As the father of four sons, I have found that thought-provoking, articulate conversations with 17 year-old males are rare and remarkable occurrences indeed. Nonetheless, I was fortunate enough to have just such an experience this past week.

It all began when I came upon an article by Kristin Rushowy that appeared on the front page of the Toronto Star on July 19th describing the accomplishments of four young people who had achieved the highest averages among Toronto public high school graduates. A quote from one of these young scholars particularly drew my attention. It’s important, he said, to “follow your passion for knowledge, and not your passion for success”.

Image Credit: Toronto Star July 19, 2015 [i]
Never having thought of these as mutually exclusive entities, I was intrigued enough to call the source of this comment, Elias Hess-Childs who had managed to attain an average of 99.5%, as had fellow graduating students Michael Nuh, Albert Loa and Sarah Tang. Turns out Elias is an engaging young man who not only knows his way around a high school curriculum, but has some rather prescient views about the educational process and is not at all hesitant to expound on them. He finds the attainment of high grades a “shallow” way to go about educating oneself and strives for deep understanding rather than simply achieving high grades. He is attracted to “interesting” courses and teachers rather than “bird courses”. Like the other students quoted in the article, he finds studying and memorization to be tedious, and largely unnecessary if one has achieved a true understanding of the subject matter. When asked what he finds most difficult, Elias tells me that conceptual and “qualitative” material such as history to be more challenging than the sciences (presumably that’s what dragged his average down to 99.5), but nevertheless plans to challenge himself with social science courses at university next year. A confident and self-aware young man with a bright future, to be sure.

However, there’s a somewhat more troubling side to the “learning versus success” concept. Notwithstanding students like my friend Elias who are able to achieve both, are our young people really being required to make this choice? Are they sacrificing their interests in order to ensure they attain great marks? Are they focusing on short-term retention and exam results rather than deeper, conceptual learning? Is all this diminishing what should be a time for open exploration and discovery? Perhaps most concerning, to what extent are those of us involved in higher education responsible?

Without question, our young people are growing up in an increasingly pragmatic and competitive world. Universities, graduate schools and professional schools such as Medicine are all utilizing academic achievement as a major component of their entrance criteria and, in fact, proudly publish the average scores of their entering students as a marker of excellence. High school marks, entrance examinations such as the MCAT, LSAT and SAT in the United States, are taking on great importance and threaten to indelibly categorize our student into those destined for “success” and those who must content themselves with alternatives. The educational process has, for many students (and, importantly, their parents), shifted from a process of discovery and enlightenment about themselves and the world, to a proving ground in which they must demonstrate their aptitude and competitiveness for future opportunities. And all this is happening during their formative teenage years.

This is further complicated by the inconsistency in high school academic standards that has occurred since the discontinuation of common examinations, and the gradual mark “inflation” that continues to occur. Medical schools, for example, face steadily increasing numbers of applicants with steadily increasing average marks, and diminishing band-width within those marks. Are young people truly getting a little smarter each year, or are high school examiners succumbing to the perhaps understandable desire to provide their students and schools competitive advantages?

One of our recent graduates, Dr. Julianna Sienna, has an interest in the topic of admission equity and a way of poking my conscience from time to time. She recently sent along a fascinating review entitled “Who Gets to Graduate?” that appeared recently in the New York Times Magazine ( In that article, author Paul Tough reviews efforts undertaken at the University of Texas to address the issue of low graduation rates. Although drawn from an American context, the issues they describe certainly resonate and seem entirely relevant to the Canadian scene.

Among the many interesting points raised in that article, a few are particularly relevant to this discussion:

  • High school marks and entrance examination results have a powerful and enduring effect on self-image and sense of “worthiness” for various universities, programs and, by extension, career options.
  • Lower family income and having less well-educated parents are factors associated with lower graduation rates, even for students with similar entry grades and SAT scores.
  • Students with more modest marks and SAT scores, particularly those from poorer socio-economic backgrounds, tend to “undermatch” meaning, in the words of the author, “ they don’t attend or even apply to the most selective college that would accept them.”

To help underachieving students succeed, educational leaders have found that it is necessary to do more than simply deal with their financial and academic issues. “You also need to address their doubts and misconceptions and fears. To solve the problem of college completion, you first need to get inside the head of a college student”. The good news is that a number of innovative programs, focusing on dealing with adversity, building confidence and promoting inclusion are showing definite signs of success where traditional remediation streams and less demanding “developmental” courses were failing and, in fact, only perpetuating the sense of inadequacy.

To summarize, early academic performance during these formative years is a hugely powerful determinant of self-image and confidence, particularly when coupled with socioeconomic circumstances that reinforce the impression, but (and this is a big “but”) does not necessarily exclude young people from eventual academic success comparable to higher-performing entry students.

So what are the messages for those involved in the selection, education and career success of our young people? Certainly we should be celebrating the success of young scholars like Elias, Michael, Albert and Sarah and providing them post-secondary programs and environments in which they can continue to flourish and realize their considerable potential. However, we also need to recognize that not all students are in a position to take full advantage of our educational programs, that our evaluative processes at the high school and university level are far from precise, and that many very capable students with much to contribute to society may be discouraged or lost in the crowd. Our entrance processes should actively search for such students by going beyond the simple ranking of marks and explore more broadly the personal attributes, experiences and life goals of our students. Expecting that a young person will have demonstrated his or her career potential by the end of high school, and using our educational systems as competitive proving grounds is unfair to our students and a disservice to a society that benefits from the broad education of all its members. We can, and should, do better.


Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education