1. United States
2. Texas
3. Letter

I’m writing to respectfully request that you amend House Bill 5294 by striking Section 1, which mandates A–F grading and prohibits pass/fail (P/F) grading in our medical schools. This provision, though well-intentioned, will ultimately harm Texas by weakening our physician pipeline, driving top students out of state, and putting us at a disadvantage in national competitiveness. Texas should be a state where the best and brightest choose to stay, train, and serve. But Section 1 does the opposite—it incentivizes outmigration. Top-performing students, who often turn down offers from out-of-state schools to stay here, will now think twice. They know that rigid letter grading will put them at a disadvantage in the national residency match. And once they leave, most won’t return—nearly 60% of physicians remain in the state where they complete their training (AAMC, 2023). The use of P/F grading is not about lowering standards. Nearly 20 years of studies show that P/F students score just as well on board exams (Bloodgood et al., 2010; Rohe et al., 2006; Kim & George, 2018). But while other top institutions embrace this system to allow students to focus on real achievement—clinical excellence, leadership, research—Texas students will be forced to divert energy into chasing grades. The result? A generation of medical graduates who are less competitive, not because they’re less capable, but because they were denied the flexibility to build a strong match profile. Residency directors today don’t prioritize grades. They value Step 2 performance, leadership, specialty commitment, and letters of recommendation (NRMP, 2024). Research is critical—many successful applicants report 10–40 projects. But with mandatory letter grading, our students will lose the time they need to build these credentials, and they’ll be perceived as weaker candidates simply for staying in Texas. This policy will damage the reputation of our medical schools, hurt student outcomes, and reduce the number of top physicians who stay to practice in Texas. And in the long term, that means longer wait times, fewer doctors in rural areas, and more families left behind in an already strained healthcare system. Ultimately, there are no upsides. Mandatory letter grading will not improve test scores, but it will damage match results, drive out future physicians, and cause Texas to fall behind other states. Every one of us – this committee, medical schools, and us students – are united in our commitment to have the highest quality physicians treating Texans, as our state deserves. Section 1 of this bill will undermine our ability to attract and retain the best of the best doctors.