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I'm curious how likely it is for a below average student (in 1st and 2nd year) to "shine" during rotations? Maybe not such a good test taker, but knows the material and is great in social situations? I'm asking because I wasn't doing as well as I am now in school, and to make myself feel adequate, I thought to myself, "I'll do much better on rotations since I'm great socially and am very passionate about people." Was this foolish of me to think? I would say I'm about average as a student now and have fixed my test taking skills but I do realize that clinical grades account for more and I want to excel, and not appear as if i'm completely clueless. Any thoughts or personal experiences? :wideyed:
 

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I'm curious how likely it is for a below average student (in 1st and 2nd year) to "shine" during rotations? Maybe not such a good test taker, but knows the material and is great in social situations? I'm asking because I wasn't doing as well as I am now in school, and to make myself feel adequate, I thought to myself, "I'll do much better on rotations since I'm great socially and am very passionate about people." Was this foolish of me to think? I would say I'm about average as a student now and have fixed my test taking skills but I do realize that clinical grades account for more and I want to excel, and not appear as if i'm completely clueless. Any thoughts or personal experiences? :wideyed:
This is just like me! I struggled extensively during first and second year to even get a high pass in a course, much less honors. Third year is still difficult to do well in because there are some factors out of your hands, but I got high pass or honors in almost all of my rotations. You still have to take a test at the end of the rotation, but great evaluations can take you a long ways! Plus it was great to receive a steady stream of good feedback after the first and second year of feeling below average. Keep up the attitude--book smart people usually struggle first and second year, but third year is for the time for those of us who have good communication skills to shine! GOOD LUCK!
 
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dr.sartorius
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This is just like me! I struggled extensively during first and second year to even get a high pass in a course, much less honors. Third year is still difficult to do well in because there are some factors out of your hands, but I got high pass or honors in almost all of my rotations. You still have to take a test at the end of the rotation, but great evaluations can take you a long ways! Plus it was great to receive a steady stream of good feedback after the first and second year of feeling below average. Keep up the attitude--book smart people usually struggle first and second year, but third year is for the time for those of us who have good communication skills to shine! GOOD LUCK!
Wow that's awesome to hear, thank you for sharing! Glad everything worked out for you! Thanks for the inspiration :)
 

DermViser

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This is just like me! I struggled extensively during first and second year to even get a high pass in a course, much less honors. Third year is still difficult to do well in because there are some factors out of your hands, but I got high pass or honors in almost all of my rotations. You still have to take a test at the end of the rotation, but great evaluations can take you a long ways! Plus it was great to receive a steady stream of good feedback after the first and second year of feeling below average. Keep up the attitude--book smart people usually struggle first and second year, but third year is for the time for those of us who have good communication skills to shine! GOOD LUCK!
To be fair, you have to try REALLY REALLY hard to get a "Pass" on a rotation. If you come to work on time, do your work, don't complain, get along with the team, stay calm w/out losing your cool and take criticism constructively, you'll at least get a "High Pass". There is a LOT of grade inflation when it comes to clinical clerkships at most medical schools. In fact the literature has shown that many med students who should have received a "Fail", actually get a "Pass" for many reasons, by medical school faculty.
 

DermViser

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I'm curious how likely it is for a below average student (in 1st and 2nd year) to "shine" during rotations? Maybe not such a good test taker, but knows the material and is great in social situations? I'm asking because I wasn't doing as well as I am now in school, and to make myself feel adequate, I thought to myself, "I'll do much better on rotations since I'm great socially and am very passionate about people." Was this foolish of me to think? I would say I'm about average as a student now and have fixed my test taking skills but I do realize that clinical grades account for more and I want to excel, and not appear as if i'm completely clueless. Any thoughts or personal experiences? :wideyed:
I think as a whole it's not really true. I think it's a great mind trick for people who are not at the tippy-top of the class to use to make themselves feel better, "I'll show them!! All this stuff is just minutiae, but when I hit the clinical years, I'll be a superstar!!"

I think SDN tends to magnify this phenomenon MUCH HUGER than what it actually is. The ones who I knew who did very well, I mean: "H" in nearly every preclinical course, got 250s-260s on Step 1, continued their superachieving level of performance in the clinical years as well checking off getting AOA, getting even higher on Step 2, and overall winning the game called medical school. That doesn't mean they didn't burn out (we all do), but they either had great coping skills or avenues of good stress release to get their energy back.

On top of all this, many of them had done research and published in clinical journals as well and were also great in social situations, and were married by the end of MS-4. There will be some people who are really that "perfect". Yes, it sucks from an ego-bruising perspective. It's best not to compare yourself to them and just be happy with what you are able to achieve.
 

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Really? Honors is capped at 12% at my school high pass at 25%. Are there schools where, say, more than half the class gets letters or honors?
Yes, definitely. Just look at Pritzker's grade distribution.
upload_2014-9-16_17-16-29.png
 
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To be fair, you have to try REALLY REALLY hard to get a "Pass" on a rotation. If you come to work on time, do your work, don't complain, get along with the team, stay calm w/out losing your cool and take criticism constructively, you'll at least get a "High Pass". There is a LOT of grade inflation when it comes to clinical clerkships at most medical schools. In fact the literature has shown that many med students who should have received a "Fail", actually get a "Pass" for many reasons, by medical school faculty.
This is definitely not my experience. Even though I did all of the above consistently, I received mostly "Pass" grades for my rotations.
 
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DermViser

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This is definitely not my experience. Even though I did all of the above consistently, I received mostly "Pass" grades for my rotations.
I'm also assuming that you actually present your patients properly, know what's going on with your patients, have a reasonable fund of knowledge expected for an MS-3, etc. If you're flubbing up all over the place, creating more headaches, then yes, you'll get "Pass". I'm assuming your grading system is H/HP/P/etc.
 
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I'm also assuming that you actually present your patients properly, know what's going on with your patients, have a reasonable fund of knowledge expected for an MS-3, etc. If you're flubbing up all over the place, creating more headaches, then yes, you'll get "Pass". I'm assuming your grading system is H/HP/P/etc.
Based on comments, I have always been doing as expected for an average MS3, except I always get a Pass.
 

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I think as a whole it's not really true. I think it's a great mind trick for people who are not at the tippy-top of the class to use to make themselves feel better, "I'll show them!! All this stuff is just minutiae, but when I hit the clinical years, I'll be a superstar!!"

I think SDN tends to magnify this phenomenon MUCH HUGER than what it actually is. The ones who I knew who did very well, I mean: "H" in nearly every preclinical course, got 250s-260s on Step 1, continued their superachieving level of performance in the clinical years as well checking off getting AOA, getting even higher on Step 2, and overall winning the game called medical school. That doesn't mean they didn't burn out (we all do), but they either had great coping skills or avenues of good stress release to get their energy back.

On top of all this, many of them had done research and published in clinical journals as well and were also great in social situations, and were married by the end of MS-4. There will be some people who are really that "perfect". Yes, it sucks from an ego-bruising perspective. It's best not to compare yourself to them and just be happy with what you are able to achieve.
"Wait til 3rd year" must be the mantra of every lousy pre-clinical med student. As if every attending just wants to be best friends with the "good social skills" guys and gals, and knowledge and work ethic count for nothing.
 

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"Wait til 3rd year" must be the mantra of every lousy pre-clinical med student. As if every attending just wants to be best friends with the "good social skills" guys and gals, and knowledge and work ethic count for nothing.
The assumption being made is that they'll be better in clerkships bc it's actual clinical medicine where they'll theoretically be harder working since they like it and know clinical information beter. I agree the skills, abilities, and competencies that are evaluated in M1/M2 are quite different than that evaluated in M3 (although it does have a shelf exam which more is a skill/ability from M1/M2 - but it's more a standardization measure).
 

DermViser

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you don't like pritzker at all. also I just learned what meharry is today so lolz learning
I didn't say, I didn't like Pritzker. I posted their grade distribution. That distribution would be ridiculous at ANY medical school. That shows such grade inflation it's not even funny. 68% of medical students getting "Honors" in Surgery? Yeah, um no. No one getting a "Pass" in FM or Peds? Yeah, um no.
 
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AMEHigh

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I am definitely average/below average on paper when it comes to exam scores.

I'm definitely above average when it comes to how I interact with patients, writing notes, coming up with a differential, etc based on feedback I've gotten from residents and attendings. I still get tripped up sometimes if I'm straight up "pimpled" and a doctor asks me to list something that's based off pure memory. But things come together for me when I'm with patients and interacting with them and coming up with a plan.

In addition, hard work seems to go a long way as well and your team appreciates it.

So yes, you can definitely excel on rotations even if you're not getting A's on your tests or the highest board scores.
 

DermViser

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I am definitely average/below average on paper when it comes to exam scores.

I'm definitely above average when it comes to how I interact with patients, writing notes, coming up with a differential, etc based on feedback I've gotten from residents and attendings. I still get tripped up sometimes if I'm straight up "pimpled" and a doctor asks me to list something that's based off pure memory. But things come together for me when I'm with patients and interacting with them and coming up with a plan.

In addition, hard work seems to go a long way as well and your team appreciates it.

So yes, you can definitely excel on rotations even if you're not getting A's on your tests or the highest board scores.
And how has that translated to your actual clinical grades of "H", "HP", etc.? There are tons of attendings who say students are doing a great job and students end up with an HP or P on their evals from that person.
 

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M3/M4 is more about good attitude and work ethic than about having super friendly social skills. Those hard working test takers would still have the edge here, unless they are just really weird. Which happens. People's weirdness really come out on rotations.
 

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To be fair, you have to try REALLY REALLY hard to get a "Pass" on a rotation. If you come to work on time, do your work, don't complain, get along with the team, stay calm w/out losing your cool and take criticism constructively, you'll at least get a "High Pass". There is a LOT of grade inflation when it comes to clinical clerkships at most medical schools. In fact the literature has shown that many med students who should have received a "Fail", actually get a "Pass" for many reasons, by medical school faculty.
Depends on the school. My school heavily weighted the shelf exam. If you didn't ace the shelf exam (I mean get in the top 10% on it of the people taking it in my class) then it was hard to honor or even get a high pass. My school is very strict about only letting 10% honor a given rotation.
 

DermViser

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Depends on the school. My school heavily weighted the shelf exam. If you didn't ace the shelf exam (I mean get in the top 10% on it of the people taking it in my class) then it was hard to honor or even get a high pass. My school is very strict about only letting 10% honor a given rotation.
That's usually different. At our school, a certain shelf exam score was required to still be eligible for Honors. Of course if you completely bombed it then it's possible to geta "P". Sucks that different schools have such strict or lax policies with regards to how many can get Honors.
 

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Most of our clerkships have shelf cut-offs for Honors or HP. Even if you were the most charismatic person in the world and had the most glowing evaluations of any medical student in history, you will not get an H or HP if you don't meet the cut-off.

Our exceptions are Family Medicine and Psychiatry, and those two rotations have a grading system that operates like so:


Seriously, a girl with great evals and a 99 on the shelf got an HP, while a girl with good evals and a 76 on the shelf made an H in Family Medicine. The girl who made the H met with the clerkship director and "discussed her desire to go into Family Med." ;)
 

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Most of our clerkships have shelf cut-offs for Honors or HP. Even if you were the most charismatic person in the world and had the most glowing evaluations of any medical student in history, you will not get an H or HP if you don't meet the cut-off.

Our exceptions are Family Medicine and Psychiatry, and those two rotations have a grading system that operates like so:


Seriously, a girl with great evals and a 99 on the shelf got an HP, while a girl with good evals and a 76 on the shelf made an H in Family Medicine. The girl who made the H met with the clerkship director and "discussed her desire to go into Family Med." ;)
lol they really buy that when people say that?
 

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lol only in Family Med. Haven't heard of shenanigans like that anywhere else
Say that you want to go into Surgery and they'll make it even harder on you. You might get away with it with the harpies on OB-Gyn.
 
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PL198

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lol only in Family Med. Haven't heard of shenanigans like that anywhere else
lol I can imagine someone crying during proceedings for FM to get their grade and then trying it on surgery and the surgeon is just like " need me to cut something?"
 

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On top of all this, many of them had done research and published in clinical journals as well and were also great in social situations, and were married by the end of MS-4. There will be some people who are really that "perfect". Yes, it sucks from an ego-bruising perspective. It's best not to compare yourself to them and just be happy with what you are able to achieve.
upload_2014-9-16_19-35-48.jpeg
 

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AMEHigh

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And how has that translated to your actual clinical grades of "H", "HP", etc.? There are tons of attendings who say students are doing a great job and students end up with an HP or P on their evals from that person.
On the rotations where I got clear feedback that I was doing well with more specific feedback I've received honors and high passes and good comments on the feedback form.
 
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DermViser

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Social skills are great with patients. But they don't grade you: you better learn that.

Just focus on getting by.
A lot of clerkship behavior is Kabuki theater. It doesn't matter how great and caring you are with patients if residents and attendings don't see it.
 

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A lot of clerkship behavior is Kabuki theater. It doesn't matter how great and caring you are with patients if residents and attendings don't see it.
I'm still bitter no one on my team saw me successfully help my patient in peds defeat bowser and rescue the princess. That's auto-honors right there.
 

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I'm not sure if the below average can truly make the leap to the top; the factors that make them below average are the same ones that will torpedo their shelf scores and even their evals. That said, there are some people who do WELL m1/m2 but aren't superstars who can make the jump into the elite group of students once they hit clinicals, but these are people who weren't far from there to begin with. People near the bottom are generally lacking in medical knowledge and work ethic, both of which don't lead to great evals.

I think the misconception comes from the few top students preclinically who lack social skills and struggle M3 with relating to others and functioning as part of a team. It's a lot easier for a rockstar test taker to fall a few places than it is for someone in the bottom quartile to become a clinical superstar. I'm trying to think of how much you'd have to learn during M1/M2 while still being unable to score well on exams. Again, I think the people who make a jump were pretty close to the top to begin with, scoring at or above average on class exams, scoring high on step 1, etc.
 
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I'm not sure if the below average can truly make the leap to the top; the factors that make them below average are the same ones that will torpedo their shelf scores and even their evals. That said, there are some people who do WELL m1/m2 but aren't superstars who can make the jump into the elite group of students once they hit clinicals, but these are people who weren't far from there to begin with. People near the bottom are generally lacking in medical knowledge and work ethic, both of which don't lead to great evals.

I think the misconception comes from the few top students preclinically who lack social skills and struggle M3 with relating to others and functioning as part of a team. It's a lot easier for a rockstar test taker to fall a few places than it is for someone in the bottom quartile to become a clinical superstar. I'm trying to think of how much you'd have to learn during M1/M2 while still being unable to score well on exams. Again, I think the people who make a jump were pretty close to the top to begin with, scoring at or above average on class exams, scoring high on step 1, etc.
I'm not sure if this is just my school but that hasn't always been my experience. Take pulm for example. Two students take the same pulm pathophysiology in-house final worth 60% of the final grade, each with an equal amount of basic science and clinical knowledge of pulmonary disease. The first student pours over the lectures time and again, memorizing everything he can including the professor's in depth 3 hour lecture of his research on PPHN. The second student spends an equal amount of time and effort pouring over Kaplan, First Aid, UWorld, Goljan, and Pathoma. Before the test, each student has an EQUAL AMOUNT of knowledge, slightly differing in content. The first student scores a 97 on the final and ends up in the top five percent. The second student scores an 85 and is straddling the 2nd and 3rd quartiles. I see this happen ALL THE TIME.
To really reach the top of the class it takes a dedicated effort to evaluate each professor's specific interests and predilections, and probably won't pay off in the clinical years.
 
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DermViser

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I'm still bitter no one on my team saw me successfully help my patient in peds defeat bowser and rescue the princess. That's auto-honors right there.
Tsk, tsk Kaustikos. You should have been more like this:


Or on different clerkships:
 

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lol just realized that telling the doctor I do my clinical stuff with(who is FM) that I want to go into rads probably wasn't the best idea
 

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I'm not sure if this is just my school but that hasn't always been my experience. Take pulm for example. Two students take the same pulm pathophysiology in-house final worth 60% of the final grade, each with an equal amount of basic science and clinical knowledge of pulmonary disease. The first student pours over the lectures time and again, memorizing everything he can including the professor's in depth 3 hour lecture of his research on PPHN. The second student spends an equal amount of time and effort pouring over Kaplan, First Aid, UWorld, Goljan, and Pathoma. Before the test, each student has an EQUAL AMOUNT of knowledge, slightly differing in content. The first student scores a 97 on the final and ends up in the top five percent. The second student scores an 85 and is straddling the 2nd and 3rd quartiles. I see this happen ALL THE TIME.
To really reach the top of the class it takes a dedicated effort to evaluate each professor's specific interests and predilections, and probably won't pay off in the clinical years.
Define "pay off".

Will their incredibly detailed knowledge of the pre-clinical professors ' specific interests be sufficient to guarantee them success? Probably not.

Will the study habits that they've developed over these two years, and the drive that led them to gain such incredibly detailed knowledge in the first place persist into third year, and lead them to develop similar levels of mastery in their clinical rotations? Probably.

It's not like the studying stops when you hit third year. The students with either incredible intellect or incredible work ethic will still have those traits.
 
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DermViser

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I'm not sure if the below average can truly make the leap to the top; the factors that make them below average are the same ones that will torpedo their shelf scores and even their evals. That said, there are some people who do WELL m1/m2 but aren't superstars who can make the jump into the elite group of students once they hit clinicals, but these are people who weren't far from there to begin with. People near the bottom are generally lacking in medical knowledge and work ethic, both of which don't lead to great evals.
THIS.

I think the misconception comes from the few top students preclinically who lack social skills and struggle M3 with relating to others and functioning as part of a team. It's a lot easier for a rockstar test taker to fall a few places than it is for someone in the bottom quartile to become a clinical superstar. I'm trying to think of how much you'd have to learn during M1/M2 while still being unable to score well on exams. Again, I think the people who make a jump were pretty close to the top to begin with, scoring at or above average on class exams, scoring high on step 1, etc.
I also think the thought process is different when it comes to answering multiple choice questions vs. doing an H&P, coming up with an A&P and then presenting it (and then all the other stuff of getting things done), which you can't just look up in a book. There are just some skills that multiple choice exams can not test. There will be some people who excel in M1/M2 and Step 1 and falter in M3.

I think those who fit in this category are a very small minority though. (11:28 and 16:08, 16:19)
 
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DermViser

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It's likely processing artifact.

The biopsy in his profile came from a dry kid with fish-like scales.
Bingo. Yes, ichthyosis vulgaris. I knew you'd get it, GWDS!! :biglove:
 

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operaman

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I'm not sure if this is just my school but that hasn't always been my experience. Take pulm for example. Two students take the same pulm pathophysiology in-house final worth 60% of the final grade, each with an equal amount of basic science and clinical knowledge of pulmonary disease. The first student pours over the lectures time and again, memorizing everything he can including the professor's in depth 3 hour lecture of his research on PPHN. The second student spends an equal amount of time and effort pouring over Kaplan, First Aid, UWorld, Goljan, and Pathoma. Before the test, each student has an EQUAL AMOUNT of knowledge, slightly differing in content. The first student scores a 97 on the final and ends up in the top five percent. The second student scores an 85 and is straddling the 2nd and 3rd quartiles. I see this happen ALL THE TIME.
To really reach the top of the class it takes a dedicated effort to evaluate each professor's specific interests and predilections, and probably won't pay off in the clinical years.
Maybe. My perception of that story is student 1 learned the material while student 2 blew off the assignment and studied review material before even learning the material the first time. I think this attitude gets people in trouble in third year and beyond. Get the actual assignment done first, then focus on additional things.

Often, these students like student 2 above are the ones in clinical years who are first out the door so they can go do UWorld questions or whatever they're using for shelf prep. They're always so focused on the "high yield" that they don't really learn anything in much depth. Student 1, on the other hand, has already put the time in learning in depth during m1/m2 and really knows and remembers the information; he can get by doing a few World questions when he gets home after busting his tail in the hospital and really learning clinical medicine, getting to know his patients, etc. He can devote himself to the clinical side because he knows he'll ace the shelf without much effort. He doesn't need Step Up to Medicine because he already stepped up months ago.

That said, your student 2 who's right on the edge may be one who's able to step it up and do well clinically. 85 on class exams is not bad and probably pretty near the class average. He's not necessarily poised to jump into superstar territory, but probably has enough medical knowledge to do well if he gets there early and reads like a fiend on his patients. Again, people looking for the 'high yield' shortcuts are not always the people willing to do that.

Student 3, on the other hand, who's coasting by playing video games all day and banging out 74% on his exams is not going to jump into honors territory just because he's a cool dude who's good with the "bishes" [sorry, couldn't resist!] ;)
 
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DermViser

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It wasn't even meant to be a burn. He described himself as performing very average for his level of education. Why anyone would expect something more than "Pass" for that is beyond me.
I know it wasn't an intentional burn. I was more referring that your statement pointed out the cognitive dissonance between someone who said his M3 performance on a rotation was average except he always got a "Pass". Assuming his evaluation of his performance is accurate, then he actually got the grade he earned. If your performance is "average", then you likely will not be getting High Pass or Honors. Pass is exactly that: average.
 
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