By Grace Hills, Kansas Reflector
TOPEKA — When Giulia Bonaminio was treated for cancer by her students at the University of Kansas Medical Center, she didn’t care about their grades.
“As a patient, what mattered most to me wasn’t a grade on a transcript but whether they demonstrated sound clinical judgement, clear communication, professionalism and teamwork,” Bonaminio said.
Bonaminio joined a handful of physicians and professors from the University of Kansas School of Medicine on Wednesday to testify before the House Education Committee. All four of the school representatives were in opposition of House Bill 2488, which would require the school to grade their medical students on a letter or tiered grading system rather than the current pass-fail system.
It was introduced by Rep. Megan Steele, a Republican from Manhattan. Steele is a nurse and a nursing professor.
The bill had one proponent. Ian Kingsbury from Massachusetts, director of research for the Do No Harm organization, a group dedicated to fighting “identity politics” in medicine, according to their website. The group previously lobbied for Kansas laws banning gender-affirming care for minors and eliminating racial diversity programs at hospitals.
“This is really all in the interest of quote-unquote equity, but stripping away that information is not doing anyone a service,” Kingsbury said. “We want to make sure we can identify the high fliers and making sure that they’re getting into those competitive residency programs.”
None of the opponents from the school mentioned equity as a reason why they implemented the pass-fail system.
They said the goal was to switch to a competency-based evaluation. The school switched over from a lettered grading system in 2017, and has consistently been at or above the national board passing rate. As for residency programs, they have had a 100% match rate the past three years. The national average was 93.5% in 2025.
“We didn’t feel like the prior system really reflected how well our students performed as physicians and we wanted to move toward that evaluation,” said Steven Stites, executive vice chancellor for the school. “Not to be a test taker, a doctor. It’s not about equity, it’s actually about trying to present a realistic view and making sure our students have the right skills to be a physician. Taking a test is a good skill to have, but the better skill to have is how to take care of people.”
Bonaminio said students can differentiate themselves through their deans’ letters, which are letters summarizing a student’s academic performance, clinical evaluations and professional character. She said students can receive honors in clinical knowledge, skills and research.
Mark Meyer, senior associate dean of student affairs for the school, said the school’s “contemporary students are much better, more well-rounded, than what Dr. Stites and I were back in the 1980s.”
Meyer said lowering stress for students allows them to volunteer their time for medical mission trips or for JayDoc, a free health clinic aimed at reducing the socio-economic barriers to health care, or conduct research.
Kingsbury said medical students don’t have the skills or expertise to be productive in research.
“We are entrusting them to do something really important, which is to become healers,” Kingsbury said. “Let’s make sure that their time is allocated towards that, and not whatever journeys they may set upon by removing that incentive structure.”
As of 2025, 80% of medical schools use pass-fail at least for a student’s first two years. Kingsbury said the move is a “huge mistake.”
“It’s human psychology and human nature that folks are going to meet you where they need to, so if it’s pass-fail they’re going to be just where they need to to pass,” Kingsbury said. “We need to incentivize them to make sure they are excelling, not just simply passing.”
Rep. Dawn Wolf, a Republican from Bennington, brought up the saying “Ds get degrees.”
Bonaminio said a B+ is considered a “pass.” Stites said the school didn’t lower its standards when it switched to pass-fail grading.
“You have to take a test to get into medical school — the MCAT is hard! — but once you’re here, we know you’re smart,” Stites said. “Our job is to make sure that you’re good enough to be a doctor.”
The medical school had a 4% acceptance rate last year. The mean Medical College Admission Test score was a 509. For comparison, the mean for Harvard Medical School was a 520.
Medical students have high rates of depression, as do physicians.
Nipam Raval is a second-year medical student at the University of Missouri-Kansas City Medical School — the only other doctor of medicine program in the metro. Her school gives out letter grades. She said medical school is already a competitive world.
“That can sometimes create a toxic environment for yourself, for your mental health,” Raval said in an interview. “I think that pass-fail should be mandatory for every school.”
