How bad is it if you only get Passes (not Honors or High Pass)?

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BoxingTheStars

chase this light with me
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Speaking about preclinical years here. Does this look bad when you apply to residency programs? If only the top 25% of the class can get an honors or high pass, it seems likely that many students will ever only get P's...
 
IMHO, almost irrelevant. If you ace the boards and do well in your clinical years, I doubt it matters. When we interview people for residency, I don't even look at the preclinical grades.

Having said that... there is the "almost". If you're not doing well in preclinicals, it would be expected that board scores would also not be stellar. If someone doesn't really grasp anatomy, physology, path etc. prior to the wards, no reason why they would suddenly start throwing down on rounds, clinical lectures or shelf exams.
 
You also need to keep in context the average board score at your school. If you're at a school which has a history of high board scores, being average in your preclinical classes (i.e. getting a pass) can still mean a respectable (220 to 230+) board score depending on where the average board score sits.
 
Yeah I know the boards are important and I feel I'll be able to do well on them. I'm just concerned that 75% of the class will end up with only a P (assuming no one fails). The school has excellent residency placement though, so it just felt like something wasn't adding up. I mean it's a pretty competitive school and a lot of bright people go there, so I worry I won't be able to break into that top quarter (at least not all the time....) but if a lot of students still match ridiculously well then I'm going to go ahead and believe it's not that big of an issue.
 
I mean it's a pretty competitive school and a lot of bright people go there, so I worry I won't be able to break into that top quarter (at least not all the time....) but if a lot of students still match ridiculously well then I'm going to go ahead and believe it's not that big of an issue.

This is an excellent insight. The key is to make sure your own stress/anxiety over the possibility of not being in the top quartile doesn't hamper your performance.





One you have to also keep in mind is that although preclinical grades are hard (<25% say get honors) -- > clinical grades will be harder since it will be based on clinical assessment and examinations.

AOA (basically the medical school honor society) is restricted to ~top 10-12% of each class, this is usually assigned based on clinical grades. Assuming you have nothing else drastically wrong with you personality wise -- these people generally get to write their own ticket. It's much much harder to get AOA than to be at the top of your class during preclinical years. In some sense, its a slightly different skillset. Are the preclinical superstars a little ahead of the game? definitely. That medical knowledge they have crammed in that the rest of us forgot long ago I'm sure makes the clinical years easier (they recognize zebras when the rest of us see horses and look like superstars) , but it isn't everything.

Bottom line, most people will settle into a groove during the preclinical years and then into a similar groove during the clinical years. And you will mostly all match. This groove will be dependent on the balance that you decide on between killing yourself to do better, and doing just enough to get by -- there will be a point of diminishing returns and most people learn to be comfortable at that point.

Yes, it's a bit fatalistic. But its like how many of us grew comfortable that we weren't going to be concert pianists or American Idol stars -- just doesn't stop us from playing the piano or belting out tunes in the shower.

smile -- and have fun. Things get better the further along in med school you get...


...and then the fear kicks in when you realize you're starting internship in a month hehe.


best of luck
 
Thanks for the post...both realistic and somewhat comforting...

I just had to go through this debate when I had to choose listening to Goljan when jogging (like some colleagues do) or listening to music that I love. The Arizona heat can be rough enough...Goljan on top? LOL

It is all about the balance...

This is an excellent insight. The key is to make sure your own stress/anxiety over the possibility of not being in the top quartile doesn't hamper your performance.





One you have to also keep in mind is that although preclinical grades are hard (<25% say get honors) -- > clinical grades will be harder since it will be based on clinical assessment and examinations.

AOA (basically the medical school honor society) is restricted to ~top 10-12% of each class, this is usually assigned based on clinical grades. Assuming you have nothing else drastically wrong with you personality wise -- these people generally get to write their own ticket. It's much much harder to get AOA than to be at the top of your class during preclinical years. In some sense, its a slightly different skillset. Are the preclinical superstars a little ahead of the game? definitely. That medical knowledge they have crammed in that the rest of us forgot long ago I'm sure makes the clinical years easier (they recognize zebras when the rest of us see horses and look like superstars) , but it isn't everything.

Bottom line, most people will settle into a groove during the preclinical years and then into a similar groove during the clinical years. And you will mostly all match. This groove will be dependent on the balance that you decide on between killing yourself to do better, and doing just enough to get by -- there will be a point of diminishing returns and most people learn to be comfortable at that point.

Yes, it's a bit fatalistic. But its like how many of us grew comfortable that we weren't going to be concert pianists or American Idol stars -- just doesn't stop us from playing the piano or belting out tunes in the shower.

smile -- and have fun. Things get better the further along in med school you get...


...and then the fear kicks in when you realize you're starting internship in a month hehe.


best of luck
 
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Speaking about preclinical years here. Does this look bad when you apply to residency programs? If only the top 25% of the class can get an honors or high pass, it seems likely that many students will ever only get P's...

And yet they all become doctors. I think you just answered your own question.
 
While only 25% or whatever get H/HP in any one class, it changes a lot from class to class. Once you get into your second year, and especially once you get on the wards, everyone is starting from scratch, we're all overwhelmed and in over our heads. So the kids you see getting honors in your biochemistry class may not get one in anatomy, and may not get one on their medicine clerkship. I think a pretty decent number of kids will get good grades in at least a couple of courses, usually the courses they're interested in and thus put some work into.

At least med school is pretty fair that way, you get what you put in: during first and second year, that means memorizing everything under the sun, and during the clerkships, that means being nice, hardworking, and doing your reading when you get home.
 
And yet they all become doctors. I think you just answered your own question.
Ya, but some of them become plastic surgeons, rad oncs, dermatologists, orthopaedists at top programs and some of them become internal medicine in a residency program located behind the local dive bar.
 
Ya, but some of them become plastic surgeons, rad oncs, dermatologists, orthopaedists at top programs and some of them become internal medicine in a residency program located behind the local dive bar.

And then that internist will work his ass off, match in GI, and make more money than the plastic surgeon in half the hours.
 
We only have H/P/F, so not quite the same, but generally similar...

Here, pre-clinical grades only matter for AOA, and even that is weighted heavily towards clinical grades. Otherwise, there is no correlation that I've seen in our Match data that would say getting honors in pre-clinicals predicts matching into successful programs. For that matter, and it may be blasphemy on SDN to say this, but CLINICAL grades and Match success aren't altogether linked either. I've seen plenty of people ride the Pass train through pre and clinicals, and get into top-notch programs. Granted, some of them had 265 Step Is, so your results may vary.
 
I have been discussing and researching this issue quite a bit. Here are my takes, let me know what you think:

1) most PDs (on SDN, research papers, etc.) rank preclinical grades fairly low on the totem pole. however step 1, clinical grades, LORs, research, and quality of school seem to make a big difference for residency selection.

2) getting Hs will obvioulsy make your class rank better. At our school, your class rank is not indicated on anything (dean's letter..which they got rid of..now they do MSPE-medical student performance eval) unless you request it (and it would be foolish to request if you are not top 20%.
However, graduating summa cum, cum laude, etc. will make your PD realize that you are in the top percentile (this is per the academic office at my school), but since we apply during 4th year, i am not sure how this information is relevant.

3) class rank is also important for AOA...but I think I posted in here earlier..only 12-15% get inducted...which in a class of 150 is only 18-20 people. AOA is big for some programs though...and i hear clinicals have way more weight...so doing well 3rd year comes up again.

4) assuming this info is true, it will be hard to differentiate between a person who got all P's with an 85% and someone who got all Ps with a 70% throughout medical school. These students with the same USMLE scores and clinical grades should be of similar competitiveness.

5) I think it is important to do well in classes...however it is about what you want also. I am learning to learn as much as I can to be a good physician. If I miss a point on an exam because i forgot with Interleukin causes neutrophil aggregation, oh well....not a huge deal, but will try to remember next time. Forget about grades and comparing (unless ultra competitive is your goal) and learn as much as you can.

JMHO as an M2 who has been getting all Ps....I think the majority of the class is in this boat.
Anyone want to rip me a new one?
 
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I feel so relaxed after reading ur posts.. 🙂 y r all med students kick ass ?!!?
 
I feel so relaxed after reading ur posts.. 🙂 y r all med students kick ass ?!!?

Just an M2 here...just giving you my opinion and things that I have heard...your best bet is probably to listen to more experienced forum members (m4s, residents, attendings, etc.)

dragonfly is a prime example...i think he is an attending
 
IMHO, almost irrelevant. If you ace the boards and do well in your clinical years, I doubt it matters. When we interview people for residency, I don't even look at the preclinical grades.

Having said that... there is the "almost". If you're not doing well in preclinicals, it would be expected that board scores would also not be stellar. If someone doesn't really grasp anatomy, physology, path etc. prior to the wards, no reason why they would suddenly start throwing down on rounds, clinical lectures or shelf exams.


This makes me feel better. I am in a class full of great future doctors and to be honest, its difficult to compete, especially when 1-2 questions wrong can drop you easily 15 percentile points. I have been busting my ass M2 though to develop the work ethic for boards time. hopefully it pays off.
 
I feel so relaxed after reading ur posts.. 🙂 y r all med students kick ass ?!!?

If you think relaxation and kicking ass are the status quo then clearly you don't read this forum much.
 
Seeing as how some schools are on a number system (yikes), some are on P/F, some are on a H/P/F, some on a H/HP/P/LP/F, and some on weird A/Q/S/T/B/E/C/E/B/C/F/H/J/N scales, and some are on Hot/Ok/Bag It/Really Hideous,

no, it doesn't really matter. Doctors on residency admissions have better things to do than sort out your classroom grades. Unless your school goes by the last type of grading I mentioned, in which case if you fail you are screwed (not in a sexual sense of course, seeing as how one who would achieve that grade would be very ugly).
 
Seeing as how some schools are on a number system (yikes), some are on P/F, some are on a H/P/F, some on a H/HP/P/LP/F, and some on weird A/Q/S/T/B/E/C/E/B/C/F/H/J/N scales, and some are on Hot/Ok/Bag It/Really Hideous,

no, it doesn't really matter. Doctors on residency admissions have better things to do than sort out your classroom grades. Unless your school goes by the last type of grading I mentioned, in which case if you fail you are screwed (not in a sexual sense of course, seeing as how one who would achieve that grade would be very ugly).

Your posts always crack me up man! I love the avatar too!

I just wanted to remind that grades do matter for AOA if you are wanting to be that top 12%.
 
We only have H/P/F, so not quite the same, but generally similar...

Here, pre-clinical grades only matter for AOA, and even that is weighted heavily towards clinical grades. Otherwise, there is no correlation that I've seen in our Match data that would say getting honors in pre-clinicals predicts matching into successful programs. For that matter, and it may be blasphemy on SDN to say this, but CLINICAL grades and Match success aren't altogether linked either. I've seen plenty of people ride the Pass train through pre and clinicals, and get into top-notch programs. Granted, some of them had 265 Step Is, so your results may vary.

Yay 🙂
 
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