Is there grade inflation at medical schools? Case study of the Zagreb University School of Medicine

Aim. To investigate if students' grades at the Zagreb University School of Medicine increased since the establishment of the School in 1917. Methods. In this retrospective descriptive study, we analyzed student sex, the length of studying, average of all grades, and grades from 5 major courses - anatomy, physiology, pathology, internal medicine, and surgery. The passing grades at the Zagreb University range from 2 (sufficient) to 5 (excellent). We analyzed data for 2,861 students from 9 representative classes, enrolled in 1920, 1930, 1940, 1950, 1960, 1970, 1980, 1985, and 1990. Results. The number of female students constantly increased up to 1970 and hereafter the female to male ratio remained stable, 60:40. The percentage of enrolled students who graduated from the School increased from 1920 to 1940 and from 1960 to 1985. Between 1940 and 1960, the percentage of students who graduated was lower than 50%. There was a continuous increase in grades during the investigated period (p < 0.001), except for students enrolled in 1960, who had lower grades than those enrolled in 1950. Students who enrolled in 1990 also had lower grades than those enrolling in 1985. Grades from the individual courses mostly followed the increasing trend of total grades. Conclusion. There has been an increasing trend in grades at the Zagreb University School of Medicine since its establishment in 1917.