Likely about to be dismissed from medical school?

[throwayaccount1375]

.

---

Members don't see this ad.

 

[FutureDoctor5000]

Is this serious? Like what in the world? You don’t get your evaluations for 6 months? And you had 3 preceptors fail you (for being potentially nervous and making a few mistakes as a 3rd year)and they did not even tell you they were doing something soo drastic that could potentially ruin your career?

 

[throwayaccount1375]

Im being dead serious. Im completely shocked and blindsided. It can take up to that. I complained to my rotation director for this very reason. Had I known I performed badly on my first rotation, I would have stepped back and really worked on my anxiety as noted on my first evaluation. Ive really improved my clinical skills and talking without nerves since then. I was just too anxious for no reason and I own up to that. So much of medicine is just being confident with your knowledge which I was not.

 

[FutureDoctor5000]

Im being dead serious. Im completely shocked and blindsided. It can take up to that. I complained to my rotation director for this very reason. Had I known I performed badly on my first rotation, I would have stepped back and really worked on my anxiety as noted on my first evaluation.

Your school has to work with you on this, just dismissing you is a very very very bad look on their part... if they do, dare I say it’s worthy of legal action against the school for unfair practices.

 

[throwayaccount1375]

Even if I dont get dismissed, I have to repeat the rotations which if I get the chance to I plan on doing whatever it takes to honor them. Idk what to think anymore. I don't want to continue if I can't match. I need to get out now. It kills me because at other school you just show up and pass.

 

[FutureDoctor5000]

Even if I dont get dismissed, I have to repeat the rotations which if I get the chance to I plan on doing whatever it takes to honor them. Idk what to think anymore. I don't want to continue if I can't match. I need to get out now. It kills me because at other school you just show up and pass.

Absolutely what your describing is overkill and a ridiculous reason to fail someone unless the behavior was egregious and unacceptable and/or put patients at risk.You can still match into something

 

[MLNS]

Lawyer up

 

[throwayaccount1375]

I was told today that there are students still waiting on feedback for their first rotation which is completely unacceptable. If your a rockstar, I guess it won't make a difference.

 

[throwayaccount1375]

Can I match family medicine or community IM? (if I don't get dismissed)

 

[FutureDoctor5000]

Can I match family medicine or community IM? (if I don't get dismissed)

I think so, especially if you thoroughly explain the ridiculous reason why you failed those rotations. I would actually go ask the preceptor who gave you those evals and ask them if they thought you deserved to fail, they might not have and had no clue that what they were putting in your evaluation could fail you due to your schools weird grading for rotations, if they don’t I would straight up ask one of them for a letter of rec stating just that they didn’t think you should have failed despite any issues you might have had, and that would help you out greatly for residencies.

 

[throwayaccount1375]

I think so, especially if you thoroughly explain the ridiculous reason why you failed those rotations. I would actually go ask the preceptor who gave you those evals and ask them if they thought you deserved to fail, they might not have and had no clue that what they were putting in your evaluation could fail you due to your schools weird grading for rotations, if they don’t I would straight up ask one of them for a letter of rec stating just that they didn’t think you should have failed despite any issues you might have had, and that would help you out greatly for residencies.

My preceptor for outpatient psych noted I had ADHD (actually what pushed me to get treatment) but was still very smart and she actually offered after the rotation to write me a letter of recommendation for residencies so l will ask her! Is it better I do it asap while she still remembers me?

 

[FutureDoctor5000]

My preceptor for outpatient psych noted I had ADHD (actually what pushed me to get treatment) but was still very smart and she actually offered after the rotation to write me a letter of recommendation for residencies so l will ask her! Is it better I do it asap while she still remembers me?

Yet you failed her rotation? Wow Hahaah this is comically unbelievable and just sad, how in the world does your school calculate rotation grades, and I would absolutely ask her asap and see if she can talk to your schools dean or something about how you didn’t deserve to straight up fail her rotation when she’s willing to write you a letter..

 

[throwayaccount1375]

I had another preceptor (inpatient) on psych that gave me negative feedback (anxiety and lack of clinical skills) so it probably wasn't enough overall. They supposedly talk to combine the rotation before giving the evaluation so it still doesn't make sense. Yeah I think I need to reach out to the preceptors.. I have nothing else to lose at this point.

 

[FutureDoctor5000]

I had another preceptor (inpatient) on psych that gave me negative feedback (anxiety and lack of clinical skills) so it probably wasn't enough overall. They supposedly talk to combine the rotation before giving the evaluation so it still doesn't make sense. Yeah I think I need to reach out to the preceptors.. I have nothing else to lose at this point.

Yes but saying you were anxious and need to improve clinical skills doesn't necessarily amount to "Fail" its just feedback for you to improve on... I am curious to know if the two preceptors who gave the evaluation including the one who gave negative feedback even know that those comments amount to a complete failure of the rotation, at my school the evals are on a numerical scoring system where at the end the preceptor/resident filling it out clearly know on a 0-100 scale with a (70 being a minimum to pass) what numerical grade they are giving you, does your school have something like that?

 

[throwayaccount1375]

The first part I honestly don't know, when I talked to the clinical rotation director, she word for word said that there is no way for a preceptor to know wether you passed or failed. They basically answer questions that say meet / exceeded / below expectations in certain areas that are computed on a 4.0 scale and you need above a 3 for a pass but the school calculates it so I guess no they dont know.The preceptor knowing what grade they give you is how it should be. Clear and Transparent. Not to mention the exam we take plays no contribution to our grade overall. They just note it separately but you can still get in trouble if you don't pass.

 

[FutureDoctor5000]

The preceptor knowing what grade they give you is how it should be. Clear and Transparent. Not to mention the exam we take plays no contribution to our grade overall. They just note it separately but you can still get in trouble if you don't pass.

wow at my school the COMAT is worth like 20% if I remember correctly of the rotation grade. Sounds like your school is doing its students a disservice by not allowing prompt feedback and not even letting the preceptors properly evaluate the students..

 

[throwayaccount1375]

The more and more I think about it the more I realize my school is the problem..

 

[deleted645092]

This sounds wild TBH. At least at my school it’s in our student contract that failing 2 rotations is grounds for dismissal. But like you said you can’t exactly improve if you don’t know your rotation grade until months down the road. Most of us are gonna assume we’re making adequate progress if we aren’t actively being told we’re ****. So you’ve probably got a good argument there to atleast be given another chance if your school has a similar policy to mine.

I also agree that your school’s grading system sounds ****ed. Your preceptors should be able to easily tell what grade they’re giving you. My schools is similar to a poster above where it’s a 0-100 scale where a 70 is minimum to pass. Our preceptors also have to write down the reasons why we failed because failing a rotation is a big ****ing deal.

I think you should be okay if there isn’t anything more to your circumstances than not knowing you were doing poorly combined with now-controlled mental health/psych issues. But if you did something egregious without knowing it and the preceptor comments reflect that then things might be difference.

I’m not one to usually say lawyer up but if you show up and the school is completely dismissive of the fact that you weren’t aware of performance issues and/or there are no preceptor comments saying why you objectively failed, then you might need to.

Edit: Saying lawyer up feels stupid but I said it lol. Also just to clarify, I’m assuming that you’re telling the truth and there’s not something you’re hiding from us. And yes it’s still possible to match.

 

[twospadz]

So obviously you are not telling the problem or describing it for what truly is. Your side is distorted therefore that is why everyone in this thread is confused by your situation. We are missing the other two sides of the story: your schools side and the truth. Anyway, can you match IM if you remediate the year? Yes but no more failures from here on out. I don’t think your school will drop you if you haven’t had any failures thus far. In medicine, you will have many bad and good days. It’s how you handle them. Keep calm

 

[FutureDoctor5000]

So obviously you are not telling the problem or describing it for what truly is. Your side is distorted therefore that is why everyone in this thread is confused by your situation. We are missing the other two sides of the story: your schools side and the truth. Anyway, can you match IM if you remediate the year? Yes but no more failures from here on out. I don’t think your school will drop you if you haven’t had any failures thus far. In medicine, you will have many bad and good days. It’s how you handle them. Keep calm

Failing a rotation usually means you did something incredibly egregious, we are talking professionalism issues and stuff that puts patients at risk, possibly having a bad attitude where the preceptor/resident doesn’t want to work with you anymore, but OP’s anxiety and adhd issues don’t seem like they are enough to warrant failing not only 1 but 3 rotations, early on in their 3rd year..

 

[Osteosaur]

I'm really sorry this is happening.

My own school is taking a while to get me clinical feedback from preceptors, too. Its unfortunate so much is riding on it.

Is it possible the preceptors don't grasp the grading scale? And everyone is "nervous"...

 

[throwayaccount1375]

I was told that I lacked clinical skills. For example in psych inpatient, I forgot to ask for HI even though it was clearly in front of my notes. My preceptor said I didn’t give an in detail HPI even though I was never ever told that until the rotation was over! Nothing when I was giving the HPI everyday to him! He waited till I could no longer improve to say anything!! He said I suffered from performance anxiety. I will admit it I was a mess stuttering during my patient presentation tripping over my words. After this, I drastically improved when I was on outpatient psych (which was moved to phone calls because of covid at my site) I literally got an email from my outpatient psych preceptor about how I was a valuable student and to contact her for anything I might need... I made mistakes but I don’t believe I deserved to fail. Pediatrics when I did HPI for patients and the doctor asked how I did, they said I “was nice but looked overly nervous”. I would not lie about something like this, I’m seriously looking at how I can get into nursing school if dismissed as I have medical knowledge.

 

[throwayaccount1375]

being nervous / anxious causes you to make stupid mistakes and look like you don’t know what your doing. I’m getting great feedback now and the only change I have made is being put on ADHD medication which has helped my concentration levels and being more confident / extroverted. I was admittedly a hot mess before. My composure now is much better.

 

[throwayaccount1375]

I also want to say was I aware of negative feedback from these rotations concerning my anxiety? All my preceptors noted it. Absolutely but again I never thought any of them would genuinely cause me to fail especially if I had show improvement and knowledge in other aspects. I did not fail boards. I do not have any professionalism issues. Ask me any other questions you have.

 

[Deleted member 1077394]

*hugs*, @throwayaccount1375 . I wish I had something else to add, but I just wanted to say I am sorry. Hang in there.

 

[FutureDoctor5000]

I was told that I lacked clinical skills. For example in psych inpatient, I forgot to ask for HI even though it was clearly in front of my notes. My preceptor said I didn’t give an in detail HPI even though I was never ever told that until the rotation was over! Nothing when I was giving the HPI everyday to him! He waited till I could no longer improve to say anything!! He said I suffered from performance anxiety. I will admit it I was a mess stuttering during my patient presentation tripping over my words. After this, I drastically improved when I was on outpatient psych (which was moved to phone calls because of covid at my site) I literally got an email from my outpatient psych preceptor about how I was a valuable student and to contact her for anything I might need... I made mistakes but I don’t believe I deserved to fail. Pediatrics when I did HPI for patients and the doctor asked how I did, they said I “was nice but looked overly nervous”. I would not lie about something like this, I’m seriously looking at how I can get into nursing school if dismissed as I have medical knowledge.

I am sorry but that’s really unfortunate, but being nervous and the need to improve your HPI is not grounds for failure, you need prompt feedback about it, for example I made simmilar mistakes as you on my first rotation which was peds and my attending was quick to point out how I needed to improve my presentation skills and I did and he wrote in my evaluation that I had greatly improved my presentation skills. I couldn’t possibly imagine him failing me for such a mistake.

 

[throwayaccount1375]

I really want to fight for myself because this is my career on the line but it feels so hopeless how I got screwed this much. I don’t even know what to do anymore 😔

 

[FutureDoctor5000]

I really want to fight for myself because this is my career on the line but it feels so hopeless how I got screwed this much. I don’t even know what to do anymore 😔

Absolutely you need to fight to the end and if needed get a lawyer, we are taking about your dream and your career as well as the last 2 years going to waste. You can still absolutely improve as you have in your rotations and match FM/IM somewhere and can overcome this!!! I would also absolutely bring up the adhd and mental health issues you were having and point out how that may have impacted your performance albeit nothing you said/did should be grounds for failure of a rotation anyways..

 

[Hippocrates II]

There must be information missing from this story. One doc fails you because you're nervous and not sharp clinically? Sure. Three independent docs all fail you for that? You either have the worst luck in the universe, or you're leaving something out.

 

[FutureDoctor5000]

There must be information missing from this story. One doc fails you because you're nervous and not sharp clinically? Sure. Three independent docs all fail you for that? You either have the worst luck in the universe, or you're leaving something out.

The thing is that they might not have even intended to fail OP, they just pointed something out during his rotation that due to his/her schools weird grading resulted in the failure..

 

[frenchyn]

It is so hard to fail clinical rotation at my school based on clinical performance...just show up...shut up...wait until they let me go...this makes no sense...sorry for this happened to you...delayed to no feedback is unacceptable tho.

 

[throwayaccount1375]

I lacked clinical skills and I thought some people do in fact fail because of this. My pediatrics preceptor told me I improved and it clicked the last few days but initially I was struggling connecting the class work information to the clinical setting. She also said I was anxious / reserved / seemed uncomfortable with patients hence why I said how you come across is very important. It’s wasn’t enough to pass in the end. My meeting with my rotation director emphasized 2 things anxiety/ADHD and lack of clinical skills. My first rotation said I needed work on physical exam skills which I thought I showed him I could do but I obviously did not. He also noted anxiety when seeing patients. I’ve basically covered all my preceptor comments.

 

[throwayaccount1375]

It really does feel like I have the worst luck I’m the world. I’m going to show my site director this tomorrow as I have a meeting with him tomorrow.

 

[throwayaccount1375]

I’m going to fight for my career even if that includes getting a lawyer before I just give up and I’ll keep you guys updated. I guess I now know that confidence is everything and I won’t make that mistake again.

 

[calivianya]

There must be information missing from this story. One doc fails you because you're nervous and not sharp clinically? Sure. Three independent docs all fail you for that? You either have the worst luck in the universe, or you're leaving something out.

You’d be surprised how dumb some schools’ grading scales are.

So basically eight things have to happen at my school for rotation grades - comat score, plus score in seven different domains on preceptor eval... independently. Nothing is averaged or a percentage; all conditions must be met simultaneously.

To pass, all seven domains have to average at least 2/5 (on every part that was graded... the preceptor can choose to not to answer items) plus the student needs an 80 on the comat. So, hypothetically, let’s say OP made a 100 on the comat and let’s say there were 25 items total on the eval across the seven domains and OP made 4s on all but two of them... but the two were in the same domain, they were the only items marked in that domain, and they were a 1 and a 2. OP would average a 1.5 for that domain. Even though the OP would average a 3.8/5 overall and have a 100 comat, seemingly well above the 2/5 and 80 comat cutoffs, OP would fail the rotation because of that one domain average.

One of the domains we get graded on is communication, fwiw. I could see OP getting 1s here based on what’s been said above.

I’m incredibly passionate/salty about this subject because I was knocked out of running for honors for the specialty I want to go into when my eval averaged a 4.8/5 because a single three-item domain was at 4.33/5, so I can talk about this literally all day long.

 

[Splenda88]

If you have to sue, do it...


However, you should work on your anxiety because patients can pick up these things. In all honesty, it's hard to fail 3 rotations because most physicians and residents don't expect too much from MS3 (even MS4) as long as they are professional, present semi-decently, and know a few things about the 1-2 patients they carry.

 

[throwayaccount1375]

Which is why I’m seriously considering going to nursing school

 

[Splenda88]

Which is why I’m seriously considering going to nursing school

Too early for that...

 

[frenchyn]

I think you should really try to talk to your school first...if they refuse then lawyer...I don’t know where you are at financially obviously...but lawyer can cost up to 10-20K depending on the type of case. Most will charge ~$300 for consultation fee...you will need education lawyers...not any type of lawyer...there are consequences from lawsuits too: publicity...will any school accept you if you loose the case? How about the residency? Will they want to take risk of taking a resident who may lawyer up on them?
By no means I try to say you shouldn’t lawyer up...I just try to tell you it is not as simple as hiring a lawyer...you should consider pro/con of every step. Also, lawsuit takes time...so that year may as well spend on repeating the rotations...I think your best bet is to talk to your school and the faculties you work with and try to work out something else.

 

[Lawpy]

What's with SDN's obsession with lawyering up? As much as the school's policy stinks, you guys really think the courts will slam the school for having a bad grading policy? That just means the lawyers and judges know more about the grading than med school faculty

OP i'm really sorry about your situation but you need to talk to your school and get faculty to support you.

 

[hallowmann]

You need to actually see if they are even considering it. I wouldn't harp much on how late the evals were, because on day 1 we were basically told to ask for feedback weekly regardless of the evaluation. I would rather emphasize that things are going better now with treatment (to prove this, you will actually need more recent evals if you don't have any yet).

It would also be in your best interest to communicate with your preceptors, because judging by your description, it's very possible they had no idea they were failing you. I remember that my school tried to make it very clear on the evals that <3/5 = failing, because some people take a scale at face value and assume 3/5 is "average".

I don't think it's time to get a lawyer, but I would reach out to preceptors and see if they'd advocate for you, especially ones from the rotations that you failed and one that you feel did well in since, because that will say more than anything you can say.

 

[Hippocrates II]

You’d be surprised how dumb some schools’ grading scales are.

So basically eight things have to happen at my school for rotation grades - comat score, plus score in seven different domains on preceptor eval... independently. Nothing is averaged or a percentage; all conditions must be met simultaneously.

To pass, all seven domains have to average at least 2/5 (on every part that was graded... the preceptor can choose to not to answer items) plus the student needs an 80 on the comat. So, hypothetically, let’s say OP made a 100 on the comat and let’s say there were 25 items total on the eval across the seven domains and OP made 4s on all but two of them... but the two were in the same domain, they were the only items marked in that domain, and they were a 1 and a 2. OP would average a 1.5 for that domain. Even though the OP would average a 3.8/5 overall and have a 100 comat, seemingly well above the 2/5 and 80 comat cutoffs, OP would fail the rotation because of that one domain average.

One of the domains we get graded on is communication, fwiw. I could see OP getting 1s here based on what’s been said above.

I’m incredibly passionate/salty about this subject because I was knocked out of running for honors for the specialty I want to go into when my eval averaged a 4.8/5 because a single three-item domain was at 4.33/5, so I can talk about this literally all day long.

I agree that everything you just said is what is wrong with these subjective evaluations influencing your grade, but there is a big difference between a bad grading rubric preventing you from getting honors vs. simply passing the rotation. I'm just speculating here, like everyone else on this thread, but I have to imagine a grading rubric would either be pretty clear that the grade being given to OP would fail them, and if not that, then the grades they received must have been so significantly below the average student to have failed them. OP is far from the only student with nerves and difficulty transitioning from preclinicals to clinicals, so if the grading rubric was so obscure that simply being nervous on clinicals failed you, they would be far from the only student at their school failing multiple rotations. So, while I feel for OP, I think there simply has to be other things going on to fail three rotations in a row. That or they have the worst luck in the universe to get three back to back preceptors that accidentally marked them so deficient that they failed OP simply because they were overly nervous.

 

[FutureDoctor5000]

I agree that everything you just said is what is wrong with these subjective evaluations influencing your grade, but there is a big difference between a bad grading rubric preventing you from getting honors vs. simply passing the rotation. I'm just speculating here, like everyone else on this thread, but I have to imagine a grading rubric would either be pretty clear that the grade being given to OP would fail them, and if not that, then the grades they received must have been so significantly below the average student to have failed them. OP is far from the only student with nerves and difficulty transitioning from preclinicals to clinicals, so if the grading rubric was so obscure that simply being nervous on clinicals failed you, they would be far from the only student at their school failing multiple rotations. So, while I feel for OP, I think there simply has to be other things going on to fail three rotations in a row. That or they have the worst luck in the universe to get three back to back preceptors that accidentally marked them so deficient that they failed OP simply because they were overly nervous.

Yea the last part could be true in this case and that’s just plain sad...

 

[throwayaccount1375]

Thats probably what happened to me and I plan to make my case to my site director today. For example, when I did an exam I was overly nervous (shaky hands) especially on my first rotation which made it seem like I didn't know what I was doing so I was dinged on that. I wouldn't have made it this far if I didn't know anything. Again all 3 of my preceptors from those rotations noted my anxiety / not being as comfortable as a typical 3rd year would be so that could be the case. I can't imagine how bad I looked being a nervous and reserved mess.. It probably made me come across as unenthusiastic and what preceptor wants that?? Im going ask my site director how I should approach reaching out to my preceptors on wether I should have objectively failed or even if they can say I have potential to be a successful doctor if I work on certain things would help.. That would hold a lot more weight than anything I could say as @hallowmann stated. Im going to need someone to advocate for me to avoid dismissal.

 

[JibsGuy52]

What school is this so I can make sure to never recommend it? (Feel free to DM me). This is not on you. This is on your school.

 

[throwayaccount1375]

UPDATE: I just got out of a meeting with my site directors and they are ready to vouch for me. They said that it is true the preceptors do NOT know wether you failed. They are currently helping me reach out to all my preceptors so they can respond on wether or not I should have objectively failed and if they see the potential in me to become a successful doctor.

 

[throwayaccount1375]

If I get even 2 which I think I will to vouch for me, I have a real shot of staying

 

[hello1234!]

UPDATE: I just got out of a meeting with my site directors and they are ready to vouch for me. They said that it is true the preceptors do NOT know wether you failed. They are currently helping me reach out to all my preceptors so they can respond on wether or not I should have objectively failed and if they see the potential in me to become a successful doctor.

I'm not involved in medical education, but isn't it the course directors job to evaluate and discuss with the preceptors if you should have failed. It seems odd to me that they would want you to contact the preceptors directly about the final grading.

 

[Goro]

I don't even know how to put this. I figured out in a span of 3 days that I failed my first 3 clinical rotations. 1 in 1 day and 2 in the same. My school isn't like other schools in the fact that preceptors dont get to objectively decide if you pass or not. Its calculated through a number scale and you are compared to the standard of I guess what the average 3rd year medicals student is. Why my evaluations came so late? Preceptors at my school are not forced to give evals until a certain amount of time has passed (6 months) / first block so I had no idea I was preforming so poorly. I falsely assumed that despite a few mistakes I was on my way to pass but I was obviously not. Comments on my eval noted performance anxiety, nervousness and lacking in clinical skills. I have no professionalism problems. I did well on my shelf exams and did not fail any of those. I was recently diagnosed with ADHD and anxiety and started medication for it and I am noticing a big improvement in my mood and focus. My current rotation is going very well and I have not gotten any negative feedback. I think rotations have finally clicked for me and I feel comfortable on the wards. While I passed the first 2 years and boards, Im afraid that this stumble is too large to overcome. To say I am devestated is an understatement. Last week was probably one of the worse weeks of my life. I have been working towards this goal for so long and to see it go away in 3 days was hard to accept. I honestly feel like what killed me is lack of confidence. I was too reserved, anxious, nervous, scared for no reason when I should have been confident in what I knew and learned but it's too late now. I had a meeting with my rotation director before my meeting with the committee who decides dismissal and its not looking good for me. But it was stated that since the evaluations came all at once that stating I didn't know things were going that poorly is a fair statement that I can bring up. I guess where I am at is even if I was to make no mistakes from now on , would I have any chance of matching IM which was my first choice? Honoring the previous failed rotations? Will the fact this was during the pandemic help as it honestly contributed to my stress? Multiple students are off course now due to pandemic at my school. I am in desperate need of advice and If I have no chance to match, I need to withdraw in the next upcoming days and look at alternative career paths.

What penal colony is this???? ARCOM? LMU?

 

[Angus Avagadro]

I doubt the school will dismiss you OP. You have no idea how much money the school and government have spent on you. I would expect they would/should offer you the opportunity to remediate and correct deficiencies. This is how I think they will proceed. I could be wrong, but it otherwise doesn't make sense. They cannot replace you with another 3rd yr. Sadly, you might not graduate on time, but that is not insurmountable. Good luck and best wishes!