Changing Class Rank

[Rockhouse]

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It seems like I always hear people talking about how they expect "class rank is going to improve during the clinical years." I was wondering if any 3rd or 4th years have seen this magic upward shift for some students (and downward for others) happen after a few clinical rotations? I honestly don't know if I would move up or down, but it seems like the people that struck hard or slacked off their first year would, for the most part, continue to do it throughout medical school, without much shifting after that first year.

 

[tiredmom]

My class rank went up after each year. I guess it went up the most after after 2nd year. The big thing that either hurts or helps 3rd year is how much more the grades count... so if you screw one up, it can hurt you big. Now that I'm 1.5 rotations away from finishing 4th year, I don't even know if we get an updated rank after 4th year or if the one at the end of 3rd year is what you finish with.

 

[Wizard of Oz]

Yes the plus of finishing third year is that everybody becomes ranked in the top half.

 

[Biscuit799]

Speaking from no personal experience nor any statistical data whatsoever:

Clinical years involve a whole different set of skills than preclinical. Yrs 3 and 4 involve more interpersonal interaction, rationale thinking, planning, and conjecture. First two years are all memorize and regurgitate. So I'd imagine that there are students who are stronger in memorize/regurg but aren't as adept at the other stuff will fall, while those with reverse skill sets will rise. And then there are those that are just good at everything, and I want to shoot those people.

 

[Biscuit799]

Yes the plus of finishing third year is that everybody becomes ranked in the top half.

Is this a 4th year joke? I don't get it... Ahhh, too much path, not enough social time!

 

[EM_Rebuilder]

I was fed that BS and certainly found it to NOT be true. The Honors from MSI got Honors as an MSIII and the Passers as an MSI got a Pass as an MSIII.....


Also, dont auto think that everyone does 500 million times better on Step II over Step I... some people DO go down....

 

[Bitsy3221]

I was fed that BS and certainly found it to NOT be true. The Honors from MSI got Honors as an MSIII and the Passers as an MSI got a Pass as an MSIII.....


Also, dont auto think that everyone does 500 million times better on Step II over Step I... some people DO go down....

Speak for yourself......🙄

Hey, the Pollyanna attitude of SDN gets to me from time to time as well, but these crazy rank and Step I-->II changes CAN and DO happen.

 

[Wizard of Oz]

Is this a 4th year joke? I don't get it... Ahhh, too much path, not enough social time!

It was supposed to be in jest, yes, but I am only an MS 1. The first sentence in the OP is somewhat of a glaring non sequitur.

If you're giving 110% as an M1/2 and still blow ass, I don't see how you can expect to improve relative to others. Med schools don't tend to fill with people who just all of a sudden stop caring, especially during M3 when you have to face greater environmental pressure. If you're slacking and somehow manage to turn it around, you can probably be optimistic for improvement.

The thing is, though, if you stink up the joint during preclinical years, I don't see how you could magically turn it around for step 1 which is going to be the primary indicator for your ability to get residency interviews. M3 will be important indeed, but really the attitude or study habit adjustment needs to take place early on.

 

[bbggw]

i guess there is no hope for me, well...life at the bottom ain't so bad😱

 

[Law2Doc]

it seems like the people that struck hard or slacked off their first year would, for the most part, continue to do it throughout medical school, without much shifting after that first year.

Your assumptions may be off -- From what I've seen, the majority of people who struggle during the first couple of years aren't slacking- they often put in the time, but just aren't effective studyers. Thus when other skill sets come into play, particularly those which are personality and task oriented, they are sometimes able to show improvement.

 

[Biscuit799]

i guess there is no hope for me, well...life at the bottom ain't so bad😱

That's right... and you get to drink more!

 

[Northerner]

This is a funny one. But my personal favorite has always been "oh, well I'm just sort of passing classes, but I'm pretty sure I'll do well on Step I (I'm a good test-taker) so I'm not that worried...."

But I'll definitely add "oh, well I'm not doing that great but I hear class rank goes up 3rd year" to the list of reckless egotistical naive statements made by med students by the time it's too late.

 

[Doctor Bagel]

At my school, they've told us that the class rank stays about the same, even though 3rd year grades are worth so much compared with everything else. However, anecdotally, I do know people who did a lot better third and fourth year, which I think still looks good for residency applications. Of course, the people who did well 1st and 2nd year are probably doing well, too, hence the lack of change in rank.

 

[dynx]

At my school, they've told us that the class rank stays about the same, even though 3rd year grades are worth so much compared with everything else. However, anecdotally, I do know people who did a lot better third and fourth year, which I think still looks good for residency applications. Of course, the people who did well 1st and 2nd year are probably doing well, too, hence the lack of change in rank.

Im waiting for the always present "everyone else does better than me because I try to understand the material and they just memorize it, I always know more than them in discussion but the tests in years one and two dont reflect that". If this is what you are expecting to give you the edge as an MS3 you will be sorely mistaken for two reasons:
1. You don't know the material and there are still shelf exams you need to honor.
2. You have an annoying personality

The reality is: rank stays about the same. The hard workers will still work hard and impress on the floor as well as the shelf. The movement factor comes into play for the RARE individuals that study hard but have really, really damaging personal skills or the people who are real dynamic personalities and able to compensate for a weaker skill set. As a note, most people think that the former catagory is common in medical school, it is not. I have a "damaging personality" but in the hospital you have to be flat out socially ******ed to hurt your grade.

 

[Law2Doc]

The movement factor comes into play for the RARE individuals that study hard but have really, really damaging personal skills ...

Maybe not "really, really damaging personal skills", but there are, in fact, folks who simply cannot talk to people, yet have no problem on written tests. From what I've seen, this isn't all that rare.

 

[Doctor Bagel]

Maybe not "really, really damaging personal skills", but there are, in fact, folks who simply cannot talk to people, yet have no problem on written tests. From what I've seen, this isn't all that rare.

Then there are the people who can't talk to people and still can't do well on written tests. 🙂

I've got to admit I do hate the notion that there's a correlation between poor social skills and good academic skills. I think the two are largely independent of each other. Some people have both, some have neither, and some have one or the other.

 

[Law2Doc]

Some people have both, some have neither, and some have one or the other.

Absolutely agree, but none of these groups is so scarce in med school that you would really call them rare. However the folks with neither skill are going to be far less common, because you need something to have gotten this far. Hence being one dimensional is seen more.

 

[getinthehole]

Your class rank should be finalized for residency applications at the end of third year. Otherwise, some are going to have easier electives than others - Sub I vs. an observorship rotation - so, it wouldn't be fair or good for comparison which is the basic purpose I guess.

As far as improvement goes in rank, those who did extremely well before will almost always continue to do well, but I think with an improvement in consistency, improvement to some significant degree (not a total reversal) is definitely possible.

Where you may have reversal is through the comments. A horrible comment can ruin anyone. But that will probably not factor in until after interviews are given usually.

 

[Taus]

Im waiting for the always present "everyone else does better than me because I try to understand the material and they just memorize it, I always know more than them in discussion but the tests in years one and two dont reflect that". If this is what you are expecting to give you the edge as an MS3 you will be sorely mistaken for two reasons:
1. You don't know the material and there are still shelf exams you need to honor.
2. You have an annoying personality

.

I feel like I have heard those exact words from several people... at least it gives me an chance to practice my "smile and nod" skills before clinicals...

 

[vtucci]

I have heard of several students moving up (or down) significantly from year to year. It sounds like an urban legend but there are cases of students at the bottom of their class first year, moving up to lower 1/3 after 2nd year and jumping to top 15 after third year. However, this is not the norm.

Speaking from personal experience, performance in first year often has little to do with whether you are hardworking. First year was memorize and regurgitate-- not an area that I am particularly adept at. Second year, which requires more reasoning than memorization IMO, and my scores jumped considerably (with the reverse being true for some of my classmates who excelled at just memorizing things). I am hoping the trend continues into third and fourth year but we'll see. 🙂

 

[Samoa]

I think most people probably stay around the same range. Each year some will move up or drop a quartile, but it's pretty rare for someone to go from the bottom of the class to the top, or vice versa, over any stretch of time.

 

[Skills of House]

I think most people probably stay around the same range. Each year some will move up or drop a quartile, but it's pretty rare for someone to go from the bottom of the class to the top, or vice versa, over any stretch of time.

I agree. I think the rank will stay pretty much the same, but the range will change. So if you're in the lower half of your class and carrying a 70% average, you may improve your own scores dramatically in clinics, but so will most others so you still end up at the bottom, only now the "bottom" is a rosey 90% 😀 while the stellars are pulling 98 and 99s.
BTW does anyone have an actual take on being successful in 3rd and 4th yrs?

 

[Samoa]

I actually did much better as a 3rd and 4th year than I did in 1st and 2nd. There's a definite trend across the years. Between 1st and 2nd year, I basically doubled my studying efficiency, and also got better at preparing for tests.

As for 3rd and 4th year, I like to think I'm good at clinical reasoning, and that I earned my grades because of it, but in reality it's probably because I leave my ego at home.

 

[AmoryBlaine]

Im waiting for the always present "everyone else does better than me because I try to understand the material and they just memorize it, I always know more than them in discussion but the tests in years one and two dont reflect that". If this is what you are expecting to give you the edge as an MS3 you will be sorely mistaken for two reasons:
1. You don't know the material and there are still shelf exams you need to honor.
2. You have an annoying personality

The reality is: rank stays about the same. The hard workers will still work hard and impress on the floor as well as the shelf. The movement factor comes into play for the RARE individuals that study hard but have really, really damaging personal skills or the people who are real dynamic personalities and able to compensate for a weaker skill set. As a note, most people think that the former catagory is common in medical school, it is not. I have a "damaging personality" but in the hospital you have to be flat out socially ******ed to hurt your grade.

I totally agree. I think people love to talk about how relative lack of success in M1/2 somehow proves that they have "interpersonal skills" and will succeed as M3/4s.

Grading in clinical years is a combination of luck, subjective evals, and shelf scores. If you didn't do well as an M1/2/Step1 you're not going to do well on shelves.

 

[Law2Doc]

Grading in clinical years is a combination of luck, subjective evals, and shelf scores. If you didn't do well as an M1/2/Step1 you're not going to do well on shelves.

I love how this thread progressed from the original question of the OP which started with the notion of slacking and having a poor class rank in first year to now being that of someone who has tanked second year and Step 1 as well. I don't know that the writing is on the wall for subsequent years that early -- plenty of people right that boat in a variety of ways during second year; their rank may still be weighted down by first year at that point, but if one did well in second year, one could be expected to do fine on the boards and shelves.

 

[AmoryBlaine]

I love how this thread progressed from the original question of the OP which started with the notion of slacking and having a poor class rank in first year to now being that of someone who has tanked second year and Step 1 as well. I don't know that the writing is on the wall for subsequent years that early -- plenty of people right that boat in a variety of ways during second year; their rank may still be weighted down by first year at that point, but if one did well in second year, one could be expected to do fine on the boards and shelves.

Clearly you have not been following the body of evidence accumulated through years of neurotic postings on SDN.

The final results of the study is that one "C" on one test in college chemistry makes your chances of securing a residency spot in any field worth doing virtually nil.

 

[Law2Doc]

Clearly you have not been following the body of evidence accumulated through years of neurotic postings on SDN.

The final results of the study is that one "C" on one test in college chemistry makes your chances of securing a residency spot in any field worth doing virtually nil.

Good point. My bad.🙂

 

[Skills of House]

Clearly you have not been following the body of evidence accumulated through years of neurotic postings on SDN.

The final results of the study is that one "C" on one test in college chemistry makes your chances of securing a residency spot in any field worth doing virtually nil.

 

[Skills of House]

I actually did much better as a 3rd and 4th year than I did in 1st and 2nd. There's a definite trend across the years. Between 1st and 2nd year, I basically doubled my studying efficiency, and also got better at preparing for tests.

As for 3rd and 4th year, I like to think I'm good at clinical reasoning, and that I earned my grades because of it, but in reality it's probably because I leave my ego at home.

How are the 3rd and 4th year shelf exams? I mean are they based off of a lot of what you may not see or learn until the 3rd or 4th years or is it more so the same as what you learn in the first two years with a more clinical approach?

 

[Northerner]

How are the 3rd and 4th year shelf exams? I mean are they based off of a lot of what you may not see or learn until the 3rd or 4th years or is it more so the same as what you learn in the first two years with a more clinical approach?

They're comprised of retired Step II board questions.

 

[Bubb Rubb]

Im waiting for the always present "everyone else does better than me because I try to understand the material and they just memorize it, I always know more than them in discussion but the tests in years one and two dont reflect that". If this is what you are expecting to give you the edge as an MS3 you will be sorely mistaken for two reasons:
1. You don't know the material and there are still shelf exams you need to honor.
2. You have an annoying personality

 

[SnowTown]

I have heard of several students moving up (or down) significantly from year to year. It sounds like an urban legend but there are cases of students at the bottom of their class first year, moving up to lower 1/3 after 2nd year and jumping to top 15 after third year. However, this is not the norm.

Speaking from personal experience, performance in first year often has little to do with whether you are hardworking. First year was memorize and regurgitate-- not an area that I am particularly adept at. Second year, which requires more reasoning than memorization IMO, and my scores jumped considerably (with the reverse being true for some of my classmates who excelled at just memorizing things). I am hoping the trend continues into third and fourth year but we'll see. 🙂

How much do third year grades matter? About the same as the first and second year combined? If so, how is the the scenerio you described possible?

Say that someone barely passed all the class and got a 2.0 GPA. Got half A's (or honor) and half B's (or high pass) and aced all the rotations in the third year.

So

2.0 1st year
3.5 2nd year
(4.0 3rd year)*2
which is about a 3.375 GPA

or even if 3rd year accounts for twice as much as 1st and 2nd year combined, it'll be about say a 3.583 GPA

I just don't see either a 3.375 or a 3.6 GPA as being enough for top 15 (I'm assuming a class size of 100+).

Or are there any other factors?

 

[PeepshowJohnny]

I think I've seen some of the more meteoric rises happen between in second year and first.

I think some of people find out second year that the specialty they're interested in is super competitive and really put the pedal to the metal to achieve. Others burn out of after working hard their first year and having to go back to the grindstone.

That said, I think the stories of the braniacs falling apart third year are greatly overexagerated. I think if you're a jerkface, you're going to suck third year, regardless of your intelligence. The ones who have really struggled in my class all tended to be "middle of the classers" who slipped because they can't play nicely with others. And the braniacs are getting good grades by wowing the attendings when pimped and killing shelves, while those who struggled have trouble discussing patients because they never really got a handle on the material.