How important are marks for getting into fields such as surgery? Would
>you say clinical rotation marks are most important? Or do marks
>generally take a back seat to reference letters?

Marks are very important for competative fields such as surgery,
surgical subspecialties, dermatology, opthalmology, as well as other
very competative fields. Letters of refference generally also
extremely important, especially if the letter is from a surgeon
affiliated with the institution you are applying to!
Good luck!
Jim Henderson, MD
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Jim Henderson, MD of Medicalstudent.net