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Two old jokes about doctors and medical school:

Joke #1:  50 percent of all doctors finish in the bottom half of their medical school class.

Joke #2:  Q: What do you call the person who finishes last in his or her medical school class?  A:  “Doctor.”

Why do we laugh at these jokes? (At least, the first time we hear them?) Because there’s an incongruity in the idea of very high achievers (as most medical students are) being portrayed as low achievers.

It’s all relative, of course. The 50 percent of the doctors who finish in the bottom half of the class at the Johns Hopkins University School of Medicine, arguably the top medical school in the country, are not low achievers. The school accepts only 5 percent of its applicants; the average undergraduate GPA of admitted students is 3.85; and the average MCAT composite score is 35, in the top 5 percent of test-takers nationally.

In contrast, the average GPA of admitted students at Lake Erie College of Osteopathic Medicine (LECOM) is about 3.4, and the average MCAT composite score is 26, around the 50th percentile of test-takers nationally. Not low achievers, to be sure, but not in the same league as those at Hopkins.

If we looked at the bottom 10 percent of Hopkins medical students, they might well exceed the achievements of 80 percent of the students at LECOM. Where do we draw the line to label a student as a “low achiever”?

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Aaron Pallas is Professor of Sociology and Education at Teachers College, Columbia University. He has also taught at Johns Hopkins University, Michigan State University, and Northwestern University, and...

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