An article from the New England Journal of Medicine discusses the debate over grading systems in medical schools, specifically the pros and cons of pass/fail versus tiered grading. A review of 40 studies showed that pass/fail assessment in the preclinical phase improves students' short-term well-being without negatively affecting academic performance. Conversely, stratified grading has low reliability and may lead to racial and ethnic disparities in grading during clinical placements. The authors emphasize that the different objectives of the evaluation lead to conflicting opinions and interpretations of the data, while the quality of the studies is limited. Recommendations include caution in interpreting the small number of stratified grades, the need for transparency, and further research on inequities in the evaluation of clinical internships. Overall, the article calls for a balanced approach that considers all relevant aspects of assessment to support both students and patients. [1]