100% pass third year. Will i have any problems getting into fm or psych?

[Ormd123]

my school is f/p/hp/h. Tried my best third year and got straight passes. Got a 231 on step 1, 240 on step 2.

Will getting only passes inhibit me from matching into FM or psych?

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[Stagg737]

my school is f/p/hp/h. Tried my best third year and got straight passes. Got a 231 on step 1, 240 on step 2.

Will getting only passes inhibit me from matching into FM or psych?

You should be fine. As long as you've got solid LoRs and clinical evals and aren't gunning for only elite programs you should be good.

 

[neoevolution]

I wish we weighted shelf grades more, you can get 90th percentile at my school and not make HP if you get average on clinical

 

[DBV]

Man that is some bullsh*t. Your schools are straight screwing you with both fists.

 

[GrandBuckeyeOH91]

my school is f/p/hp/h. Tried my best third year and got straight passes. Got a 231 on step 1, 240 on step 2.

Will getting only passes inhibit me from matching into FM or psych?

nope, not with those board scores.

 

[moisne]

I'm a MD 4th year from a decent med school. I got in the 4th quartile Step 1 was 237, step 2 is pending. I got killed mostly on clinical rotation because I'm pretty shy/introverted and a touch of social awkwardness (all my shelves were fine...). I'm couple matching with ortho :O (but he's competitive).

Does the last quartile kill me? I had applied to like 80 places though.

 

[Stagg737]

Sorry to rant but clinical grades are such BS. Some schools give half the class honors/high pass, while other schools like mine only give honors to top 5% and high pass to the next 5%. No one fails unless you did something insanely stupid or got wrecked by the shelf. That means 90% of people get pass. And you have to choose the right rotation site and hope you get the preceptor that just gives the highest grades otherwise you'll end up with a pass. Our school actually has a document going around with the "easy site" for rotations but this year the preceptors at some of the sites changed so the gunners got ****ed over (haha). That's how messed up it is. They need to just scrap this grading system and use a combo of step 1/2 and clinical eval feedback and LORs for residency placement.

I'd like to see clinical grades just be P/F at every school (no HP/H) and require attendings to give actual evaluations of students. I realize that creates a lot more work for the attendings as well as those going through the residency applications, but it would take care of some of the inconsistency of clinical grading systems. Plus residency panels could just skim the grades to make sure there weren't failures and go straight to the attending evals if they want to see if a person stood out. Or just create some system that is used at all med schools, but that's not happening any time soon.

 

[sinombre]

my school is f/p/hp/h. Tried my best third year and got straight passes. Got a 231 on step 1, 240 on step 2.

Will getting only passes inhibit me from matching into FM or psych?

Anecdotally I had two classmates who had red flags (one with a failed step 1, another with a failed class during second year) who matched at "big name" family medicine and psych programs. A family friend also failed step 2 not once, but twice, and wound up matching at a big name psychiatry program (this was several years ago). Granted all three of these people are very personable and have other redeeming qualities. But still, it seems that if you're coming from a US MD school you have a whole lot of say as to where you'll end up regardless of scores in these specialties.

And that said, your scores are solid. Your grades will not hold you back. While it always looks good to honor rotations, PDs understand how arbitrary third year grades are. I'm in a very different specialty (general surgery), but I had a PD of an other program tell me (when I was interviewing last year) that he literally ignores third year grades because he can't compare applicants with them.

YMMV, but you'll almost definitely do well in the match barring any other red flags or personality defects.

 

[sinombre]

I'd like to see clinical grades just be P/F at every school (no HP/H) and require attendings to give actual evaluations of students. I realize that creates a lot more work for the attendings as well as those going through the residency applications, but it would take care of some of the inconsistency of clinical grading systems. Plus residency panels could just skim the grades to make sure there weren't failures and go straight to the attending evals if they want to see if a person stood out. Or just create some system that is used at all med schools, but that's not happening any time soon.

They do include comments in the dean's letter for each rotation (at least they did at my school), which I think makes a lot of sense.

 

[Stagg737]

They do include comments in the dean's letter for each rotation (at least they did at my school), which I think makes a lot of sense.

My school does as well. I think it's pretty standard, but Idk enough to really say. I'm just talking about standardizing the actual clinical grades though. I know people at other schools who got mostly honors because they're mostly graded on attending evals, while they may not have honored anything at my school because we're only graded based on shelf scores. It just creates so much inconsistency that Idk how a PD would be able to adequately compare clinical grades from different schools unless they were really familiar with how each school assigned those grades.

 

[Stagg737]

Well at my school they still have to give comments in the eval, and I'm not trying to brag but my attending left very good comments and said I'm more competent that many of the residents he's worked with. But, I still got a pass on that rotation (and my shelf exam score was above the average). My school also has residents determine grades for some rotations and it is extremely abusive/malignant. What sucks about that is you are literally around a resident every minute of the day, and at the end of the rotation they all meet in a room and project your face on the wall and talk about you. Basically if you messed up even in the slightest way they will all hear about it and slam you on evals.

I'm not arguing for or against any particular method of grading, just saying that I think creating a standardized method across all medical schools would be beneficial. I'm also all for comments on evals, but their subjectivity is a problem when trying to compare applicants who worked with completely different attendings. We also get comments in our evals, they just don't count as part of our grade at all (so I get where you're coming from with "grade deflation" compared to other programs).

 

[Donald Juan]

To go back to the OPs question: you will be very competitive for FM and get interviews at a ton of places. Psych you won't have any trouble matching at all.

 

[W19]

My school does as well. I think it's pretty standard, but Idk enough to really say. I'm just talking about standardizing the actual clinical grades though. I know people at other schools who got mostly honors because they're mostly graded on attending evals, while they may not have honored anything at my school because we're only graded based on shelf scores. It just creates so much inconsistency that Idk how a PD would be able to adequately compare clinical grades from different schools unless they were really familiar with how each school assigned those grades.

That might be the best way to standardize 3rd year grades. Everything (including OSCE) should be P/F. Use the shelf exams to give H/HF/P...

 

[moisne]

That might be the best way to standardize 3rd year grades. Everything (including OSCE) should be P/F. Use the shelf exams to give H/HF/P...

I wish. Our 3rd year is 90% subjective grading with 20%/20% caps for both. Too bad no one remembers me (for good or for bad) - I sit there, do my work, present the cases, and talk to my patient. I'm not into small talk :/

 

[WedgeDawg]

If you make the grade totally dependent upon the shelf exam, then how does clinical year really differ from your preclinical years? There has to be some evaluation of your clinical performance because that's really the most important part. Not saying the way it's done now at a lot of school is necessarily objective or completely fair (it definitely disadvantages certain personalities and there's a lot of intangibles that are out of your control) but I don't think that making the grade 100% shelf fixes the problem so much as ignores it.

 

[Stagg737]

Clinical knowledge is different than basic science knowledge. Whole lot more of "what do you do next in managing this patient" rather than "African American woman, granulomas, what is the dx" types of questions. That in itself is enough to base 3rd year completely off of grades. And the whole evals part is too subjective. I've had some residents think I'm amazing and others think I'm an idiot just because of the situation or topic being discussed. If the schools are so worried about their student's social skills or professionalism, they need to change their admissions interviews to gauge that better.

That's true, but there's a lot more to being a physician than just reading a question stem and figuring out "what's the next step in management" or "what treatment would you recommend". That completely ignores the aspect of actually gaining the information that is present in the question stem, physical exam skills, as well as any of the intangibles such as actually being able to work in a team or with your patient. You can get perfect scores on your shelf exams, but they're completely meaningless if you can't identify the pertinent physical exam findings or you're incapable of taking a decent history.

Edit: I'd also add that there's a huge difference between getting a question stem and having to come up with an answer on your own vs. being given multiple choice options. So even then, I don't think they're a great measure of how prepared a person would be to enter that field...

 

[WingedOx]

If you make the grade totally dependent upon the shelf exam, then how does clinical year really differ from your preclinical years? There has to be some evaluation of your clinical performance because that's really the most important part. Not saying the way it's done now at a lot of school is necessarily objective or completely fair (it definitely disadvantages certain personalities and there's a lot of intangibles that are out of your control) but I don't think that making the grade 100% shelf fixes the problem so much as ignores it.

I think most clinical evaluation grades are stupid and subjective and yet I still more or less agree with this.

 

[Stagg737]

I think most clinical evaluation grades are stupid and subjective and yet I still more or less agree with this.

This is why I think it's kind of silly that MSPEs aren't released until 2 weeks after ERAS goes out. I feel like it would be more beneficial and easier to see the evals that go with the grades right away rather than having to go through applications, then go through them again and match evals to the single letter grades in the ERAS app. Especially in fields where hard cutoffs for Step scores are less common.