Questions About Grades

The Big Picture

It feels like premeds spend a lot of time stressed out about grades. Why do med schools focus so much on GPA?

Med schools focus less on GPA than premeds think. They ultimately want to know that any applicant that they admit will be able to successfully navigate the curriculum and the board exam (which plays a large role in residency placement). Every school will have a target GPA range in mind, derived from students in their program who have been successful in the past. You can see these GPA ranges for individual schools in the MSAR (free access at HPA) and GPA ranges for Princeton applicants in our virtual data binder (netID login required).

Medical schools measure academic readiness in a number of ways, including:

  • overall and science GPA
  • course choices
  • GPA trends (trajectory over time)
  • MCAT score

Recovering from a lower GPA in one term could be a sign of resilience and persistence (important qualities in future doctors); an upward trajectory can demonstrate capacity for improvement and adaptability. Continued struggle without making active changes to address them could be a red flag. They will look to your letters of recommendation for corroboration of your potential for academic success.

Beyond academic profile, your personal competencies and your potential as a classmate, colleague, care provider, are also critical. In addition to academic metrics, medical schools place a high value on civic engagement/service, physician shadowing, clinical experience, leadership, and performance in the interview when selecting students (see the AAMC Using MCAT Data in Medical Student Selection report for more information). They’re also looking for individuals who fit their particular missions (this podcast provides a good example of this).

And the more experience you have beyond your grades, the more they have to evaluate. Give yourself the time you need and seek the experiences necessary to develop yourself personally and professionally. HPA can help you figure out what experiences can help you achieve this.

How do med schools calculate GPA? Will my departmental GPA affect my medical school chances?

When you apply to medical school, your application will calculate GPA in a few ways:

  1. By class year: this helps them see trends. High school, freshman, sophomore, junior, senior, postbac, and graduate are all calculated separately.
  2. Science GPA: consisting of ALL courses you’ve taken at the undergraduate level in biology, chemistry, physics and mathematics (this is called your BCPM)
  3. All Other GPA: everything that is not BCPM
  4. Cumulative GPA: all classes

There is, for better or worse, no place in the application to list your departmental GPA. Medical schools want confirmation that you are able to handle the sciences that form the foundation for medical education, and they want to know that you’ve taken on a broadly challenging and interesting undergraduate course of study… but ALSO keep in mind that these numbers are parts of a much bigger picture of the overall application that you will submit. Please come by to talk to an adviser about your preparation for the health professions – either academically or otherwise – at least once a semester.

First-Year Transitions

I’m a first semester first-year. Everyone tells me Princeton will be harder than high school, but how do I know if I’m doing what I need to do when I won’t get grades until midterms?

It’s great that you’re thinking proactively about doing well here! As a prehealth student, every semester’s grades count, and it’s nice to gain some momentum in this first semester rather than having to dig yourself out of a hole. Some ideas:

  • Use office hours! If you're not sure how ...
    • ask faculty / preceptors for clarification on a topic from class
    • ask faculty / preceptors to look over your notes and see if you’re capturing the important points
    • sit with faculty / preceptors and explain how you understand topics from lecture, to see if you really understand them the way that they expect you to.
  • The McGraw Center is another of your best resources to be sure that you’re studying efficiently and effectively:
    • Attend workshops about study strategies and effective learning
    • Go to study halls and work through problem sets with a trained upper-class tutor, or you can
    • schedule a one-on-one learning strategies consultation where you can talk about what you’re doing in your classes and get suggestions on adjustments that might make you even more successful.

Office hours and McGraw are for any student who wants to do better, not just for students who aren’t doing well. Students who attend office hours and often the ones who can ask for letters of recommendation and feel like they really know their faculty--sometimes they're even hired to assist with classes after they take them. And many of our prehealth students go on to work at McGraw as tutors and learning strategies consultants!

I'm a first-year and I'm nervous about my first exams! Any advice?

We talked about this at our Aspiring Docs lunch this week! Here are some of the ideas that we brainstormed:

  • Use McGraw Center resources: read their test prep tips, check Principedia for specific advice on test prep for your classes or schedule a Learning Strategy Consultation to talk through your game plan. Feeling like you’re in control and have a plan can reduce stress.
  • If you’re nervous about a premed course exam, consult with an HPA Peer Adviser about how they and their prehealth friends studied for their exams.
  • If possible, do a practice exam sitting in the classroom where you’ll take the real exam, under the same time constraints. This can serve as a “dress rehearsal” for the real exam. As you sit in the room, think about what strategies you’ll use if you start to feel anxious during the exam. What will you focus on in the room to help you re-center? Are there certain seats that may be better for you (for example, there may be fewer distractions if you sit close to the front, or away from the door).
  • The night before the exam, get a good night’s sleep. Studies show that getting healthy sleep is critical to your mental health.
  • On the day of the exam, take five minutes to write down all of your worries about the exam. Putting the thoughts on paper can help you compartmentalize them and keep them from running through your head as much during the exam itself.
  • Remember that no single test or single grade will make or break your prehealth plans. Go in as confident as you can, try to establish a positive frame of mind, stop and take a deep breath from time to time, and know that every test you take will help you be better prepared for the next one.

Good luck!

    I'm a first-year and received a C on an ART midterm. I’m wondering how this will affect med school. I guess it's better for this C to be in a ART class and not in my CHM class, right? I was pretty disappointed and any advice is appreciated.

    Yours is a very typical question this time of year, as many students experience post-midterm misery.  Let us first point out that you're a first-year and you have seven more semesters to shine academically. It's also a midterm, not a final grade, so there's still time to right the ship this semester!

    An extremely common phenomenon among incoming premeds (and non-premeds) is the shock of realizing that Princeton isn't like high school, and the focus and discipline required to excel in high school, while a good foundation, needs to be built upon in college - not rested upon.  As long as your academic performance continues to improve over the years prior to applying to medical school and your final grade point average is in line with accepted students at the medical schools to which you're applying, then some trouble in freshman year - or even sophomore year - is not an issue.  In fact, capacity for improvement is one of the qualities that medical schools seek in applicants, so take heart and work on improvement! 

    What GPA should I aim to have at the end of freshman fall?

    Try not to place any value judgments on yourself based on your first semester. Whatever grades you receive, you should focus more on the story and the effort behind those grades, and on lessons learned this semester that you can apply to subsequent semesters.

    If you struggled in one course, do an analysis of what you could have done differently—maybe you need to ...

    • preview information before class
    • review notes right after class
    • work with study groups
    • go to office hours
    • rebalance your overall course and cocurricular schedule so that you have more time to devote to certain classes.

    Do the same analysis for courses where you did well—what helped you succeed in these cases? Are there lessons that you can apply to others?

    Your grades will be less important to medical schools (and to your future career more broadly)—your capacity for improvement, resilience, and growth mindset (YouTube link) will be much more important. 

    The Science (or BCPM) GPA

    What do I count in my premed science GPA?

    Your "premed" GPA is more commonly known as your science GPA, and sometimes referred to as your "BCPM" (Biology, Chemistry, Physics, Math) GPA . When you apply to medical schools using the online application (AMCAS for MD programs, AACOMAS for DO programs), you will classify your courses according to the course content.

    If over 50% of the content of a course is Biology/Chemistry/Physics/Math (BCPM), regardless of the course number, professor, or department, you can classify the course under its BCPM discipline. The application services leave these decisions up to you; you are the person who categorizes your courses. 

    For guidelines on what AMCAS suggests for course classifications for MD programs, refer to the AMCAS Course Classification Guide online.

    After you submit your application, a verifier will compare your official transcript to the information that you entered in your application. You are responsible for selecting the correct course classification, but AMCAS and AACOMAS reserve the right to change classifications if they believe that the classification that you have selected is inaccurate. You can then appeal these changes and may be asked to provide additional information to help make your argument (for example, the AMCAS Academic Change Request process is described here).

    How do programs other than MD look at my science GPA?
    • Allopathic (MD) medical programs look at your grades in all classes that are Biology (including Neuroscience), Chemistry, Physics, and Math
    • Osteopathic (DO) medical programs compute a “Science GPA” that does not include Math but does include Biological Anthropology, Engineering, Epidemiology, and Public Health (see AACOMAS Course Subjects Guide).
    • Veterinary medical programs have a similar system to DO (see VMCAS Course Subjects Guide).
    • Dental schools include Math and most types of Engineering within the Science GPA (see AADSAS Course Subjects Guide).
    • Other professions that use a standardized application system (e.g., Physician Assistant, Optometry, Pharmacy) will have a similar subject guide – if you have questions about others, let us know and we can help you find that information.

    P/D/F and Audit

    How do PDFs look to med schools?

    The spirit behind a P/D/F is to encourage exploration and experimentation in curricular areas in which you may have had little or no previous experience. If that's the way that you're using the P/D/F, it shouldn't be a problem. 

    Do med schools see any significant difference in taking a class P/D/F or audit? I'm worried that if I P/D/F, I may accidentally end up with a D.

    If you haven't audited other classes in the past, go ahead and switch to Audit if you want to. Having more than one Audit on your transcript may appear overly cautious so limit yourself to one, if possible. Having one ‘audit’ on your transcript doesn't make much difference, however. Just make certain that you are sitting well with credits toward graduation and that, as a rule, you’re not always shying away from difficult coursework. A question might come up at a medical school interview about your decision to audit a course, so think through how you'd want to address it if it does.

    What GPA do I need?

    Would it be considered positively if I take a lot of advanced courses and can it compensate for low grades? If, for example, I get a B in the graduate level class, would that be considered an A normally since it's a more difficult class?

    It’s impossible to generalize to every medical school admissions philosophy, but in general, we’d say that maintaining balance in everything that you do is key (and we know that this is easier said than done). An ambitious course schedule is something that we highlight when we write your committee letter to medical school, to be sure that they’re aware that it distinguishes you among your peers. That said, if your class schedule is negatively affecting your physical or mental health, leaving you no time to develop important personal competencies (e.g., teamwork, social skills, communication skills) in co-curricular activities, and ultimately not allowing you to enjoy everything that Princeton has to offer, you might reconsider your choices. Don’t forget that medical schools aren’t just looking at your academic ability – they’re looking holistically at your potential as a classmate, colleague, and care provider.

    To address the second half of your inquiry, a B in a graduate class isn’t a “low” grade by any means, but we would encourage you not to try to make conversions between grades and the difficulty of classes. We provide additional context regarding your GPA (in terms of your major, course choices, Princeton’s grading policy, and many other factors), but the GPA is ultimately the number that the medical schools will see. If you’re concerned about your academic progress, don’t hesitate to come in and talk with an adviser about it.

    I’ve talked to older students who took the MCAT who are hoping for high scores that’ll make up for lower GPAs. How high do you need to score on the MCAT to make up for a low GPA?

    Determining whether your academic metrics are competitive for medical schools is dependent on a lot of factors: what courses you took; what the trajectory looked like (did you have a hard first year and then improve over time?); what medical schools you’re aiming for; how strong your academic letters of recommendation will be, especially in the sciences; and the strengths of other aspects of your candidacy, among other factors. A junior with a lower GPA, for instance, would almost always be better off waiting to strengthen other aspects of their candidacy so that their academic metrics had time to improve, they’d have stronger letters (from thesis, for example), and they’d have more experiences as part of their portfolio before applying. A student who has taken two glide years who showed academic improvement and who has done amazing humanitarian, clinical, or research work (with strong letters to go along with them) has more of these other strengths that may help to offset GPA to a degree.

    We talk with students all the time about the strength of their candidacies and we’re happy to do so with you, but if you just want some numbers, the MCAT/GPA grid published by the AAMC will give you some data to use as a guide. For example, in the 2018-2020 application cycles, it shows that among students with a GPA of 3.0-3.1, about 17% were accepted, regardless of MCAT; about 81% of students with a 517 or greater MCAT were accepted regardless of GPA.

    There are other "AAMC FACTS tables" that will give you additional data, including the MCAT/GPA averages by race/ethnicity and MCAT/GPA averages by state of residence. Accepted Princeton students tend to have a lower GPA and higher MCAT relative to national averages, but averages are just averages: there's a wide range of accepted GPAs and MCATs and many other factors come into play! In addition to academic metrics, medical schools place a high value on community service, physician shadowing, clinical experience, leadership, and performance in the interview when selecting students (see this report for more information). In addition to studying for the MCAT and classes, give yourself time to engage in enriching co-curricular experiences.

    HPA has additional data that we share with students available in our office and on our website under Admissions Statistics.

    What GPA is low enough that I should take postbac courses?

    It’s impossible to put an exact number on this and we would want to learn more about you and gain a more holistic understanding of your candidacy before deciding whether or not we’d suggest postbac course work, and if so, what type of course work. Some factors that come into play: how many sciences you’ve taken, the level of rigor in your course choices, academic trajectory, BCPM and cumulative GPA, strength of letters of recommendation, MCAT score, state of residence, factors that may have affected your ‘distance traveled’ to medical school (such as coming from a first-generation, lower-income, or underrepresented in medicine background), and any external factors that affected your academic performance. Generally, it is very difficult to gain acceptance to medical school with a BCPM below 3.0 and we have seen students participate in postbac programs with GPAs up into the 3.4/3.5 range, but again, it is very case by case. Learn more about postbac programs in general on our website.