Is there grade inflation at medical schools? Case study of the Zagreb University School of Medicine.

AIM: To investigate if students' grades at the Zagreb University School of Medicine increased since the establishment of the School in 1917. METHODS: In this retrospective descriptive study, we analyzed student sex, the length of studying, average of all grades, and grades from 5 major courses--anatomy, physiology, pathology, internal medicine, and surgery. The passing grades at the Zagreb University range from 2 (sufficient) to 5 (excellent). We analyzed data for 2,861 students from 9 representative classes, enrolled in 1920, 1930, 1940, 1950, 1960, 1970, 1980, 1985, and 1990. RESULTS: The number of female students constantly increased up to 1970 and hereafter the female to male ratio remained stable, 60:40. The percentage of enrolled students who graduated from the School increased from 1920 to 1940 and from 1960 to 1985. Between 1940 and 1960, the percentage of students who graduated was lower than 50%. There was a continuous increase in grades during the investigated period (p<0.001), except for students enrolled in 1960, who had lower grades than those enrolled in 1950. Students who enrolled in 1990 also had lower grades than those enrolling in 1985. Grades from the individual courses mostly followed the increasing trend of total grades. CONCLUSION: There has been an increasing trend in grades at the Zagreb University School of Medicine since its establishment in 1917.

Zagreb University School of Medicine: students grades during war.

AIM: To investigate whether examination grades of the students at the Zagreb University School of Medicine changed during the 1991-1995 war in Croatia. METHODS: The retrospective descriptive study included examination grades from 5 major courses in the first 5 years of the medical studies: Anatomy (first year), Physiology (second year), Pathology (third year), Internal Medicine (fourth year), and Surgery (fifth year). We compared the war-period (1991-1995) with two control periods: before (1989-1990) and after the war (1996-2000). The passing grades at the Zagreb University range from 2 to 5, with 2 as the lowest and 5 as the highest grade. There were a total of 17,682 examinations from the 5 courses in the studied periods. RESULTS: Grades were higher in the pre-war and post-war periods than in the war period (p<0.001 for both comparisons). Grades in the individual courses followed the general trend, except for the surgery course, where grades during the war were better than in the control periods, and the physiology course, where continual worsening, irrespective of the war, was observed. CONCLUSION: Medical students obtained significantly lower grades in 5 major courses during the war than before or after it. Thus, it is reasonable to assume that different factors, some related and some unrelated to war, could have adversely influenced students performance.