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Below class average in residency

chromaticscale

Full Member
2+ Year Member
May 2, 2019
72
46
96
  1. Resident [Any Field]
Hello,
Finishing up intern year and received the end-of-the-year evaluation from the hospitalists. In general, they state that I have been improving and performing at the satisfactory level but numerically I am performing below the average of my peers. Mainly they say my weakness is medical knowledge.
I have a feeling part of this evaluation is subjective because at the beginning, I did have a tough transition and received negative feedback about my performance. Near the end of the year I did not have the same hospitalists evaluate me who I suspect are part of the clinical competence committee.
Anyway, just wanted to know if anyone else had a similar experience and if they have any advice on how to do well (as a senior especially) or perform above average. I am interested in a very competitive subspecialty (there is in-house fellowship but there's no guarantee that they'll let their residents take the spots!). Thanks in advance!
 

DrMetal

To shred or not shred?
10+ Year Member
Sep 16, 2008
2,304
1,208
276
  1. Attending Physician
Hello,
Finishing up intern year and received the end-of-the-year evaluation from the hospitalists. In general, they state that I have been improving and performing at the satisfactory level but numerically I am performing below the average of my peers. Mainly they say my weakness is medical knowledge.
I have a feeling part of this evaluation is subjective because at the beginning, I did have a tough transition and received negative feedback about my performance. Near the end of the year I did not have the same hospitalists evaluate me who I suspect are part of the clinical competence committee.
Anyway, just wanted to know if anyone else had a similar experience and if they have any advice on how to do well (as a senior especially) or perform above average. I am interested in a very competitive subspecialty (there is in-house fellowship but there's no guarantee that they'll let their residents take the spots!). Thanks in advance!

We love to ping on 'medical knowledge' b/c it's the easiest thing to call people out on, everyone is lacking in some regard. That's fine, and its an easy fix. Study more (study board relevant things at your level, ie MKSAP, read good review articles, guidelines, etc. I'd advise to keep it board relevant, that way you're in essence preparing for your ITEs and BC exam).

If you're advancing to PGY2, you're fine. Work hard and be professional. These are the issues (laziness, unprofessional instances) that we have the most trouble with, with respect to trainees, so don't have those issues! The cure for a paucity of medical knowledge is more studying (any one can do that). The cure for professional/personality issues is. . . NOTHING. It's really hard to change someone's personality and attitude; deficiencies there get people into hot water very quickly.

And the 'chromatic scale' is wonderful, EVH made a career out of it.
 
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mdjo

Full Member
5+ Year Member
Dec 5, 2014
69
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146
  1. Attending Physician
I also had a "class rank" for various evaluation items in residency, but unlike medical school, I'm not sure it was really relevant in getting in to fellowship. It's about a million times more important to get to know attendings in your subspecialty who will write you great letters, call their friends in other programs about you, and hook you up with some research projects. Your PD isn't going to put your "rank" into their letter about you if it makes you look bad; they'll just put the highlights at what you are great at.
 
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Nespresso

Full Member
Jun 1, 2020
120
98
56
  1. Resident [Any Field]
Hello,
Finishing up intern year and received the end-of-the-year evaluation from the hospitalists. In general, they state that I have been improving and performing at the satisfactory level but numerically I am performing below the average of my peers. Mainly they say my weakness is medical knowledge.
I have a feeling part of this evaluation is subjective because at the beginning, I did have a tough transition and received negative feedback about my performance. Near the end of the year I did not have the same hospitalists evaluate me who I suspect are part of the clinical competence committee.
Anyway, just wanted to know if anyone else had a similar experience and if they have any advice on how to do well (as a senior especially) or perform above average. I am interested in a very competitive subspecialty (there is in-house fellowship but there's no guarantee that they'll let their residents take the spots!). Thanks in advance!

You'll be fine. Just study the diseases your patients have when you go home. Usually they pin the knowledge thing when the intern can't regurgitate Light's criteria for a pleural effusion patient, or seem confused about why we want a BUN in an upper GI bleed.
 
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tylerb1800

Full Member
7+ Year Member
Feb 23, 2013
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206
  1. Medical Student
I agree with the above recommendations. Read on your patients. Try to do it everyday. On the clinic side, it really helped me gain more knowledge if I pre-charted and read relevant topics on my clinic patients the night before/morning of the visit. If you make a habit of it earlier in residency, you will not have to do it as much as your progress during residency plus it makes your clinic quicker, easier, and better patient care.
 
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shouldigomd

Full Member
7+ Year Member
Jun 22, 2012
338
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  1. Fellow [Any Field]
Don't worry about it. Intern year is stressful and everyone handles it a bit differently. Just consistently read / learn.

Honestly those evaluations are meaningless for fellowship.
 
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