This session will include a review of the history and use of grading systems other than conventional letter grades in professional health sciences program. A discussion of how the WSU DVM program approached the decision to adopt a modified pass/fail grading system will serve as an evidence-based illustration of implementation in an authentic context. Finally, we will consider the pros and cons of using ranks as a measure of student performance in a professional program, again with data from our own program to serve as a basis for discussion.