage of students awarded a classification, and a median of 15% of students received any type of classification from their university (range 5.3% to 38%). There was a wide range in the percentage of students awarded each classification type across the universities (e.g. Honours, range = 3.1%-24%). ConclusionsWe demonstrate considerable variation in the way UK medical degree classifications are awarded-regarding terminology, criteria and percentage of students awarded classifications. We highlight that classifications are another form of inequity in medical education. There is a need to fully evaluate the value of hierarchical degree awards internationally as the consequential validity of these awards is understudied.