<p>It’s probably somewhere in between there. Some classes will routinely give out A+'s to the best student in the class, and perhaps a couple of others who are basically indistinguishable. This is probably more common in large, lecture based classes.</p>
<p>Smaller classes are more likely to be a little more picky. Generally you’d have to really impress a professor on exams, assignments, and in-class discussion in order to earn such a grade.</p>
<p>So while I don’t think you have to be the best student a professor has ever seen to earn one, I also don’t think every class every year gives out at least one.</p>