Clerkship grades

[Volvulus10]

Hey everyone,

I just received all my 3rd year clerkship grades and did terrible. I received passes in every rotation except for surgery where I got honors. . Our school does stuff a little different so that's why I received them all after my 3rd year ended. Objectively, I had done well this past year...got a 95 on my IM shelf, and in the high 80s on my other shelves (I'm planning on matching in IM). However, I had some preceptors that I got along with very well but where hard graders..compared to other classmates who had preceptors who would throw around very high numbers when rating their students. This totally screwed me.

I was certain that I would receive honors (or at least a high pass) in most of my rotations because I objectively did well. The funny thing is that my IM preceptor wrote me a LOR that was a wonderful letter (saying that he was honored to write me a letter, I was a great student, yada yada). I ask for feedback throughout my rotations and got great feedback..and if I hear something to work on, I made sure I worked on it.

Not to toot my own horn but I was really hoping to apply/interview at some of the top programs (Hopkins, Duke, UCSF) but getting "passes" has hit me hard. I got a 246 on Step 1 and a 252 on CK, I have a bunch of posters, a few published abstracts, tutoring..but as great as all that sounds, I can't get over the fact that I'm going to be applying with "passes," especially in the field I'm interested in. The only saving grace is that I've got an honors in my internal medicine subI away rotation. I have one more away at a top 5 program that I'm hoping on honoring, assuming I act like my normal self.

I know I'm rambling but I've really been down in the dumps about this. I've also attempted to objectively look at myself..am I not as personable as I thought? If multiple preceptors gave me poor scores..I have to be doing something wrong, right? It can't all just be bad luck. But my aways have gone great and I've only heard good things from attendings and residents.

I know everyone has bumps in the road and I'm hoping this isn't a big one. Any words of wisdom would be appreciated.

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[guitarguy23]

FWIW, coming from an M4 who also just finished 3rd year, mind you:

Focus on the positives. If you can secure any other strong LORs in IM then do so. I think LORs, in general, are more important than clinical grades in the match process overall. If you are dying to go to your away location for residency then you should do whatever you can. Your board scores are definitely above average for IM which will help. You seem well rounded and passes don't make you a bad applicant. Just look for strong people who can vouch for you from your away. Focus on what you can do now! Maybe another LOR that you can send as a supplement later? And knock your interviews out of the park! Residency interview invites are apparently notorious for being random as heck. Some awesome programs may offer you an invite while some "safeties" might snub you. It really is a random process so when you get your interviews at strong programs make them count!

IM is great because there are actually so many great programs. I am not doing IM, and I wish I had the amount of programs to choose from. I think you will be fine.

Sorry for being wordy-I get a lot of great advice on this forum and I wanted to offer what I could to someone else. Good luck!

 

[premedk]

I think LORs, in general, are more important than clinical grades in the match process overall.

Really....where'd you hear that? I certainly hope so, but I somehow doubt it. Im also a M4 applying to IM. I got all Bs on all of my core rotations(below average for my class). I do have 2 strong letters from senior faculty who I know really well, but I dont think that will trump my poor grades and step scores(226 on step 1).

 

[GoSpursGo]

You'll be fine. In general I think sub-I's are more important than clerkship grades, and as long as you have good letters and high pass/honor your sub-I's you should at least get consideration at just about any program across the country. Of course, you may not get an interview at each program and might wind up a tier lower than "top tier," but if that happens it'll simply be because it's a numbers game and the number of qualified applicants exceeds the number of residency spots at those programs, not because you got a pass on your clerkship.

 

[GoSpursGo]

Really?

At both my med school and residency, it's basically a given that you will get honors in the Sub-I.

Our program definitely puts more weight on M3 grades when we look at candidates

Idunno, I didn't apply to IM so I could be wrong. At my med school, we definitely had people who didn't get honors on their sub-I, in IM as well as other specialties. Similarly, it was a running joke that on your MS3 clerkships the line between honors/high pass and pass/high pass was often the luck of who you wound up having as your preceptor--some people give straight 5/5 and some give straight 3/5, yet will write the same glowing comments at the bottom of the sheet.

The passes are obviously not great, but it doesn't seem like that should torpedo an otherwise strong application. As I said, I wouldn't say he's a lock anywhere, but I don't think the pass by itself closes any doors either. I do think it would be helpful if his letters are a little more specific than your stock positive letters.

 

[mvenus929]

At both my med school and residency, it's basically a given that you will get honors in the Sub-I.

I'm still not clear on how we grade our M4s, but we didn't receive grades at all for our sub-Is in med school. Just a pass. And they didn't even delineate out on our transcript what we took during our fourth year.