I read the article by Dr. Frishman1 with great interest, and agree with his take on preserving the meritocratic system that has been established in medical schools in the United States. While the United States currently has a system that rewards excellence and consistency throughout medical school, this is hardly the norm throughout the world. I would like to cite an example of my country, India, where a student’s excellence in different aspects of medicine, like research, community service, or leadership are not rewarded in acquiring residency positions, and instead, they depend solely on a single 210-minute, 300-multiple-choice-questions examination.