Grading and evaluation for the 3rd year rotations at downstate are in line with the industry standard. Most of them have a shelf exam worth 40-60%, a few have an oral exam, observed clinical skills exam or optional final project. Evaluations make up the balance. The comments you get play into the grade for the course and also show up in your dean's letter.
Most people feel that there is a certain arbritrary/subjective-ness built into the 3rd year. You are constantly thrust into the role of the new guy and you have to find some strange balance of being an observer/student/participant. The amount of work and effort you put in does not always correlate with the grade you get out. Expectations are not always clear.
That said, I've personally never had any problem with the evaluations. I've certainly heard stories about sites, services or attendings that should be avoided. You get the feeling that despite what they tell you, your final grade tends to line up with your shelf score more than anything else.
So you do your best, try to know your patients, know your stuff and be a helpful member of the team. This year most everyone I know was happy with their match, so it all works out. 😀
