MS3 Struggling on clerkships

[gwiggy900]

I am a current MS3 attending a top 20 med school, step 1 score ~242.
As the title states, I am 3 clerkships in and have only received 2 passes and 1 high pass. Distribution at my school is around 20% pass, 40% HP, 40% H. So obviously I am likely 4th quartile. No negative comments on MSPE. Was very close to honoring my HP rotation and one of the P was due to poor shelf score.

I am seriously considering anesthesiology, but I was wondering if poor clerkship performance would bar me from matching as a 4th year. I am open to both academic and community programs and plan on applying broadly.
I have no research experience, but I was hoping to get involved with something this summer hopefully.

Any advise on what I can work on moving forward?

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[JiPo]

Top 20 medical school with 242, you are going to be just fine.

 

[gwiggy900]

Top 20 medical school with 242, you are going to be just fine.

I guess one thing that concerns me is when I look online, most people have fantastic clinical grades even with low board scores which makes me wonder if my grades are going to be a red flag for when I apply. Any recommendations for anesthesia rotation i have coming up in couple months? I was hoping to secure a lor during my home rotation.

 

[deleted697127]

As JiPo pointed out, between your board scores and going to a top 20 school, you will be fine. I would recommend trying to figure out what it is that you’re struggling with.

Its easy to give advice on how to succeed on standardized tests. It is very hard for an outsider to understand what a schools clinical grades are based on and impossible for an outsider to provide meaningful insight on how to improve clinical performance for your specific complicated grading regimen.

I cannot emphasize enough how important it is for medical students to seek advice on how to succeed from their schools own upperclassman. There is no need to reinvent the wheel. How many times have you finished a class and thought to yourself: i would have approached this differently had i known what i know now at the beginning of the class/rotation. Take a step back and look at the bigger picture of where your grades come from.

This is also something that you should discuss with your mentor. If you don’t have a mentor that you are comfortable seeking advice from, find one that your classmates recommend. Seeking advice, following it, making improvements, and showing gratitude is a pattern that creates a strong recommendation letter once applications come around.

Last, are you wasting time on notes no one reads? Are your presentations difficult to follow? Do you spend hours you could’ve been studying or sleeping preparing 1 minute long presentations for after rounds that your classmates seem like they get away with essentially reading off uptodate? I’m not recommending being lazy but there are common things medical students often struggle with.

Good luck

 

[BLADEMDA]

The OP should easily be able to match into Anesthesiology. Most likely an upper tier or mid tier program. I don’t think lower tier or community programs are even necessary for his/her application. Instead, focus on getting good LORs and applying broadly to good university programs.

 

[Drwine]

Google "how to do well on clinical rotations"
Being intelligent isn't going to carry you through clinical rotations. You need a different skill set. Acting professional , being engaged and showing some enthusiasm goes a long way to do well in clinicals.

 

[dabears505]

1st world problems. You will easily match, unless you have some very strange personality issue that can be picked up in an interview.

 

[nimbus]

Vast majority of students from top tier schools match at top tier anesthesia programs. Many were in the middle or bottom of their class.

 

[secretasianman]

Anesthesia is not plastics or derm. You will be fine.

 

[fadedrebel]

Granted it has been quite awhile since I applied to residency, given your USMLE score, I wouldn't be too concerned. Best advice with a high USMLE score... ace your audition rotations:

How to ace it?

As others have mentioned... show enthusiasm (even when you are not).

Show up on time (early) and pre-read about anesthetic management/surgery of the cases the night before.

Ask questions, but know WHEN to ask questions (unstable gunshot wound to the aorta?... probably not the best time to ask about the NPO fluid replacement equation)...

Do procedures (Don't necessarily have to be 100% successful at them) but know WHEN to ask to do them (probably don't ask/expect to intubate/line up the aforementioned gunshot wound to the aorta)...

Know that in certain emergencies, the best way to help is to stay out of the way and chart/count blood bags/iV bags/set up the level 1/Belmont/transducers/etc

Oh its 530 pm and there are still in patient preops to do? Sure, I would LOVE to go see the patient!

lastly, don't be weird.

 

[Ronin786]

I've interviewed residents at three programs. Don't think I ever really care about rotation scores once I get the application. A 242 and your med school is going to get you interviews. Make sure you have good letters, don't be an idiot or a bore and you'll go wherever you want.

 

[Silo004]

I am a current MS3 attending a top 20 med school, step 1 score ~242.

Exact same test score. All Ps third year. Top twenty residents program. Now a CA3. Just accepted offer with fantastic group in town.

 

[Consigliere]

Read the infamous "Stone Memo" which will ultimately result in CRNA only care in all VA hospitals. Independent practice rights will soon be granted in every state. AMC only employment in the near future. The sky isn't falling....it has fallen. Take your good Step score and top 20 medical school to a residency where you'll actually have a future. Or don't and end up punching yourself in the head on a daily basis.

 

[gwiggy900]

Read the infamous "Stone Memo" which will ultimately result in CRNA only care in all VA hospitals. Independent practice rights will soon be granted in every state. AMC only employment in the near future. The sky isn't falling....it has fallen. Take your good Step score and top 20 medical school to a residency where you'll actually have a future. Or don't and end up punching yourself in the head on a daily basis.

lol thanks. I like anesthesia tho

 

[gwiggy900]

Thanks for the encouragement everyone, motivating me to push harder!

 

[dabears505]

You should honestly push harder to get into a different field instead of pushing hard to get into this field. Anesthesia how become one of the easier fields to get into these days. You have good scores and can probably get into something you'll be much happier with later in life. It seems like a cool profession as a student, but as an attending its a whole different ballgame.

 

[Consigliere]

It seems like a cool profession as a student, but as an attending its a whole different ballgame.

Write this down, laminate it, and put it in your wallet. Then, if you are foolish enough to pursue a career in anesthesia, you can pull it out and read it whenever a surgeon barges in on you while you're interviewing a patient and interrupts like you're not even there. Or, when you get your first "talking to" for not being a "team player" when you correct some knucklehead CRNA and save a patient's life. Then I want you to remember "I told you so."

 

[deleted171991]

https://www.asahq.org/-/media/sites/asahq/files/public/advocacy/alerts/washington-alerts/crna-practice-during-the-covid-19-national-emergency-04212020.pdf

Please note "strongly encourage". For any questions, one can contact the midlevels running the show (also note the sausage of irrelevant titles). You've been warned, OP.

FYI, VA patients are older and way sicker than the average non-VA OR patient. That's exactly why this precedent is so dangerous (both for the patients and the doctors).

The solution? Any (sub)specialty where you can practice independently. Hence IM (especially with a fellowship) beats the pants off anesthesia.

 

[sice4]

Write this down, laminate it, and put it in your wallet. Then, if you are foolish enough to pursue a career in anesthesia, you can pull it out and read it whenever a surgeon barges in on you while you're interviewing a patient and interrupts like you're not even there. Or, when you get your first "talking to" for not being a "team player" when you correct some knucklehead CRNA and save a patient's life. Then I want you to remember "I told you so."

Consigliere, is your biggest reason for dissuading students away from anesthesiology that you feel that there is a lack of respect for anesthesiologists?
In contrast, do you feel that there are compelling reasons for why a medical student today should decide to pursue a career as an anesthesiologist in the near future? Genuinely interested in your thoughts as you seem to have strong opinions about anesthesiology as a specialty.

 

[GassYous]

Write this down, laminate it, and put it in your wallet. Then, if you are foolish enough to pursue a career in anesthesia, you can pull it out and read it whenever a surgeon barges in on you while you're interviewing a patient and interrupts like you're not even there. Or, when you get your first "talking to" for not being a "team player" when you correct some knucklehead CRNA and save a patient's life. Then I want you to remember "I told you so."

Man I am so glad I work with good surgeons and no crnas

 

[GassYous]

Anesthesiology still has pretty decent fellowships though no? Not too much encroachment in cardiothoracic, pain or ICU.

lolol

 

[Consigliere]

Consigliere, is your biggest reason for dissuading students away from anesthesiology that you feel that there is a lack of respect for anesthesiologists?
In contrast, do you feel that there are compelling reasons for why a medical student today should decide to pursue a career as an anesthesiologist in the near future? Genuinely interested in your thoughts as you seem to have strong opinions about anesthesiology as a specialty.

I couldn't care less about the perceived level of respect of surgeons; respect comes from within. It's the fact that you have to deal with idiot CRNAs if you want to be employed in 85% of the USA.