The following study in Academic Medicine examines the relationships between curriculum structures, grading scales, and student well-being. Survey results as well as burnout and stress tool results illustrate that, compared with students in schools using pass/fail grading, students in schools using grading scales with three or more categories had higher levels of overall burnout, stress, emotional exhaustion, and depersonalization and were more likely to seriously consider dropping out of school. There were no relationships with time allocation in didactic and clinical experiences. The authors posit that evaluation of students has a greater impact than other aspects of curriculum on student well-being. Curricular reform ought to incorporate pass/fail grading.