Only a handful of U.S. dental schools use a pass/fail grading system, and the details vary more than you might expect. Two of the most well-documented are Columbia University College of Dental Medicine and the University of California, San Francisco (UCSF), both of which replace traditional letter grades with some form of pass/fail on student transcripts. Most dental schools still rely on letter grades or numerical scales, making true pass/fail programs relatively rare in dental education.
Schools With Confirmed Pass/Fail Systems
Columbia University College of Dental Medicine uses a Pass/Fail system for the didactic (classroom-based) portion of its curriculum. Student transcripts show only P or F. However, Columbia still tracks exam scores internally and uses them to monitor academic performance, communicate with residency programs, determine graduation awards, and decide admittance to the national dental honor society. So while the transcript reads pass/fail, the school retains a more granular picture of each student’s performance behind the scenes.
UCSF takes a slightly different approach. During the first two years of dental school, grades are reported as Pass or Not Passed. In the third and fourth years, an Honors designation is added, creating an H/P/NP scale. GPAs and class rankings are not computed for dental students at UCSF. The Honors grade is awarded for outstanding achievement in clinical courses, with criteria set by individual course directors. UCSF’s academic senate regulations also list traditional letter grades (A through F) as options for professional students, but the dental program specifically uses the P/NP and H/P/NP tracks for its DDS candidates.
True Pass/Fail vs. Honors/Pass/Fail
Not all “pass/fail” systems work the same way, and this distinction matters if you’re comparing schools. A true binary pass/fail system, like Columbia’s transcript model, records only two outcomes. You either passed or you didn’t. An honors/pass/fail system, like UCSF uses in its clinical years, introduces a tier above passing that lets high performers stand out. This creates a functional difference: in a binary system, everyone who passes looks the same on paper, while an honors tier reintroduces a form of stratification.
Even at schools with pass/fail transcripts, internal scoring often continues. Columbia explicitly states that exam scores are used for residency communications and awards. This means the pass/fail label on your transcript doesn’t necessarily erase all distinction between students. Residency programs may still receive information about where you fell within your class, just through different channels than a traditional GPA.
Pre-Clinical vs. Clinical Year Differences
Some dental schools split their grading approach across the four-year curriculum. UCSF is a clear example: pure pass/not passed for the first two years of foundational science coursework, then honors/pass/not passed once students enter clinical rotations. This hybrid model reflects a philosophy that preclinical coursework benefits from reduced competitive pressure, while clinical performance warrants more differentiation since residency programs want to evaluate hands-on skills.
If you’re researching schools, ask specifically about each phase of the curriculum. A school might advertise “pass/fail grading” but only apply it to the preclinical years, reverting to letter grades or tiered systems once you start treating patients. The answer to “is this school pass/fail?” often depends on which year you’re asking about.
How Pass/Fail Affects Student Well-Being
Research from medical education (which closely parallels dental education in structure) consistently shows benefits to pass/fail grading. A study published in Mayo Clinic Proceedings compared first-year medical students under pass/fail grading to a cohort using a traditional five-tier system. The pass/fail students reported significantly less perceived stress (median score of 15.0 vs. 21.0) and greater group cohesion (34.5 vs. 30.0) by the end of their second year. Mood scores trended better in the pass/fail group as well, though that difference didn’t reach statistical significance.
Importantly, the two groups showed no significant differences in test-taking anxiety or board exam scores. Students in the pass/fail system performed just as well on standardized licensing exams as their traditionally graded peers. The researchers also found that the stress-reduction benefits of first-year pass/fail grading persisted into the second year, even after students transitioned back to a traditional grading system. The takeaway: pass/fail grading appears to lower stress without compromising academic performance.
Impact on Residency Matching
A common concern is whether attending a pass/fail school puts you at a disadvantage when applying to competitive specialty residencies. The evidence suggests it doesn’t hurt your chances of matching, though it may slightly reduce the number of interview invitations you receive.
A study examining the shift to pass/fail scoring on USMLE Step 1 (the major medical licensing exam, analogous in importance to dental board exams) found that applicants with numeric scores received about one additional interview offer compared to those with pass/fail scores, after adjusting for academic performance. However, this difference disappeared when looking at actual match outcomes. Scoring type did not affect odds of successfully matching into a residency. The association with extra interviews was strongest in nonsurgical specialties and was not statistically significant in surgical fields.
For dental students specifically, pass/fail schools like Columbia and UCSF compensate by providing detailed Dean’s letters, faculty evaluations, and in some cases internal performance data to residency programs. UCSF’s honors designation in clinical years also gives strong students a way to distinguish themselves. The lack of a GPA or class rank shifts more weight onto board scores, clinical evaluations, research experience, and letters of recommendation.
What to Look for When Comparing Schools
If pass/fail grading is important to you, dig into the specifics before making assumptions. Here’s what varies across programs:
- Transcript reporting: Does the transcript show only P/F, or does it include honors tiers, high pass designations, or numerical scores?
- Internal tracking: Does the school still compute GPAs or rankings internally, even if they don’t appear on the transcript?
- Year-by-year structure: Is pass/fail applied to all four years, or only the preclinical phase?
- Residency communication: How does the school convey student performance to specialty programs? Some provide percentile data or narrative evaluations that effectively recreate a ranking system.
Dental school grading policies also change over time. Several medical schools have adopted pass/fail in recent years, and dental schools periodically revisit their own systems. Check directly with admissions offices for the most current information, especially if you’re comparing schools for an upcoming application cycle. The ADEA Grading Resource Guide, published by the American Dental Education Association, remains the most comprehensive reference for comparing policies across institutions.