Grades at med school

[greens]

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Hey everyone,
I'm a kiwi med student (New Zealand if most of you don't know the slang) and I have a few questions to ask US med students about grades. First off, are the majority of schools on a pass-fail basis for all four years or only for the clinical years like they are over here? Second, if you do get grades like A, A-, B+,etc. in med school especially pre-clinic years what is considered a good and competive grade for residencies in the states? Any info would be much appreciated.

 

[Law2Doc]

Hey everyone,
I'm a kiwi med student (New Zealand if most of you don't know the slang) and I have a few questions to ask US med students about grades. First off, are the majority of schools on a pass-fail basis for all four years or only for the clinical years like they are over here? Second, if you do get grades like A, A-, B+,etc. in med school especially pre-clinic years what is considered a good and competive grade for residencies in the states? Any info would be much appreciated.

While everything gets considered, pre-clinical grades tend not to have a huge impact on residencies. The Step 1 scores and clinical year grades tend to make or break you. If you got AOA and honored everything during the early years, that wouldn't hurt, but generally, if you pass everything the first couple of years, grades will have pretty nominal effect as compared to other stuff on the residency app. Most US med schools are some variation of P/F, with the best students getting Honors. But there are a handful of US schools that still use letter grades. How competitive a US student is for residencies depends a lot on what specialty they are looking at. To just get any residency isn't that hard for a US allo student. There are more residency slots than US allo students, and so 94% or so match and generally the rest find something outside the match (at least for a year). The competition comes in if you want a competitive specialty, or if you want a specific geographical location, or if you want to be at a certain institution which is the mecca for your desired specialty. Folks coming from outside the US system tend to have lower match percentages, but that may be a function of board scores and other credentials; it may also be a function of bias of a system designed to train US doctors for US healthcare needs.

 

[Anka]

While there's been a trend toward more of medical school being pass/fail, I think most schools still use some grading system. Ours is pass/fail for the first semester, then honors/pass/fail (usually top 20-30% getting honors, and only 0-1 people failing) for a year after that, at which point we start our clinical rotations which are honors/high pass/pass/fail (think A B C F). Preclinical grades are less important for residency, although for the most competitive residencies might be factored in. Clinical grades during the required clerkships are extremely important. Not that you have to get honors in everything to match well, but honors in medicine and surgery are important. Step I scores are extremely important, especially weighted for the amount of time you actually spend taking the test.

I'm not sure how it works for FMGs, though.

Best,
Anka

 

[Tired Pigeon]

Really outstanding performance (honoring everything) in pre-clinical may be somewhat helpful, and truly atrocious performance (multiple failures & remediations; having to repeat a year for academic reasons) in pre-clinical can be a problem. However, the ultimate measure of how much you've taken away from the pre-clinical years is your Step 1 score.

 

[greens]

Thanks for the help guys. My pre-clinical years saw scores between A, mostly A-, and B+, and only one B-. So far last year I got honours in Emergency Med, Psych, and Surgery. Pass in Gen Med., Anesthetics, Ortho, and Family Practice. (We only have Distinction, Pass, and Fail). Hope to get Honours in at least Peds, Specialty Surg, and O&G this year. So I was just wondering where I stood in comparison

 

[PeepshowJohnny]

Thanks for the help guys. My pre-clinical years saw scores between A, mostly A-, and B+, and only one B-. So far last year I got honours in Emergency Med, Psych, and Surgery. Pass in Gen Med., Anesthetics, Ortho, and Family Practice. (We only have Distinction, Pass, and Fail). Hope to get Honours in at least Peds, Specialty Surg, and O&G this year. So I was just wondering where I stood in comparison

I'd consider your preclinical grades "good", but it'd be more useful to compare them to the rest of your class. Are you top of the class? Middle? Surely not bottom. But I don't know how strict or lenient they are.

As for rotations, honoring surgery is good, emergency mdicine as well. "Honoring" general medicine is something that a lot of residency directors like to see but it's by no means required. All the honors you can get are good, but none matter as much as medicine and surgery. I.E. Ob/Gyns don't care that you honored ortho and radiologists don't care you honored peds. What are you intersted in for residency by the way?

 

[Blade28]

Unfortunately, for most FMGs, one of the most important factors is the USMLE - your Step 1, 2 CK, etc. scores will be used heavily.

Your grades (via your transcript) are much less importantly, sadly.