I went to state schools in Ohio for college and medical school. There was no grade inflation that I ever witnessed. When I did my internship/residency/fellows

I went to state schools in Ohio for college and medical school. There was no grade inflation that I ever witnessed. When I did my internship/residency/fellowship at Duke I was shocked at the grades given to the worst medical students that were on rotations with me by the attending physicians. I asked one attending I knew well why they gave such inflated grades for such poor students. They said the medical students paid a lot to go to Duke Medical School and they expected all A's so that they could get into a good residency.