MD All P's in Clinical Clerkships, how much does it hurt?

[warrior209]

Hey everyone, need some advice/perspective on prospects moving forward after a tough clinical clerkship year. Just some background, I go to a top 10 medical school that does clinical clerkships in 2nd year med school. In a combo of average clinical evals, average shelf scores, and some family matters, I will not have gotten an HP or H in any of my 2nd year clerkships.

My questions: How much does that screw me come ERAS time? I'm interested in Internal med, anesthesia, and EM. My goal isnt necessarily a prestigious residency program, but would like to be in a city. Haven't taken Step 1 yet (our dedicated starts in a few months). Does getting Honors in my SubI's next year (I will be doing 4 subI's next year) offset a poor 2nd year?

Thanks in advance for your advice.

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[Poit]

What percentage of students honor, HP and pass any given clerkship?

 

[Dr. Doctor MD]

Hey everyone, need some advice/perspective on prospects moving forward after a tough clinical clerkship year. Just some background, I go to a top 10 medical school that does clinical clerkships in 2nd year med school. In a combo of average clinical evals, average shelf scores, and some family matters, I will not have gotten an HP or H in any of my 2nd year clerkships.

My questions: How much does that screw me come ERAS time? I'm interested in Internal med, anesthesia, and EM. My goal isnt necessarily a prestigious residency program, but would like to be in a city. Haven't taken Step 1 yet (our dedicated starts in a few months). Does getting Honors in my SubI's next year (I will be doing 4 subI's next year) offset a poor 2nd year?

Thanks in advance for your advice.

You'll do just fine. If you were applying for plasticdermorthopedic neurosurgery, this might be a huge issue/red flag, but I'm sure that coming from a top school, you will get loads of interviews in IM/Anesthesia/EM and eventually find a program you're happy with. Maybe not a top 10-20 program (but who really knows, could be possibility), but a good one regardless. Someone has to be in the bottom half of students who get Pass, and at a top 10 school, those applicants are still probably very good and desirable.

Edit in bold

 

[Lawpy]

You'll do just fine. If you were applying for plasticdermorthopedic neurosurgery, this might be a huge issue/red flag, but I'm sure that coming from a top school, you will get loads of interviews in IM/Anesthesia/EM and eventually find a program you're happy with. Maybe not a top 10-20 program, but a good one regardless. Someone has to be in the bottom half of students who get Pass, and at a top 10 school, those applicants are still probably very good and desirable.

I don't know but some members in the specialty forums think OP can net interviews at top programs in IM because school name plays a major role. Although I don't know the distribution of clinical grades at OP's school and that can be important. If OP goes to a school where >50% get honors/high passes, getting straight passes could be a problem despite school name.

 

[warrior209]

What percentage of students honor, HP and pass any given clerkship?

Anywhere from 15-25% get honors, 25-35% get HP, and the rest get P depending on the rotation. Grades are based on a combo of clinical evals and shelf exam scores, with certain requirements for honors (shelf must be top 1/3rd of the class, etc.)

 

[operaman]

It will certainly cost you but hard to say how much. A lot will depend on your future grades, step, etc.

When I see solid Ps my immediate worry is that the person is hard to work with. That may or may not be true, but we all know that honors is basically a measure of how well liked someone is. Someone with straight Hs is someone who CAN get along well with most anyone; solid Ps makes me more wary.

The bigger issue for you is not residency but rather how you plan to improve your performance before sub-i time. If you do EM, things like the SLOE are huge and if you struggle on rotations in the future it may seriously penalize you regardless of how good your school is. Figure out what you need to do to earn those Hs so you can do well going forward.

 

[Lawpy]

It will certainly cost you but hard to say how much. A lot will depend on your future grades, step, etc.

When I see solid Ps my immediate worry is that the person is hard to work with. That may or may not be true, but we all know that honors is basically a measure of how well liked someone is. Someone with straight Hs is someone who CAN get along well with most anyone; solid Ps makes me more wary.

The bigger issue for you is not residency but rather how you plan to improve your performance before sub-i time. If you do EM, things like the SLOE are huge and if you struggle on rotations in the future it may seriously penalize you regardless of how good your school is. Figure out what you need to do to earn those Hs so you can do well going forward.

What are your thoughts on straight HPs?

 

[whoknows2012]

If you do well on step 1 it won’t open more doors but would prevent more from being shut. I agree you’ll do just fine and you can definitely increase your chances by doing well on step 1/2 and getting some hp’s and h’s during your sub-i. Also it can sometimes be helpful to get a good understanding from an advisor where you deficiencies lie (if any).

 

[NeurologyHopeful2018]

It will certainly cost you but hard to say how much. A lot will depend on your future grades, step, etc.

When I see solid Ps my immediate worry is that the person is hard to work with. That may or may not be true, but we all know that honors is basically a measure of how well liked someone is. Someone with straight Hs is someone who CAN get along well with most anyone; solid Ps makes me more wary.

The bigger issue for you is not residency but rather how you plan to improve your performance before sub-i time. If you do EM, things like the SLOE are huge and if you struggle on rotations in the future it may seriously penalize you regardless of how good your school is. Figure out what you need to do to earn those Hs so you can do well going forward.

How do you know if those all Ps are from clinical evals, instead of Shelf exam? Most people in my school did not honor clerkships due to shelf exams..

Also some of my best performing rotations barely left any remarkable comments other than "great to work with and professional"

 

[ciestar]

How do you know if those all Ps are from clinical evals, instead of Shelf exam? Most people in my school did not honor clerkships due to shelf exams..

Also some of my best performing rotations barely left any remarkable comments other than "great to work with and professional"

My school actually designates this somewhere.. (not sure where, MSPE? Maybe?)

 

[NeurologyHopeful2018]

My school actually designates this somewhere.. (not sure where, MSPE? Maybe?)

My school did not show individual shelf scores. It did show distribution of grades.

Nonetheless, most people get very positive evals but did not crack the H threshold due to shelf score.

 

[ciestar]

My school did not show individual shelf scores. It did show distribution of grades.

Nonetheless, most people get very positive evals but did not crack the H threshold due to shelf score.

Someone at my school said something about letting programs know where you stood in your clerkship despite your shelf score... (as i sit here studying, ~10 point off the honors score)

 

[operaman]

What are your thoughts on straight HPs?

Better then straight Ps, not as good as straight Hs.

In all seriousness, it’s hard to qualify exactly and depends on how it fits in the overall app. Also depends on the percentage breakdown from the school and how grades are done. If it’s someone that has average step scores and just doesn’t quite ace the shelves enough to honor but has killer evals, then that may come across differently than someone who aces the steps and shelves but gets dinged by the subjective evals.

I’ll say that for our little competitive field, applicants with no clinical honors are uncommon and successful ones rarer still. We have average step 1 scores pushing 250 so most of our applicants don’t struggle with the shelf exams; for us, the clinical grades all hinge on evals and likability. A complete absence of honors would be a red flag; not honoring your sub-I would probably get your application tossed at most programs.

 

[NeurologyHopeful2018]

Better then straight Ps, not as good as straight Hs.

In all seriousness, it’s hard to qualify exactly and depends on how it fits in the overall app. Also depends on the percentage breakdown from the school and how grades are done. If it’s someone that has average step scores and just doesn’t quite ace the shelves enough to honor but has killer evals, then that may come across differently than someone who aces the steps and shelves but gets dinged by the subjective evals.

I’ll say that for our little competitive field, applicants with no clinical honors are uncommon and successful ones rarer still. We have average step 1 scores pushing 250 so most of our applicants don’t struggle with the shelf exams; for us, the clinical grades all hinge on evals and likability. A complete absence of honors would be a red flag; not honoring your sub-I would probably get your application tossed at most programs.

Are you in a very small surgical specialty like plastics or vascular?

H in SubI is luck. One medicine attending at our institution rarely gives out even HP.

Also even the most distinguished graduates this past year do not have all Hs. My friend who matched derm with AOA status has only 1/3 H, 2/3 HP.

 

[warrior209]

It will certainly cost you but hard to say how much. A lot will depend on your future grades, step, etc.

When I see solid Ps my immediate worry is that the person is hard to work with. That may or may not be true, but we all know that honors is basically a measure of how well liked someone is. Someone with straight Hs is someone who CAN get along well with most anyone; solid Ps makes me more wary.

The bigger issue for you is not residency but rather how you plan to improve your performance before sub-i time. If you do EM, things like the SLOE are huge and if you struggle on rotations in the future it may seriously penalize you regardless of how good your school is. Figure out what you need to do to earn those Hs so you can do well going forward.

Thanks for the feedback. I agree that it would raise some flags. Most of my evaluations have been positive, I think my shelf exam scores have been on the poorer side although I am usually within a few points of the mean each exam.

 

[Shigaliketoxin]

You're at Duke. You're fine.

 

[tomorrowDoc]

You're at Duke. You're fine.

Came by to say that too lol

OP, you should be alright, especially if you do well on Step 1 and 2. The extra research time should help too!

 

[NeurologyHopeful2018]

Thanks for the feedback. I agree that it would raise some flags. Most of my evaluations have been positive, I think my shelf exam scores have been on the poorer side although I am usually within a few points of the mean each exam.

Its concerning that only "most" of your evals are positive.....do you have a few negative ones?

I can tell you I had a horrible OB eval - and despite going into Neurology - I was asked about it at some places.

 

[CherryRedDracul]

The Duke name will carry you.

 

[ithd]

But he said only 15-25% get H, and 25-35% get HP. At Duke, most rotations have >70% honors rate (a few have ~50% honors). Maybe he goes to Harvard or something.