Class Rank Wording

[emboli]

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Just wondering if all schools use the same ranking terminologies? I reviewed my MSPE today and it appears as if they go by thirds? Or do schools choose wordings based on the student's actual standing in the class so that it can sound better? For example, the letter would say middle third instead of bottom half? etc etc.

 

[NotAProgDirector]

Each school is different. Some are thirds, some are quartiles. Some only rank the top 2 quartiles, and then the bottom half. Some don't rank at all. Some give exact class rank.

 

[emboli]

Thanks aPD!

 

[DrSnips]

Just wondering if all schools use the same ranking terminologies? I reviewed my MSPE today and it appears as if they go by thirds? Or do schools choose wordings based on the student's actual standing in the class so that it can sound better? For example, the letter would say middle third instead of bottom half? etc etc.

At mine they flat-out told us they make it sound as good as possible. Those in the top ten will actually have it say "first in class" or "seventh in class". Then they have like top 10%, top 20%, top-third, top-half, middle-third, and then lower half.

 

[Law2Doc]

Just wondering if all schools use the same ranking terminologies? I reviewed my MSPE today and it appears as if they go by thirds? Or do schools choose wordings based on the student's actual standing in the class so that it can sound better? For example, the letter would say middle third instead of bottom half? etc etc.

Lots of places just use different wording and stay away from specific rankings. Basically student A is "good" and student B is "really good" and student C is "really, really good". kind of meaningless though, because they'll already know you honored x, y and z, got good evaluations in rotation Q, R and S etc. Most PDs aren't so focused on the grades/rank, and instead will focus on your Step 1 and core rotation evaluations, making these grade breakdowns pretty insignificant. I had a med school mentor who described the fact that med school grades really don't count for anything as the "dirty little secret" of med schools -- you need to learn the info, and having a grading system may foster that, but in the end the grades themselves are far less meaningful than the typical first or second year student ever appreciates.

 

[NotAProgDirector]

At mine they flat-out told us they make it sound as good as possible. Those in the top ten will actually have it say "first in class" or "seventh in class". Then they have like top 10%, top 20%, top-third, top-half, middle-third, and then lower half.

I'll point out that this little trick doesn't really work. I see lots of applications from each medical school, especially when I can review the last several years worth of data. If I see one student reported as the top 10% and another as in the top 20%, it's pretty clear that the second person is in the 11th - 20th percentile.

Lots of places just use different wording and stay away from specific rankings. Basically student A is "good" and student B is "really good" and student C is "really, really good". kind of meaningless though, because they'll already know you honored x, y and z, got good evaluations in rotation Q, R and S etc. Most PDs aren't so focused on the grades/rank, and instead will focus on your Step 1 and core rotation evaluations, making these grade breakdowns pretty insignificant. I had a med school mentor who described the fact that med school grades really don't count for anything as the "dirty little secret" of med schools -- you need to learn the info, and having a grading system may foster that, but in the end the grades themselves are far less meaningful than the typical first or second year student ever appreciates.

I don't think this accurately represents what I do. Yes, step scores are important and they are a uniform measure (since everyone takes the same exam). However, clerkship grades are very important in our interview and ranking decisions. I do agree that M1 and M2 grades are much less significant (at least to me)

 

[DrSnips]

If I see one student reported as the top 10% and another as in the top 20%, it's pretty clear that the second person is in the 11th - 20th percentile.

Yeah, it's a bit silly I admit. Besides, my MSPE says exactly what my M3 grades were, so a PD familiar with my school's grading breakdown could come even closer to determining my true percentile than the vaguely worded statement gets you.

 

[icaruswalks]

Hello aPD,

Out of curiosity, what specialty are you in, and do you actually read the MSPE evaluations? I have some really great comments on my MSPE, but I figure everybody else does as well... this whole MSPE thing is very obtuse, at least on the medical student side of things, and clarifying this point would greatly help my anxiety (and ability to get good sleep at night). Thanks!

Update:

Also, I go to a competitive west coast medical school (M.D.), top 40... Does this also make a difference? I think most of my classmates are pretty stellar, which makes class ranking trickier...

Thanks!

 

[greg1184]

 

[icaruswalks]

Unfortunately, closer to reality than I might prefer. Lol

 

[NotAProgDirector]

Hello aPD,

Out of curiosity, what specialty are you in, and do you actually read the MSPE evaluations? I have some really great comments on my MSPE, but I figure everybody else does as well... this whole MSPE thing is very obtuse, at least on the medical student side of things, and clarifying this point would greatly help my anxiety (and ability to get good sleep at night). Thanks!

Update:

Also, I go to a competitive west coast medical school (M.D.), top 40... Does this also make a difference? I think most of my classmates are pretty stellar, which makes class ranking trickier...

Thanks!

I'm in Internal Medicine.

Yes, the MSPE is one of the most important parts of your application (to me). It's not obtuse at all -- it's an overall summary of your entire performance in medical school.

IMHO, trying to compare medical schools one to another and say that the bottom of one class is as good as the middle of another school's class based on ranking is silly. I've worked with really smart students from "low ranked schools". I've worked with less-than-stellar students from "the school that shalt not be named". School pedegree is meaningless, IMHO.

 

[icaruswalks]

Or I guess more specifically, do the aPDs and PDs read more than just your class ranking? I've heard some mixed things, I know there's a local PD at a community site here who just skips to the last paragraph or so... Is that what the majority of your fellow PDs and aPDs do?

I am also planning on going into internal medicine...

 

[greg1184]

Or I guess more specifically, do the aPDs and PDs read more than just your class ranking? I've heard some mixed things, I know there's a local PD at a community site here who just skips to the last paragraph or so... Is that what the majority of your fellow PDs and aPDs do?

I am also planning on going into internal medicine...

I think you answered your question, it is highly PD dependent. I know of one PD that doesn't even wait for the Dean's letters to start sending out interview (back when they came Nov. 1).

 

[Law2Doc]

... However, clerkship grades are very important in our interview and ranking decisions. I do agree that M1 and M2 grades are much less significant (at least to me)

and hence the class rank isn't particularly meaningful because it's driven by pre-clinical year grades...

 

[Anne2009]

and hence the class rank isn't particularly meaningful because it's driven by pre-clinical year grades...

At my school it's driven more by clinical year grades (honors) unless you didn't pass a preclinical class and had to remediate. Also it's good, great, outstanding, etc. (something along those lines, I don't remember the exact order). Every school is probably unique - It's described in the letter, but it's definitely not something that is very uniform or easy to sort out!

 

[icaruswalks]

aPD, I was wondering, when you read a MSPE/Dean's Letter, what parts do you read besides the "ranking"/quartiles part at the end? Is the rest of the letter even considered? I have some great comments all throughout the MSPE, but not a great ranking. Also, my school's third year rotations, a lot of them only give "honors" or the top grade to 1-2 students/rotation... is that something that is considered as well? Thanks!

 

[gutonc]

aPD, I was wondering, when you read a MSPE/Dean's Letter, what parts do you read besides the "ranking"/quartiles part at the end? Is the rest of the letter even considered? I have some great comments all throughout the MSPE, but not a great ranking. Also, my school's third year rotations, a lot of them only give "honors" or the top grade to 1-2 students/rotation... is that something that is considered as well? Thanks!

I only have to review a small fraction of the number of MSPEs that I think aPD does (probably 10% at the most) but I at least scan through it looking for things other than the rank. I mostly care about the IM comments (and MICU or SubI if they're available).

 

[thecampuslegend]

However, clerkship grades are very important in our interview and ranking decisions. I do agree that M1 and M2 grades are much less significant (at least to me)

Hi aPD, thanks for taking the time to answer our questions - what you do is invaluable for us anxious medical students.

I have a question in regards to "honoring" clerkships. Unfortunately my school does not have "honors" as an option for clerkships - only pass/fail. I believe this puts me at a disadvantage because I really worked my butt of on every rotation and believe I would have honored numerous clerkships. What my school has instead is a "clinical score." Basically they have an evaluation system based on clerkship performance and shelf score that spits out a score on a 70-100% scale. The clerkship performance is based on end of a rotation evaluation with a 1-5 scoring system for numerous factors. Is this something that would make you raise an eyebrow and say, "what in the world is this med school doing, I'm not sure that I can properly evaluate this student" or do you have enough experience with this odd way of reporting to have a meaningful way to understand the score? Any insight is much appreciated, thanks!

 

[NotAProgDirector]

aPD, I was wondering, when you read a MSPE/Dean's Letter, what parts do you read besides the "ranking"/quartiles part at the end? Is the rest of the letter even considered? I have some great comments all throughout the MSPE, but not a great ranking. Also, my school's third year rotations, a lot of them only give "honors" or the top grade to 1-2 students/rotation... is that something that is considered as well? Thanks!

I read the whole thing. And part of the point of the MSPE is to tell whether "Honors" means anything. There are schools out there that only give Honors to the top 10% of the class (UVM comes to mind). Then there are schools that give honors to everyone. And, "the school that shall not be named" gives Honors to people in the middle of the class, and "High Honors" to those at the top.

Hi aPD, thanks for taking the time to answer our questions - what you do is invaluable for us anxious medical students.

I have a question in regards to "honoring" clerkships. Unfortunately my school does not have "honors" as an option for clerkships - only pass/fail. I believe this puts me at a disadvantage because I really worked my butt of on every rotation and believe I would have honored numerous clerkships. What my school has instead is a "clinical score." Basically they have an evaluation system based on clerkship performance and shelf score that spits out a score on a 70-100% scale. The clerkship performance is based on end of a rotation evaluation with a 1-5 scoring system for numerous factors. Is this something that would make you raise an eyebrow and say, "what in the world is this med school doing, I'm not sure that I can properly evaluate this student" or do you have enough experience with this odd way of reporting to have a meaningful way to understand the score? Any insight is much appreciated, thanks!

Yes, this is what the MSPE is all about. Trying to figure out what those grades mean. One of the programs in Florida does this, and gives us histograms of the performance of the whole class. It's important, because in some clerkships an 84% is dead bottom, but in others it's top. We review all of this.

 

[icaruswalks]

Thanks for your feedback aPD! It definitely helps alleviate some of the stress and anxiety about this. I haven't seen a lot about the MSPE in particular on SDN. Hopefully this will help others as well.

So would it be correct, that from what you are saying, the corollary that most program directors are familiar with most of the US MD schools and the type of students they tend to send? I also heard that a lot of this has a lot to do with the quality of the last candidate the program receives from that medical school...

Thanks again!!

 

[gutonc]

So would it be correct, that from what you are saying, the corollary that most program directors are familiar with most of the US MD schools and the type of students they tend to send? I also heard that a lot of this has a lot to do with the quality of the last candidate the program receives from that medical school...

The second one.

PDs aren't/can't be familiar with the vagaries of the grading system in every med school in the country, and how they rank their students. PDs can be familiar with a subset of schools, and the ones that they're most likely to be familiar with are the ones that they've taken students from in the past. So it's a bit of a self fulfilling prophecy that way.

Also, a PD has two - not necessarily overlapping - goals in this process. One is to ensure that all spots are filled. The second is to ensure that they get the best possible candidates. So taking a bunch of applicants that are likely to be "good enough" may be a more desirable outcome than shooting for the stars, getting a few of them, but winding up with a few empty slots (or worse...a few slots you wish were empty).

 

[NotAProgDirector]

The second one.

PDs aren't/can't be familiar with the vagaries of the grading system in every med school in the country, and how they rank their students. PDs can be familiar with a subset of schools, and the ones that they're most likely to be familiar with are the ones that they've taken students from in the past. So it's a bit of a self fulfilling prophecy that way.

Also, a PD has two - not necessarily overlapping - goals in this process. One is to ensure that all spots are filled. The second is to ensure that they get the best possible candidates. So taking a bunch of applicants that are likely to be "good enough" may be a more desirable outcome than shooting for the stars, getting a few of them, but winding up with a few empty slots (or worse...a few slots you wish were empty).

Although I can't keep each school's grading system in my head, each MSPE spells out it's grading system (to some extent). So, most schools tell us via a table or graph what the grade breakdown was for each clerkship. Hence, I can usually get a good sense of how you did compared with your peers. Some schools are better about this than others. Some schools are completely pass / fail, which makes things much more complicated (Lerner SOM is a good example). Some schools, like "the school that shall not be named", don't tell us anything and assume that any graduate is superior to all grads from other schools.

 

[icaruswalks]

Thanks aPD! How much of the interview comes down to the "fit" of the candidate to that of the program too? I was told by some of the PDs from my corner of the country that they put a huge emphasis on getting the right "fit" for their program as well. Would you say this is important for your program and for others on the east coast?

 

[gutonc]

Thanks aPD! How much of the interview comes down to the "fit" of the candidate to that of the program too? I was told by some of the PDs from my corner of the country that they put a huge emphasis on getting the right "fit" for their program as well. Would you say this is important for your program and for others on the east coast?

Here's the thing...you can (usually) train/educate a nice, friendly person. You can't usually make a brilliant d-bag be less of a d-bag.

So yes, fit matters. And there are plenty of programs where brilliant d-bags will fit in perfectly.

 

[majahops]

Here's the thing...you can (usually) train/educate a nice, friendly person. You can't usually make a brilliant d-bag be less of a d-bag.

So yes, fit matters. And there are plenty of programs where brilliant d-bags will fit in perfectly.

True story.