10+ Year Member
7+ Year Member
Apr 22, 2006
I know SDN is full of superstars with great board scores and clinical grades so this is probably not the best place to ask this question, but I was wondering how detrimental it is to just get Passes (in a P, HP, H system) for all your third year clerkships. I'm looking to do ER or anesthesia right now, so nothing ridiculously competitive. I've been through surgery, and psychiatry so far and will probably get passes on both of them. I just sort of get the sense that I will probably just pass all my rotations. My written evals haven't been bad but I just don't seem to really impress any of my attendings or residents. Furthermore, my shelf scores have kind of sucked (69, 68). I read and feel ready for the test but I guess I'm just not good at taking educted guesses on questions I'm not 100% sure about. Anyway just wondering how terrible it is to just be average in the grand scheme of residency applications.


Excellent, Smithers
Moderator Emeritus
10+ Year Member
7+ Year Member
Jul 14, 2005
Resident [Any Field]
Clinical grades are important will depend on the specialty you want to do, where you want to go, and your step 1 score. The problem is that "passes" aren't always average, like you suggest. In a lot of schools, mine included, the average clinical grade is a HP so getting all passes would probably be a red flag. In others, maybe 70% of the students get passes so it won't be looked at quite as negatively. Either way, getting all passes isn't really ideal.

I would get as much feedback as possible from your residents and attendings and find out the areas in which you can improve. Hopefully, that will help you impress the team on your next rotation and give you a better chance at scoring some better grades. Also, evaluate your study habits to figure out why your shelf scores aren't as high as you would like them to be. For example, maybe you need to read more consistently throughout the rotation or do more questions.

You have a long way to go in 3rd year and a couple passes in fields you're not going into won't hurt much, if at all. Try to adjust accordingly and go from here.