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Lawmakers hear hours-long testimony on KU School of Medicine grading bill as members question costs and evidence
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Summary
House Bill 24-88 would require the University of Kansas School of Medicine to adopt a tiered grading system (at least four levels) and prohibit simple pass/fail grading. University officials and medical-school leaders testified strongly against the bill, citing competency-based assessment, high match rates and large implementation costs in the fiscal note; advocates for tiered grades argued residency directors need more information on top performers.
The Committee on Education heard extended, at-times heated testimony on House Bill 24-88, which would require the University of Kansas School of Medicine to use a tiered grading system with at least four designations (for example A–F) and would prohibit a simple pass/fail grading system at the school.
An unnamed proponent argued that tiered grades create incentives for students to master clinically relevant topics and give residency directors information to identify top candidates. The proponent cited commentary in the New England Journal of Medicine and warned that pass/fail systems can push students into a "shadow economy" of research and external activities to stand out.
University officials and faculty testified in opposition. Dr. Steven Stites, executive vice chancellor for the University of Kansas Medical Center, said the bill would "interfere with evidence-based medical education" and undermine the school’s competency-based assessment approach. "I strongly oppose House Bill 24-88," Stites said, and he urged the committee to consider KS medical education goals and the school’s accreditation-aligned evaluation methods.
Julia Bonamino, senior associate dean for medical education at KU, described KU’s assessment system in detail and traced the campus’s changes: "Our pass/fail in first and second year began in 2017 with the advent of our ACE curriculum," she said, and in 2025 the school moved toward pass/fail grading in the third year while retaining "distinction" designations. Bonamino told the committee KU uses nationally benchmarked exams, objective structured clinical examinations (OSCEs) with standardized patients, written evaluations and narrative assessments to measure competence across multiple domains. She said a "pass" at KU corresponds to a high standard of performance and is not equivalent to a minimal or historic low bar.
Members focused on the fiscal note. The chair read figures from the fiscal document that were unclear when read aloud in the hearing transcript, but the fiscal note itself (uploaded for members) lists a multi‑million-dollar cost in one year and identifies 16 FTEs as affected by implementation. Committee members repeatedly pressed conferees to explain why grading differently would require additional staff time, standardized-patient stations, videotaped reviews and centralized grading across three campuses. Bonamino and Mark Meyer (senior associate dean for student affairs) explained that the added workload would stem from expanding standardized clinical assessments, training and paying standardized patients, ensuring reproducible grading across electives and campuses, and staffing the review process.
Mark Meyer also emphasized student well-being: medical training is stressful and programs must balance assessment with support. Meyer said KU’s graduates match into competitive programs and that the school’s evaluations allow residency directors to assess clinical performance beyond a single letter grade.
Members asked the university to provide hard data on national grading trends and indicated they might schedule additional work sessions. The chair said the committee planned to continue consideration and could delay action if members wanted more information. The transcript records no final committee vote on HB 24-88 during this session.
