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3rd year grades and match

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How important are 3rd year grades factor into the application process? I have always been told that it is the number one thing that programs look at, even more important than board scores, letters, etc. I think that I am a good student from a good school in the southeast. I did well my first two years >3.6 GPA and on the boards >240 with some research experience but am struggling this year on the wards and have been making Bs so far, even in medicine. I want to go to a good programs like UCLA, UCSD, Stanford, Yale, Colombia, Penn, etc. (not MGH/Hopkins/BWH) and am planning on doing aways at some of these places to improve my chances. Do residency programs understand that it is really hard to make As/Honors in 3rd year since there are obviously alot of subjectivity to grading and a really hard shelf exam that could really hurt your grade? I really do think that I am a good applicant but this year has put doubts into my mind and make me wonder if I am a good student and if I can really get into the really good programs out there that I want. Any help would be appreciated.
 

VCMM414

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How important are 3rd year grades factor into the application process? I have always been told that it is the number one thing that programs look at, even more important than board scores, letters, etc. I think that I am a good student from a good school in the southeast. I did well my first two years >3.6 GPA and on the boards >240 with some research experience but am struggling this year on the wards and have been making Bs so far, even in medicine. I want to go to a good programs like UCLA, UCSD, Stanford, Yale, Colombia, Penn, etc. (not MGH/Hopkins/BWH) and am planning on doing aways at some of these places to improve my chances. Do residency programs understand that it is really hard to make As/Honors in 3rd year since there are obviously alot of subjectivity to grading and a really hard shelf exam that could really hurt your grade? I really do think that I am a good applicant but this year has put doubts into my mind and make me wonder if I am a good student and if I can really get into the really good programs out there that I want. Any help would be appreciated.

Hey, congratulations on excellent work in medical school so far. My experience has been that the first two years' GPA will not matter much in the long run, unless it leads to AOA status. However, your boards will definitely help out. Were you able to publish your research (obviously that would further help your cause)? Yes, the clerkship grades do matter quite a bit. I've seen people with lackluster first two years suddenly become excellent candidates by acing the third year. Residency programs are certainly aware of how difficult it is to Honor third year rotations, which is why they like applicants who have done well in their third years. You should remember that there are still people getting A's, even at your own institution, so the B in Medicine will hurt a bit. My advice is to do your senior subinternship EARLY and get an A, as well as a LOR from your attending there.

You seem like a fairly good candidate otherwise, so I would veer toward the conservative side with the away rotations. Unless you absolutely blow them away during your away rotation, it would likely not make much of a difference, and may potentially even hurt you. I suggest that you approach your away rotations as ways to learn more about the programs, with "gaining an edge" as your secondary goal. My n=4 experience has been that away rotations ultimately did not help my classmates match at specific programs (MGH, Duke, UCSF, and Stanford), even though these programs topped my classmates' respective ranklists.

You ought to also know that, while MGH/BWH et al are certainly very tough matches, some of the other programs you've listed can be nearly as tough. Among those that you've listed (UCLA, UCSD, Stanford, Yale, Columbia, and Penn), I would say Penn and Stanford are going to be the toughest matches. Depending on your location preferences, I would also broaden your search to include Duke, WashU, Michigan, UChicago, UT Southwestern, UW, and UCSF. In particular, conventional wisdom tells us that since you are applying from the southeast, Duke and UTSW will likely be more willing to take a serious look at your application. Not that you don't already know this, but Duke is a highly regarded program easily on par with the likes of Penn and Stanford. Unless you absolutely must get out of the south, Duke is definitely a program worth considering.

Anyway, I wish you luck in this process.
 

Ben Smith

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I go to a well regarded medical school. I had a 4.0 coming into 3rd year and >250 board scores. I made honors in all rotations except in med and surg... got screwed big time by some completely unethical residents/faculty. My board scores on both of these shelves was in the 99% (even then still didn't get honors). Two of my letters were from some of the biggest names (I'm talking editor-in-chief of THE main text in medicine as well as other major texts) in internal medicine (and I actually worked with both of them so it wasn't simply name dropping) and they wrote fantastic letters.... one of them even said my near honors in medicine was a mistake). I was AOA. Even with all this, I didn't get interviews to BGW, Hopkins, UCSF, Columbia, or Stanford. My experience has shown that if you don't get an A in medicine, they won't even look at the rest of your application.... it simply gets screened out by the computers; therefore, I highly suggest doing away rotations at places that you really want to go to. Good luck to you.
 

tum

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you had a 4.0 in med school?
 

Adcadet

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At one interview at a big name place my interviewer was rather brisk and made it clearly that he only cared about my medicine sub-i grade.
 

Medical123

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I was AOA. Even with all this, I didn't get interviews to BGW, Hopkins, UCSF, Columbia, or Stanford. My experience has shown that if you don't get an A in medicine, they won't even look at the rest of your application.... it simply gets screened out by the computers; therefore, I highly suggest doing away rotations at places that you really want to go to. Good luck to you.

I don't know how programs determine who gets an interview or not. Though I didn't even apply to any of the above programs, I never heard from a couple of places where my advisor and I thought I had a good shot of being interviewed.

A dean (who used to be a PD) told me during my third year that getting an interview at certain programs depends on WHO reviews your application and what mood they are in on a given day. She admitted that there were times when she honestly could not tell you why one applicant was selected to interview and another one was not. I know of people in my class who interviewed at all of the above places (and some even Matched) who had less stellar board scores, did not Honor Medicine, and haven't done a lot of research. Though they don't look as great as some people on paper, I do believe that all of them have the potential to become excellent physicians. One even admits that she passed biochemistry only by "sucking up" to the professor! They must have had something going for them in terms LOR's, extracurriculars, etc.

On the other hand, I have classmates that are extremely bright, AOA, and scored really well on the boards who were also outright rejected by all of the above places. I think that they look at the whole application and decide if they think that someone is a "good fit" for the program. It is definitely arbitrary.
 

hagart33

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It's a random process but don't let these posts scare you. Ben Smith's situation is unusual...Typically AOA students with board scores above 230 from a top 50 med school will get interviews at Hopkins, Penn, Stanford, Columbia, provided their letters are good and personal statement isn't weird.

I've heard the Brigham pretty much only interviews students in the top 10-15% of their class, regardless of what school they go to. I know students from top 5 schools who did a year of research at the Brigham with the Sarnoff fellowship, on a first name basis with the big names, and didn't get interviews there!

Also, UCSF and MGH are a crapshoot for anyone. Who knows what formula they use. The initial screening process does seem to be heavily based on honors in medicine and AOA. Keep in mind that ERAS on the computer has made it more competitive to get interviews because everyone applies to 20+ schools in the beginning. The top programs get swamped with 2000+ applications. It's unfortunate because a lot of great applications get thrown out or hardly get looked at.

I go to a well regarded medical school. I had a 4.0 coming into 3rd year and >250 board scores. I made honors in all rotations except in med and surg... got screwed big time by some completely unethical residents/faculty. My board scores on both of these shelves was in the 99% (even then still didn't get honors). Two of my letters were from some of the biggest names (I'm talking editor-in-chief of THE main text in medicine as well as other major texts) in internal medicine (and I actually worked with both of them so it wasn't simply name dropping) and they wrote fantastic letters.... one of them even said my near honors in medicine was a mistake). I was AOA. Even with all this, I didn't get interviews to BGW, Hopkins, UCSF, Columbia, or Stanford. My experience has shown that if you don't get an A in medicine, they won't even look at the rest of your application.... it simply gets screened out by the computers; therefore, I highly suggest doing away rotations at places that you really want to go to. Good luck to you.
 

Teejay

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It's a random process but don't let these posts scare you. Ben Smith's situation is unusual...Typically AOA students with board scores above 230 from a top 50 med school will get interviews at Hopkins, Penn, Stanford, Columbia, provided their letters are good and personal statement isn't weird.

I've heard the Brigham pretty much only interviews students in the top 10-15% of their class, regardless of what school they go to. I know students from top 5 schools who did a year of research at the Brigham with the Sarnoff fellowship, on a first name basis with the big names, and didn't get interviews there!

Also, UCSF and MGH are a crapshoot for anyone. Who knows what formula they use. The initial screening process does seem to be heavily based on honors in medicine and AOA. Keep in mind that ERAS on the computer has made it more competitive to get interviews because everyone seems to apply to 20+ schools in the beginning. The top programs get swamped with 2000+ applications. It's unfortunate because a lot of great applications get thrown out or hardly get looked at.

A friend of mine who is a minority (AA) was talking about going into one of those top tier programs. He was really concerned about the selection process i.e, if being a minority will hurt or help him since residency selection may be a different ball game from med-school admission. He actually thinks it could hurt him for some reason. He is a stellar candidate with average grades and good board scores and he has good extracurricular activities. He has not done his medicine rotations yet.
Could anyone give an insight on how minorities are selected so i could pass the information to him?
 

atsai3

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How important are 3rd year grades factor into the application process? I have always been told that it is the number one thing that programs look at, even more important than board scores, letters, etc.

For strong programs in IM, your clerkship grade is very important (especially if your school has shelf exams), and your sub-I grade had better be honors. Doing an away rotation may or may not help you, totally depends.

For what it's worth (since everyone on SDN will tell you different things), here is one more data point for you to consider: I did a visiting sub-I at Duke when I was a medical student, and I made it clear when I was there that I was seriously considering their program (dual-board IM/psych). The Duke IM attendings I worked with gave me very good feedback and an honors evaluation, and that combined with the honors I got during my home institution sub-I helped them get past my not getting honors in my third year clerkship. My attending (one of the program directors), and one of the former program directors with whom I interviewed, both told me the same thing. It was basically, "well, the psych part of your application is strong, but that doesn't lower the bar for you to be considered for the IM program. You did great here, and you got honors on your sub-I, so I guess it's okay that you didn't get honors in your third year clerkship...".

Cheers
-AT.
 

emtji

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I go to a well regarded medical school. I had a 4.0 coming into 3rd year and >250 board scores. I made honors in all rotations except in med and surg... got screwed big time by some completely unethical residents/faculty. My board scores on both of these shelves was in the 99% (even then still didn't get honors). Two of my letters were from some of the biggest names (I'm talking editor-in-chief of THE main text in medicine as well as other major texts) in internal medicine (and I actually worked with both of them so it wasn't simply name dropping) and they wrote fantastic letters.... one of them even said my near honors in medicine was a mistake). I was AOA. Even with all this, I didn't get interviews to BGW, Hopkins, UCSF, Columbia, or Stanford. My experience has shown that if you don't get an A in medicine, they won't even look at the rest of your application.... it simply gets screened out by the computers; therefore, I highly suggest doing away rotations at places that you really want to go to. Good luck to you.

there's alot of truth to this. i had a 253 and 255, did well in preclinicals, but had high passes in med/surg/psych with honors in peds/ob. i had trouble getting prelim interviews at alot of places (BIDMC, beth israel ny, lenox hill), despite coming from a top 50 school.
 

hagart33

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it's too bad that 3rd year medicine counts for so much. On the one hand, I can see how people think it's a more "objective" measure with the shelf exam. But schools evaluate so differently, with some weighing the shelf more than others. At some schools it's easy to get honors, while others, you have to walk on water and have a greater "fund of knowledge" than your chief's.

Also, does anyone really think basic medicine demonstrated your real potential to manage patients? i just remember eagerly doing scut for the interns and having all night to prepare and memorize a patient presentation. The subi evaluations should count for more. Perhaps they don't weigh the subi as much because there's grade inflation at that stage.

there's alot of truth to this. i had a 253 and 255, did well in preclinicals, but had high passes in med/surg/psych with honors in peds/ob. i had trouble getting prelim interviews at alot of places (BIDMC, beth israel ny, lenox hill), despite coming from a top 50 school.
 

Adcadet

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I definitely think the sub-i should count for more than the basic medicine rotation. But I think both are important. I'm sure we all know of people with amazing board scores, junior AOA, etc, who just couldn't talk to patients, residents, or attendings and their medicine clerkship and sub-i grades reflected this.
 

hagart33

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Oh, just wanted to mention that the overemphasis on 3rd year basic medicine honors seems to be at the initial cutoff for interviews stage. When they're actually sitting down and ranking people to match, seems like they really do comb through every word that was written about you in your letters, your subi evals, interviews, the whole package. So once you make it to the interview stage, a high pass in medicine won't necessarily make or break you.
 

joejabjab

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M3 planning on going into medicine --> cards. Honors on clinical grade on my M3 medicine rotation, shelf exam score pending.

Should I do an audition sub-I at another university program (better reputation than my school) or cards rotation at that same institution?
 

hagart33

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I'm a fan of away rotations, but I'm wary to recommend doing an away subi. Doing really well as a subi depends a lot on how well you can navigate that particular hospital system.

There's less risk with doing an away cards consult elective. You can get to know key faculty who can get you an interview with their letter or phone call.

If you feel like you might come across much better in person than on paper, by all means do an away subi or elective and work your a** off like there's no tomorrow. The real value of doing an away rotation, though, is to see if the place you're interested in lives up to the hype.

M3 planning on going into medicine --> cards. Honors on clinical grade on my M3 medicine rotation, shelf exam score pending.

Should I do an audition sub-I at another university program (better reputation than my school) or cards rotation at that same institution?
 

tum

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:)
 
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NDESTRUKT

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What about other grades? Does just the Medicine grade matter?

I think I might just end up passing Surgery. I honored Medicine and a few others, but the pass in Surgery is going to kill my 3rd year GPA.

What do you think?
 

Medical123

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What about other grades? Does just the Medicine grade matter?

I think I might just end up passing Surgery. I honored Medicine and a few others, but the pass in Surgery is going to kill my 3rd year GPA.

What do you think?

At my school, the Shelf grades are a big part of your final grade for the course. However, the Dean's Letter just mentions whether or not you passed or failed the Shelf. No one gets a numerical score.

I just passed Surgery, but I Honored or High Passed the rest of my rotations. I Matched at my #1. During the interviews for IM, no one asked about my Surgery grade. Now....I imagine that if I had been going into surgery, this would have been a different matter.:(
 

Master Duron

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I would hope that PDs look at other criteria on whether or not someone honored their third year clerkship. Alot of different factors go into a grade for one of the cores, and personality factors with attendings and residents play a large role. I have personally seen many a bright medical students, some of them with good board scores, get very poor evaluations on rotations that I was with, even when they were working very hard, taking care of patients, and presenting well. I think that alot of attendings on clinical rotations were kicked around as medical students, maybe were at the bottom of their class or didn't make it into that dermatology residency that they wanted, and enjoy the enormous power that they have over your evaluation. For examples, if you are working with an internist who hates their job, attacks the residents for apparently inocous reasons, and belittles you and other students what hope do you have of getting a decent evaluation?

Secondly, and this is important, is that if it is well-known that you want to go into say ob/gyn, and your attendings on the ob/gyn service realize this, they WILL grade you differently from other students, and will find a reason to give you a bad evaluation to make sure you don't go into ob/gyn (even though you may be outperforming half of your fellow students on the clerkship). This may also occur in medicine if you have Student A who is gung-ho on going into IM and wants a prestigious IM residency, they may be graded a lot more difficulty than other students who say are interested in pediatrics. This is one dirty little secret of medicine that not alot of academic types like to talk about.

Thirdly, there is a large amount of jealousy and resulting student abuse in medicine that many other professions, including heavy abuse at places like Harvard. The reason? Some say that most medical students are gifted, intelligent, bright etc . . . and are more prone to abuse for this. I have often seen fellow medical students more knowledgeable than me, and nicer, etc . . . get reamed at by attendings and residents who feel threatened, whereas I can get a good to excellent evaluation by talking down about myself. Trust me it works, just talk about how you are struggling to learn x,y and z, and if a resident or attending could explain it to you. Nothing makes an attending or resident more angry than if you appear to know more than them, or know an answer to a question that they don't know. The politics of medicine are real and many a medical student will get burned if they don't know how to negotiate these treacherous water ways.
 

MSKy108

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Sounds like you had a pretty disillusioning experience. However, i think its unfair to make any hard and fast rules. For every one person that has a negative experience with third year, there are a bunch of well deserving students, smart, hard-working, and moral, that are recognized by attendings. 3rd year is very subjective, and true, frusturating as all [email protected]**, but I think in the end, the comments written about you by attendings can be more important/telling that an "H" or "P".
 

BlackNDecker

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Our school does not give honors, and I am curious what numerical score correlates with honors, high pass, and pass?
 
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