2 Rotations Down ... 2 'Excellent' (2nd best) with no negative feedback...

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Well... this is what is so annoying about clinical grades. They are subjective!
If you are really getting all good comments, then you have to get lucky enough to get someone who will play the game and mark the highest boxes on the form they're given.
For example, your eval form might have boxes for terrible, bad, average, excellent, and outstanding.
And then the form might include instructions designed to prevent grade inflation saying something like "it is perfectly fine to mark this student as being average if they are performing at the same level as their peers." And then the person thinks, well, I like fluffy and I thought she did a good job and so I'll mark the box for excellent. But you end up with a B, and that sucks. Sorry but half of getting good clinical grades is just luck!
One possibility, though, is that you're at one of the schools that only gives like 5-10% high honors in which case you might actually be doing far above average!
 
Even if they really like you, a lot of these attendings have no idea what the difference between a 4 and a 5 means. Straight out ask them for 5s. I've had it work before.
 
Well, that is one of the frustrating things about clinical grades. Truth is, you'll Probably get a few honors at some point -- maybe when you don't expect it! And unless you,re applying to derm or maybe ENT I don't think you need all honors. Even radonc is doable with average grades and a year of research. So don't give yourself an ulcer over this stuff!
 
First off, I'm aware grading is now very subjective and annoys everyone.

I am just curious as to how one gets 'High Honors' in clerkships? I have done very well on the shelf exam but it is an entirely separate grade from our clinical evaluation/grade. All of my feedback has been very positive and I have just received my second 'Excellent'. It is just frustrating as I even received mid-rotation feedback which was all positive comments.

I'm just worried as I am interested in a competitive specialty and did well M1/M2/Step 1, so I have been trying my best to maintain my grades throughout 3rd year and it hasn't happened yet (in terms of the clinic grade). I understand 'Excellent' is a great grade but I was under the impression residency programs only care about Honors vs....not honors.

Basically... How do I push beyond excellent into honors (without being super annoying)?

Thanks for any input !

Not sure if you go to the same school as me but when it came time to review the dean's letter, a ridiculous percentage of students honored (>50%)in 3 of the core clerkships. This seems largely due to the fact that many sites seem to give out honors just for showing up, but others are extremely stringent. How you can compare students in such a fashion, and actually count these scores twice is beyond me. I'm not sure there is anything you can do- I was in the same boat as you were- great shelf exams, comments, almost all preclinical honors, high step 1. If the residents you are working with seem cool (don't do this with OB-GYN or surgery), maybe explain to them your predicament. I still finished at the top of the class in class ranking though so just do the best that you can and move on. I'm also going for a competitive specialty too...
 
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