Senate Bill No. 234, known as the "Medical School Letter Grade Act," mandates that all public postsecondary education institutions in Louisiana offering medical doctorate degrees implement a tiered grading system for assessing student performance. This system will include designations of High-Pass (HP), Pass (P), Low-Pass (LP), or Fail (F), or an alternative tiered grading system with at least four designations. The bill specifies that these policies must be adopted starting in the 2026-2027 academic year, with an effective date of July 1, 2026.

The bill also includes a severability clause, ensuring that if any part of the law is deemed invalid, the remaining provisions will still be enforceable. Notably, the grading scale has shifted from a traditional letter grade system (A, B, C, D, F) to the newly defined tiered system. Additionally, the bill has undergone amendments that clarified the start date for implementation and removed provisions for civil penalties.