How hard are H in yr 3 & 4.

[jaz]

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It seems like a lot of people that post and a lot of people I talk to say that they did ok the first two years and then got mostly honors third and fourth.
Is it easier to get H in the clinical years, or is it that some of those that don't do so well in books, shine on the wards.
Just wondering....

 

[GO_MEDPEDS]

Although there is grade inflation everywhere, it is still relatively difficult to get an Honors during your third clinical year. Speaking for at least my institution, most rotations have mandated that Honors go to only the top 20% or so, then 30% High Pass or so, and 40% Pass or so, with approximately 5% failing. This, of course, does not hold true for many rotations, but I've heard that many institutions are doing much better at controlling grade inflation over the last several years, so it's probably getting close to this.

Do you see people who got HPs or Ps during their basic science years "step up to the plate" and get Honors their 3rd and 4th year... YES (I sure did!). However, this does not hold true for everyone, nor do people who did well their first couple of years have any guarantee that this will continue. Hard workers tend to be rewarded during the clinical years, whereas brilliant students tend to do better the first couple of years... but this is just a massive generalization.

If you both make a point to read up and study and perform all of the duties assigned or otherwise implied with gusto, then there is no reason you shouldn't have a fair shot at getting an Honors!

Good Luck!

😀

 

[ex-oh-medic]

For the most part: You get honors by working your ass off, not by showing how much you know. This certainly is not normally the case in the first two years. That said, I think it can be hard to get honors in some rotations no matter how hard you work.

 

[melvindo]

At our school half of your grade is from your work or from your attending. The other half is from shelf exams. I heard that it is hard to H without H the shelf exam.
just a thought.......

 

[ktat72]

at our school, it is usually hard to get honors on clinical rotations. i know people who do more work than some of the younger residents and i know they do not get honors because the chief tells everyone that no one will get it. some residents are just so lazy when filling out your eval that they will just check mark everything down to the bottom in the satisfactory column and not write down any comments - happened to me on my OB/GYN rotation. Some clerkship directors will just one one liner in the positive comments and one in the negative comments - that is what happened on my Surgery evaluation.

 

[MD'05]

I'm getting the distinct impression that the better you kiss *ss, the easier it is to honor clinical rotations (provided that you honor the shelf exam). I am speaking from observation, not from personal experience. Be sure to build a positive relationship with the site director AND the rotation director.

 

[lowbudget]

Mmm... Better yet, you get the H if you want to be a doc of that rotation when you graduate. I'm starting to find that out myself.

 

[bobbyseal]

I found grades to be an interesting thing at my school. For the most part, I've found that if you keep up on your stuff, know everything on your patient down to the last time she farted, and show an interest in learning it's recognized as such.

At the same time, you do need to do well on the shelf. No matter what they say about how much the shelf is weighed, it does matter a lot. In general it seems like there's a few people who are just ridiculously good at a clerkship, a few people who are ridiculously bad at it, and then the rest who are pretty much the same. The shelf exam is what separates those mediocre people and puts some into honors, others into high pass.

On the other hand it never hurts to be a thin female with long legs.

 

[nuclearrabbit77]

Originally posted by bobbyseal

On the other hand it never hurts to be a thin female with long legs.

i would like to conduct a study on this topic. i see chicks wearing "f*ck me boots" and miniskirts running around and it's got to help.

this is how i propose to do the study:
1)gather a large sample of 4th year female medical students photos.
2)have a panel of residents and attendings rate them on a scale of 1-10.
3)statistical test for correlation


it'd be so easy to do.........

 

[nuclearrabbit77]

...statistical correlation to their 3rd year core clerkship grades.
forgot to include that bit.

 

[uclacrewdude]

what do you guys mean by "do the reading"? do you get to look at the pt charts prior to rounding the next morning? or are there assigned textbooks and stuff where you read up on the disease of the next morning? do you do your own research like online for how to do certain procedures? whats the deal with that?

 

[GO_MEDPEDS]

This would be my suggestion concerning how much and what you should read to get an Honors... (this is provided that you have a reasonable patient load and are doing a rotation that will encourage student participation):

1. You should know your patient's chart better than anyone else on your team. You don't have to have it memorized down to the date for each surgery (unless you are on Surgery and they are very demanding), and you don't have to be able to rattle off the patient's entire medical history off the top of your head. However, you are the "expert" historian when it comes to that patient... you shouldn't be "surprised" by factoids that the interns, residents, or attendings bring up, and you should be able to quickly remind them of necessary information.

2. You need to read whatever necessary to have a sound understanding of the patient's disease process. Although no one would expect you to have a complete understanding of Pneumocystis carinii pneumonia in your AIDS patient the second he/she presents (though they may throw out a few questions just to see what your basic knowledge is), they will certainly expect you to be able to answer questions on follow-up days. You should try to review a little bit of general medicine every day (i.e. medicine recall, blueprints, palm resources, whatever), and then make sure that you read about a patient's specific condition as soon as possible (certainly by the next day).

3. Journal articles, case reports, and EBM should also be incorporated. This is not to say that you have every piece of literature in your hand right after you see the patient, but while you are researching the patient's condition after he/she has presented, you should concurrently bring up 1-2 pertinent studies, articles, etc. Although Up-To-Date is wonderful for a general reference, these articles should be the original studies/case reports that were drawn upon by Up-To-Date (i.e. don't rely on Up-To-Date to be your only journal reference).

4. Read the news (or at least glance at the Yahoo!, Google, MSN, etc. version). It is also important to have at least a basic knowledge of any major topics in medicine/health, politics, or other breaking stories. A truly exceptional student is not only able to take care of patients and be a walking encylcopedia of medical knowledge, but they also need to have some understanding of the world around them. Also, this is a great way to impress your attendings with your political savvy (even if they don't agree with you, they will appreciate your ability to add to discussions.) I don't know how the rest of you feel, but it seemed as if these topics were brought up almost just as often as patient care, and it couldn't hurt to have some knowledge to add to these conversations as well...

This may seem like quite an impressive list, but I really think it's manageable if you just force yourself to stay on top of things and selectively read what seems important. I don't think anyone would expect you to be a world's expert during rounds, but it is important to be able to hold your own and have at least demonstrated that you know how to find these different sources of information.

Good Luck!

😀

 

[docuw]

At our school you have to get Honors on the Shelf to get an honors grade overall. Honors on the shelf is set to be a score in the top 10% based on how well students in the class ahead of us did on the same rotation at the same time of year (to keep it fair for people who take FP without every having had OB or Peds for example).

You also have to get honors on your evals, but that is pretty easy. You just have to work hard. Anyone can get honors on these. The difficulty is getting honors on your shelf.

It kind of makes it frustrating knowing that you can completely kick ass on the wards, and still no honor. Almost an incentive to slack off on the wards.

 

[irlandesa]

I have found that most residents are not particularly strong in quizzing you during rounds or doing much teaching during that time, and other than psychiatry and 2 weeks of Transplant Surgery, I've yet to round with an attending (except for our weekly rounds with the General Surgery chair, who picked a case to teach the residents and students and pimped us a little). In Surgery, the best preparation you can do is to know what someone is coming in for and in the beginning know at least the basics about that patient's condition from Surgical Recall (or Up To Date is fine too). Recall is a must for answering questions. For psychiatry, preparing good, short didactic presentations is an essential part of the rotation at most hospitals, and most review books and Psych texts are sufficient. This is in addition to more obvious advice like know your patients, know their vitals every morning, etc.