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Why I don't believe in honors for 3rd year clerkships and advocate for P/F and also getting rid of AOA: a short thread 
During an ice breaker on favorite countries traveled, a white student talks about traveling in Europe and the attending goes off on a long conversation with that student. An Asian student mentions having been to Japan, the attending says, "nice," and moves on
The white student is now the attending's best friend for the rest of the rotation. This was shared by a newly minted MS3 friend who recently started on rotations. Whether it's food, music, TV shows, etc. Things like this happen ALL THE TIME for minority students, especially URMs
Does that mean, we shouldn't ask these questions? Not necessarily. I think they could be a fun way to get to know each other, but we need to recognize how these kinds of interactions can easily lead to trainees feeling they don't belong and bias when it comes to evaluations
Evaluators are humans, and as such, evals are too often based on how likable the student was in the eyes of the attending. How can we have such a huge component of medical school performance and residency app be based on so much subjectivity?
Minority students are likely at a disadvantage as our cultures are different and evidence have already shown racial disparities in 3rd year grading and AOA after adjusting for factors like Step 1 score https://pubmed.ncbi.nlm.nih.gov/31032666/
Increasing diversity is a must, but we need to also set them up for success once they are in med school. And honors clerkship grading and AOA likely do not and further perpetuate inequity
p.s. honors grading can also lead to a hostile learning environment and showmanship over true patient care and learning among others 
p.p.s. Lastly, I’ve seen first hand how devestating a bad/abusive experience with an attending or resident can be on a student’s mental health and believe P/F can also mitigate that.
That’s my last tweet on the topic
That’s my last tweet on the topic
