Blindsided by grade...What to do?

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megatron88

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For my internal medicine 3rd year clerkship, I got very positive reviews from all my residents/attendings who said I was at an intern level. My comments said I was a strong house officer candidate and should consider a career in IM. I scored 91st percentile on the shelf. I've honored every other clerkship so far, but got my grade and I got a pass. I have no idea how I got this grade based on the feedback I received and my shelf score. I want to go into IM and am feeling really down now about my chances of a good residency spot. I scored 260+ on step 1 but I'm afraid I will get screened out of a lot of interviews based on only passing IM. Should I try and speak with the course director about my grade? Any advice appreciated. Thanks
 
Something doesn't add up with your story. I would, ever so politely, speak with the site director first, then the course director if needed. Something similar happened to a friend of mine during a sub-i, and the site director had accidentally switched her grade with another student on the rotation.
 
Even if you can't reverse your grade, you have 260+ step 1 and more rotations to come in your fourth year.

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Find your balls and ask the clerkship director. What else is there to do?
 
what do the comments say
Here are some of the comments
1. showed tremendous growth and progress on service. differential dx was most impressive to me and during her presentations, she would clearly explain why or why not a dx was possible. clearly did a thorough investigation prior to rounds and was always very prepared. stood out among her peers in medical knowledge and presentation skills. Patients loved her and she was as a valuable team member.
2. extremely strong medical student, with a very solid fund of medical knowledge, with a strong understanding of cardiac physiology
3. Integrated well into the team. Presentations on rounds were of high quality. Patients were presented in a clear logical and thoughtful manner. Documentation and physical findings were accurate. Student actively sought constructive criticism and was very motivated during the rotation. she was always professional in her interactions. I did observe a history and physical. she was able to skillfully elicit and clarify further details of the chief complaint. Physical exam was performed appropriately with consideration of patient comfort.
4. a very solid job. She had good ideas for differential diagnoses on several patients. Showed great interest on rounds and learned from all the patients. Great patient rapport and empathy.
Improvements: Continue to build medical knowledge, rehearse presentations to make them more polished and concise.
5. delivered very well-organized presentations. She is able to develop comprehensive, yet concise differential diagnoses based on a patient's presenting signs and symptoms that is above what is expected for her level of training. She was enthusiastic and followed the expected number of patients.
Improvements: Continue the great work! Continue to work on integrating your medical knowledge into an understanding of the psychosocial aspects of the patient's care.
 
Here are some of the comments
1. showed tremendous growth and progress on service. differential dx was most impressive to me and during her presentations, she would clearly explain why or why not a dx was possible. clearly did a thorough investigation prior to rounds and was always very prepared. stood out among her peers in medical knowledge and presentation skills. Patients loved her and she was as a valuable team member.
2. extremely strong medical student, with a very solid fund of medical knowledge, with a strong understanding of cardiac physiology
3. Integrated well into the team. Presentations on rounds were of high quality. Patients were presented in a clear logical and thoughtful manner. Documentation and physical findings were accurate. Student actively sought constructive criticism and was very motivated during the rotation. she was always professional in her interactions. I did observe a history and physical. she was able to skillfully elicit and clarify further details of the chief complaint. Physical exam was performed appropriately with consideration of patient comfort.
4. a very solid job. She had good ideas for differential diagnoses on several patients. Showed great interest on rounds and learned from all the patients. Great patient rapport and empathy.
Improvements: Continue to build medical knowledge, rehearse presentations to make them more polished and concise.
5. delivered very well-organized presentations. She is able to develop comprehensive, yet concise differential diagnoses based on a patient's presenting signs and symptoms that is above what is expected for her level of training. She was enthusiastic and followed the expected number of patients.
Improvements: Continue the great work! Continue to work on integrating your medical knowledge into an understanding of the psychosocial aspects of the patient's care.

That's not a pass. I wouldn't go to the Clerkship director though. The first person to go to is the person who gave you the grade
 
Those are fantastic comments lol def an honors
 
Glad to hear people think those are good comments @OP! Those are the kinds of evals I tend to get as well, but always thought they seemed very generic/average.
 
Those are fantastic comments lol def an honors
hmm not sure if they were fantastic but were pretty similar to what I got in other rotations where i got honors. who knows though. maybe there usually isn't much of a difference between comments for pass vs honors?
 
I have heard of such evals but never seen one! lol.....

Yeah, I suck but apparently you don't.

I would go to the clerkship director and ask about my grade. Tell them you plan to do IM and are worried about how this will look for your overall residency application. Something does not make sense here and the more time you waste the less chances are things will get changed. The squeaky wheel get the oil.....start squeaking! lol
 
hmm not sure if they were fantastic but were pretty similar to what I got in other rotations where i got honors. who knows though. maybe there usually isn't much of a difference between comments for pass vs honors?
I agree what is the difference?
 
"2. extremely strong medical student, with a very solid fund of medical knowledge, with a strong understanding of cardiac physiology"

I would imagine someone described as the above would do more than just pass lol but what do I know..
 
Echoing the advice to meet with your clerkship director asap. There is a strong possibility that this is simply an error - it's easy for someone to key it in incorrectly. I knew people who had this happen, though obviously the grades were adjusted when the error was discovered.

If you truly got a pass, find out by just how much and if it was one person's eval who did it. I've seen clerkship directors contact the person and inform them that their evaluation is the sole thing keeping the student from earning honors. Given the comments you received, assuming you didn't edit out anything, it may be someone who didn't realize they clicked something that dinged you.

Go in with a good attitude like you've had in this thread and you should be fine. You sound like the kind of student the faculty really likes and they will be likely to do whatever they can to help you, especially if this is your chosen field. Make it clear you're totally willing to accept whatever grade you earned, but that you're confused by how glowing comments and a stellar shelf score and a proven history of honoring all other rotations could suddenly result in a pass, that you'd like to find out if it's simply an error or if there is something you're doing wrong and need to improve upon over the next few months before you do your IM sub-I and start asking for letters. I think that's a nice way to slip in the point that you plan to apply to IM residency.

Good luck!
 
This sort of thing defines third year for most people. GL, OP you deserve better than a pass.
 
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