LAUSR

T he world is in crisis as this commentary is being drafted and as such it is challenging to focus on this subject. We agreed to pen this just days before the pandemic reached the shores of the United States and now we sincerely wish health and safety to all of our colleagues in health care battling to save lives and protect those suffering. As surgeons, ‘‘crisis management’’ is in our DNA and in times of urgency such as these we become true leaders conveying a sense of calm. That said, we will rise out of this, hopefully smarter, better, and more well prepared for anything like it in the future and so we will continue to address the aspects of academic medicine that press at our collective mindset. The author of the article ‘‘Ensuring that Step 1 isn’t the Next ‘‘Back in my day’’’’ presents a perspective applauding the decision to convert the USMLE Step 1 examination to a pass/fail grading system. In advocating his position, he has conflated the shortfalls of standardized tests with the ‘‘importance’’ of reducing competition by transforming the examination to a binary pass or fail. One of his arguments is that the importance of Step 1 has become too extreme and there is wide consensus around this. Program directors, deans, medical students, and nearly all educators share that opinion. How we got to this point as an educational community is where our paths diverge. Perhaps due to his youth, he does not reflect on the gradual slide down the slippery slope of eliminating grades that has occurred in medical education over the past several years, and his perspective is limited by this lack of longitudinal experience. As grades (especially in the preclinical years) were set aside under the premise of reducing stress and competition among medical students, increasing value was inadvertently placed on the only objective tools remaining: the