You've all heard the joke about what they call the person who finishes dead last in medical school -- doctor.
Such was the case Friday when 138 students graduated from the Medical University of South Carolina en route to residencies around the country and, eventually, outstanding careers in their chosen field of medicine.
Like most ceremonies, there was sufficient recognition for those who finished the four-year curriculum at the top of their class.
But what about the rest of them?
What kind of doctors will they be?
"First of all, no dummies get into med school," laughed Dr. Jeff Wong, MUSC's senior associate dean for medical education. "You have to have top grades in college just to get in.
"So when you think about the hurdles they have to clear just to get accepted, you're talking about a really elite group."
It's like being an Olympic athlete, Wong said. Even if you don't win the gold medal, you were still good enough to be in the Olympics.
Last year, more than 2,600 people applied for only 175 slots at MUSC, so the competition is fierce.
"And on the first day of med school, most of these high achievers suddenly realize that half of them are below average," Wong said.
But when they grabbed that diploma Friday, they all received the same degree.
Only a few, Wong said, were not the best of students.
"Less than a handful struggled," Wong said. "If you could figure out who they were going to be in the beginning, you might not invite them in. These are the 2 percent you worry about. They've demonstrated that perhaps they aren't reliable, lack maturity or have mental issues."
But when you go into a doctor's office and see all the credentials hanging on the wall, there's nothing that says he or she finished first or last in their class.
Quite often, those with lesser grades turn out to be the best physicians because of the intangibles that go along with being a doctor.
"Things like altruism, compassion and professionalism are important," Wong said. "As a doctor, you have to really like people when they are at their worst -- sick, hurting, angry, upset. There's a lot more to it than grades."
Mostly, Wong said, physicians must earn patients' trust and be able to communicate.
Thus, we've all encountered doctors who lack bedside manner, who seem unable to relate to the patient despite their vast knowledge.
"The truth is that test scores and board scores only measure your ability to take tests well," Wong said. "They don't measure how well you will do with patients. It's hard to predict."