In high school, if you don't study, you fail.
You study, you get a C.
You study a bit harder, you get a B.
You study very hard, and you get an A.
In medical school, you don't study, you fail.
You study, you fail.
You study a bit harder, you fail.
You study VERY hard, you get a C.
You study EXTREMELY hard, you get a B.
You study without sleeping, without eating, without a social life, you get an A.