Honors in one rotation, but Pass in another...

[otacon88]

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I'm honestly shocked at my grade. I received Honors in my home rotation, but just got my grade in my away rotation and got a Pass. This is a very highly regarded program nationally known and very competitive, but I still don't understand how my performance can go from an Honors to just a Pass.

How will this affect me? Should I apply to more schools?

 

[gman33]

I guess you know this by now, but clinical grades are a crapshoot.
Some people may look at your grades and figure that your home institution gave you an honors just to not screw your app and the away program grade is more reflective of your true performance.

I'm not saying this is the case, just repeating what I've been told by some PD's.

Doesn't really matter at this point, since there is nothing you can do about it.

 

[otacon88]

I guess you know this by now, but clinical grades are a crapshoot.
Some people may look at your grades and figure that your home institution gave you an honors just to not screw your app and the away program grade is more reflective of your true performance.

I'm not saying this is the case, just repeating what I've been told by some PD's.

Doesn't really matter at this point, since there is nothing you can do about it.

well I think that's complete bull****! I worked twice as hard on my away, went to more than half of the resident conferences, participated in the extra things that were going on, scored the highest grade on the end of the rotation test in the class and all I get is a Pass...

 

[Apollyon]

went to more than half of the resident conferences,

What, 4 conferences and one journal club, and you went to 3? Free meal at journal club?

I'm just sayin' - you say you worked hard, but why weren't you at every conference? Personal impressions are least accurate.

At least where I was when I was a med student and resident, the same people sat in the same seats at every conference, so we noticed when someone there wasn't a regular.

 

[otacon88]

What, 4 conferences and one journal club, and you went to 3? Free meal at journal club?

I'm just sayin' - you say you worked hard, but why weren't you at every conference? Personal impressions are least accurate.

At least where I was when I was a med student and resident, the same people sat in the same seats at every conference, so we noticed when someone there wasn't a regular.

Not making any excuses, but the only times I didn't go to conferences was when I had a shift during conference time or I just got off an overnight shift and I could hardly even drive (that was only once).

But besides that, on all my evaluations everyone said I had amazing work ethic, strong knowledge, excellent ddx and plan, could handle many patients at once, good procedural skills, etc - so I don't understand how that performance is only a Pass. I'm more perplexed than anything.

 

[pseudoknot]

Apply to more programs and do your best with interviews. Consider talking to the clerkship director where you got a pass, but ONLY if you make it absolutely clear that you just want to understand your weaknesses better for self-improvement, not that you're trying to change the grade.

 

[jstuds_66]

Not making any excuses, but the only times I didn't go to conferences was when I had a shift during conference time or I just got off an overnight shift and I could hardly even drive (that was only once).

But besides that, on all my evaluations everyone said I had amazing work ethic, strong knowledge, excellent ddx and plan, could handle many patients at once, good procedural skills, etc - so I don't understand how that performance is only a Pass. I'm more perplexed than anything.

I haven't actually received a grade from my away yet, but I have a feeling it'll be no higher than a pass. I actually found out that one of the residents didn't like me and wrote some bad stuff about me in my reviews. (There went that great SLOR I was hoping for!) I just wish he/she hadn't told me to my face that I was doing a great job. Just apply broadly and hope for the best.

 

[Redrox]

Life isn't fair.

In many schools, students can only get grades of pass or honors but on the SLOR there's a box to check for high pass. Maybe you picked up one of those, you could ask your ERAS coordinator to take a look at the SLOR and check.

The programs I rotated at only gave Honors to 5% of the students they saw. Finding that out made the sting of high pass a little softer. Lot of excellent candidates are going to get passed over that way. It's all a crap shoot.

 

[gman33]

I'll probably be posting the same thing when I realize I got a pass on my away. 👎

In any case, don't worry about it.
A pass may be a decent grade from that site.
It should say on the SLOR what the breakdown of grades are for the year.

Just apply where you want to go, and see what happens.

 

[gman33]

Another point is that grading an EM rotation is pretty tough.
You work with so many different people, it's hard for them to get a good feel for your work.

Some of the attendings, you may only work with them 1 shift and only spend a few minutes total presenting patients to them.
How can they really evaluate you? What if 1 case is outside your comfort level? That might be the only thing they remember.

It sucks that one bad or medicore eval from 1 person might wreck your grade.

I know I got a few luckwarm evals on my last rotation. The rest were pretty good, so hopefully that amounts to a good grade.

Whatever. I can't really control it anyway.

 

[ShanFan]

Just found out that the same thing happened to me. 😕

 

[meowdoc]

med school sucks

 

[Redrox]

Some of the attendings, you may only work with them 1 shift and only spend a few minutes total presenting patients to them.
How can they really evaluate you?

Rotating in July when interns are a distraction (rightfully so) makes it even harder to stand out and impress.

Really is like we're not evaluated on anything more than an ability to make strong first impressions. Hard to explain the frustration of this to family, friends, or colleagues in other fields.

But yep, life aint fair and I can't think of a better system. Some places have you follow an "EM mentor" for the majority of your shifts which is nice for letters of rec but more difficult if you're trying to meet more than just one faculty.

 

[deleted65604]

Really is like we're not evaluated on anything more than an ability to make strong first impressions.

But yep, life aint fair and I can't think of a better system.

I agree. In recruiting ER residents, we tend to reward talkative, gregarious people who can fill in the awkward silence with interesting conversation.

This skill is useless on a busy ER shift.

I prefer residents who can move the meat, get the charting done and answer most of their own questions through utilization of available resources. If I hear about their personal life too much on a shift, they aren't seeing enough patients.

 

[Arcan57]

I agree. In recruiting ER residents, we tend to reward talkative, gregarious people who can fill in the awkward silence with interesting conversation.

This skill is useless on a busy ER shift.

That is a mountain of truth packed into two sentences. And the talkative, gregarious students wonder what the hell happened when residency starts.

On a slight tangent, I think we use extroversion as a surrogate marker for all sorts of learned skills that are useful in the ED.Skills like quickly establishing rapport or being appropriately bold tend to be associated with extroverts. Collectively, it seems we find it easier to discipline cowboys than motivate timid residents.

 

[pinipig523]

Life isn't fair.

Even as a resident, you still get those crazy evals that don't make a whole lot of sense. I recall an eval that I got as a 3rd year resident that perplexed me for some time.

It happens and it sucks. Just pick yourself up from it and learn from whatever you may have made mistakes on.

Perhaps, you pissed off an attending or resident or you just rubbed them the wrong way. I've given not so great evals on MS4 who I felt just don't get the County vibe. Not that they're bad students, but just not right for the program in my opinion.

 

[meowdoc]

Does anyone actually take the individual components of an evaluation seriously? For example, at one program they use cards that include things like knowledge and data interpretation along with a scale from 1-5 (5 is the best, 3 is average, 1 is like wtf). If you didn't think a student fit in with your program, would you just go down the line and give them all 3s, or would you think through each one and give the student appropriate marks in each category?

 

[Apollyon]

I've given not so great evals on MS4 who I felt just don't get the County vibe. Not that they're bad students, but just not right for the program in my opinion.

Wow...that sounds kinda dickish. You personally don't think they fit, irrespective of ability, so you sandbag them?

I remember two med students that rotated with us (who were married, which I didn't know, although it made sense after I found out) when I was a resident (not outside rotators - with the med school), and they were out-f******-standing, and my evals of them reflected same. She went into Peds, and he into ophtho. I never ever thought to give them less than they deserved just because I thought they "didn't fit".

 

[pinipig523]

Wow...that sounds kinda dickish. You personally don't think they fit, irrespective of ability, so you sandbag them?

I remember two med students that rotated with us (who were married, which I didn't know, although it made sense after I found out) when I was a resident (not outside rotators - with the med school), and they were out-f******-standing, and my evals of them reflected same. She went into Peds, and he into ophtho. I never ever thought to give them less than they deserved just because I thought they "didn't fit".

Not dickish.

If a student is good but complains of the patient population or if the student complains that they have to be the transport as well as the patient's primary in the ER - that's a ding. If it seems like they're unhappy in the ER - the eval reflects it. If I don't think they're going to enjoy it in a County setting, the eval reflects it. You don't want to work with someone who's miserable.

I don't ding their knowledge or professionalism - but maybe their interpersonal interaction and it will be reflected in the written part of the eval form.

I give fair evals and I'm not as hard an evaluator as some people I know. Most of the time, if you get along with me - you get 4s and 5s (out of 5).

 

[pinipig523]

Does anyone actually take the individual components of an evaluation seriously? For example, at one program they use cards that include things like knowledge and data interpretation along with a scale from 1-5 (5 is the best, 3 is average, 1 is like wtf). If you didn't think a student fit in with your program, would you just go down the line and give them all 3s, or would you think through each one and give the student appropriate marks in each category?

Even if the student does not fit the program - it is wrong to give them 3s down the line just because he/she does not fit.

I would write in the written portion of the eval form why the student doesn't fit the particular program but still mention the good parts about the student. The last thing you want to do is ruin the student just because he/she does not fit in 1 particular EM program or setting.

Some evals have "would you like to work as a colleague?" portion.

 

[Apollyon]

Not dickish.

If a student is good but complains of the patient population or if the student complains that they have to be the transport as well as the patient's primary in the ER - that's a ding. If it seems like they're unhappy in the ER - the eval reflects it. If I don't think they're going to enjoy it in a County setting, the eval reflects it. You don't want to work with someone who's miserable.

I don't ding their knowledge or professionalism - but maybe their interpersonal interaction and it will be reflected in the written part of the eval form.

I give fair evals and I'm not as hard an evaluator as some people I know. Most of the time, if you get along with me - you get 4s and 5s (out of 5).

That's not what you said.

You said: "Not that they're bad students, but just not right for the program in my opinion." - so you give them worse evals. Then, in this next post, you say it's for legitimate reasons, like professionalism. The prior post, where you said "Not that they're bad students" says you are specifically giving them bad grades based on your feeling that they're not right. Which is it? The first is unethical and indefensible. The second is legitimate - a student complaining about having to do work is showing unprofessionalism, and that deserves to be docked.

But you clearly stated that, if you felt that the person wasn't "right", then you would mark them down. That is different from a student not willing to work in a more austere/"county" environment.

I believe I now understand your point, but I feel you were not clear in the manner in which you stated it.