How important are Third Year grades?

[fatboy]

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As the saying goes, "long time lurker, first time poster." First off, I just wanted to thank you for all the posts about pathology!! They have been very insightful and entertaining. As I now consider myself a seasoned MIII, I especially enjoyed the anti-clinical medicine thread. In fact, I was wondering if anyone was interested in starting a movement to take the physical exam findings out of the "Objective" and place them in the "Subjective" portion of the SOAP note where they belong! I will reserve actual recruiting for this movement for a later date...

At any rate, my question to the forum veterans is, "How important are clinical grades to matching at a competitive pathology program?" Here's my situation: I thoroughly enjoyed pathology as an M2 (could not put down Robbins), did one year of path research in med school (which confirmed my desire to pursue it as a career), did well on Step One (>240), attend a non-top 20 med school, and am HATING clinical medicine and will most likely only receive a "pass" for all my third year clerkships (my school does not have "high pass"). My written evals are good, just not stellar and not enough for "honors." I desperately want to pursue an academic career in pathology and understand that to do so, it would probably be in my best interest to train at a big name institution (MGH, Brigham, Johns Hopkins, UCSF, Stanford etc). So what do you think? Is it imperative that I honor at least one rotation to be a competitive applicant? Please tell me "no" because the thought of sustaining more fake enthusiasm for the rest of the year could put me over the edge 🙂

PS
I apologize if this has been answered already and thank you all for your input!!!

 

[Brian Pavlovitz]

As the saying goes, "long time lurker, first time poster." First off, I just wanted to thank you for all the posts about pathology!! They have been very insightful and entertaining. As I now consider myself a seasoned MIII, I especially enjoyed the anti-clinical medicine thread. In fact, I was wondering if anyone was interested in starting a movement to take the physical exam findings out of the "Objective" and place them in the "Subjective" portion of the SOAP note where they belong! I will reserve actual recruiting for this movement for a later date...

At any rate, my question to the forum veterans is, "How important are clinical grades to matching at a competitive pathology program?" Here's my situation: I thoroughly enjoyed pathology as an M2 (could not put down Robbins), did one year of path research in med school (which confirmed my desire to pursue it as a career), did well on Step One (>240), attend a non-top 20 med school, and am HATING clinical medicine and will most likely only receive a "pass" for all my third year clerkships (my school does not have "high pass"). My written evals are good, just not stellar and not enough for "honors." I desperately want to pursue an academic career in pathology and understand that to do so, it would probably be in my best interest to train at a big name institution (MGH, Brigham, Johns Hopkins, UCSF, Stanford etc). So what do you think? Is it imperative that I honor at least one rotation to be a competitive applicant? Please tell me "no" because the thought of sustaining more fake enthusiasm for the rest of the year could put me over the edge 🙂

PS
I apologize if this has been answered already and thank you all for your input!!!

I don't think third year grades really mean too much--especially for Pathology program directors. You're clearly a very competitive candidate already; not being a program director ( 🙂 ), I think your year of research will probably hold more weight than third year grades.

Get good letters--one from your research year, perhaps. In addition, I'd try to get at least one from a pathologist. As you may already know, the world of pathology is not that large.

Other than that, since you obviously have real enthusiasm for pathology, programs will (or should!) pick up on that.

 

[AngryTesticle]

You don't need honors grades but they definitely will help if you have them. But still try to put some effort and maybe you'll get lucky and score an Honors grade or two. That being said, a mixture of high passes and pass grades should be OK. Plus, it's the comments in the Dean's Letters that are more scrutinized because the actual letter grade you get is pretty subjective and the grade distributions from school to school vary widely. I've seen several strong applications from folks where the clinical grades lacked Honors grades. In fact, when I do see Honors grades and a lot of them, my radar perks up...but that's just me. Personally, I like to see transcripts riddled with passes and high passes. That tells me that the applicant is "keepin' it real", is "down to earth", and "laid back and easy to work with" instead of being some super-competitive, ass-kissing, tightwad, panties in a bunch, gunner monkey. Personal statement...meaningless. I literally read the first paragraph and decide, "yeah sounds like the same **** I wrote...moving on." If it's bad, I have a good laugh and then don't think anything more of it. (Why the hell do applicants have to write these stupid things anyway?!?!?)

More about grades being variable and subjective...when I see a person who got Honors in a core clerkship like medicine, peds, or surgery, I go straight to the histogram to see what percentage of the applicant's classmates got honors. For instance, if I see that the applicant got honors in medicine but so did half of his/her classmates (and I won't mention which school that is), I move right on. Now, if the applicant got honors and only 5% of his/her classmates got the same grade, I conclude that the person's fellatio and rimjobbing skills are unparalleled.

But these grades aren't all that important to me in the grand scheme of things. I actually pay much more attention to the comments made in the Dean's Letter. Basically, I look for comments testifying to the person's work ethic and an indication as to how easy the person is to work with. Other than that, I skim through the letters which all kinda look the same anyway. If the person is MD/PhD, I scrutinize the LOR from the PhD mentor. But even after that, that only gives me a very rough indication of the person.

And this is where the interview comes in. I'd say 90% of my opinion of a person comes from actually meeting and talking with the person. I don't like being in the position of evaluating people especially in a situation where you're supposed to pimp me for honest information. Nevertheless, I have what's called a subconscious mind...and this part of my brain can't help but form opinions especially if it perceives "red flags." From talking to the other residents, it's amazing the kinds of opinions that people can have of you even after meeting you for a short while. It's kinda scary. What's even scarier is that we could be getting the wrong impression. Moral: Interviews are very important...don't f*ck it up!

So that being said, when it's all said and done with and you're on the interview trail...f*ck the grades. But now you're in the situation where you can do something about your grades and hell, if you get some honors sprinkled in your clinical transcript, that can only help.

 

[AngryTesticle]

I realized that my comments regarding high pass grades don't apply to you since your school has the honors/pass/fail system.

Well, that's unfortunate. Try to get an honors grade or two in some of the easier rotations. For instance, Family Practice or Psych. Getting an Honors grade in FP probably involves you seeing a lot of patients, empathizing with them, crying when they cry, holding their hand when they're down, providing counsel, empathizing some more, being nice and polite to your patients, not telling your preceptor that you're going into pathology, not telling your preceptor that you hate clinical medicine and you hate people...living people...etc etc. Of course, you drive home everyday at 5 pm thinking, "What the f*ck was that all about???"

 

[cytoborg]

Get good letters--one from your research year, perhaps. In addition, I'd try to get at least one from a pathologist.

Agreed. I do think glowing 3rd yr evals help - they certainly don't hurt - but good-not-great evals aren't going to sink you. Just keep in mind that you're going to need letters - a path letter, a letter from your research mentor, and hopefully one letter from a clinician. So all you really need is to find one clinical attending who loves you. If you absolutely can't, then 2 path letters would work, too (of course, make sure you shine during your path rotation 4th year).

 

[deschutes]

With a user ID like "fatboy" I feel inexplicably compelled to respond... 😉

Like AT says, this is the time to get some nice comments on your evals while you're still going through the rotations (the sick part is of course that this is entirely random, and depends more on whether your preceptor likes you than on whether you were actually any good... but we all know this so I won't belabour the point).

The only thing I can think of to add apart from acting like you're going to go into Psych while on Psych and FP while on FP, is that I phoned the clerkship coordinator for surgery and specifically requested to work with a preceptor whom the senior clerks had recommended and who was easygoing and would let me "do stuff". I ended up getting a High Pass without ever having to round before 7.

In the grand scheme of things your letters will matter much more in the paper application.

I actually haven't looked at the M3 grades of the people I've taken to lunch in much detail (partly because I was relying on the admissions committee to have weeded through that stuff already - if I had more say in the matter than just taking people to lunch I would probably pay more attention!)

Where they're from, research/publications, interests/hobbies, Step 1/Step 2 scores for academic interest 😉 and LORs. I've seen maybe one interesting personal statement of the 15 or so that I've looked at.

(As an aside, evaluating applicants in writing is really hard! There's this whole vibe thing going on that just doesn't translate well onto paper...)

 

[beary]

At any rate, my question to the forum veterans is, "How important are clinical grades to matching at a competitive pathology program?" Here's my situation: I thoroughly enjoyed pathology as an M2 (could not put down Robbins), did one year of path research in med school (which confirmed my desire to pursue it as a career), did well on Step One (>240), attend a non-top 20 med school, and am HATING clinical medicine and will most likely only receive a "pass" for all my third year clerkships (my school does not have "high pass"). My written evals are good, just not stellar and not enough for "honors." I desperately want to pursue an academic career in pathology and understand that to do so, it would probably be in my best interest to train at a big name institution (MGH, Brigham, Johns Hopkins, UCSF, Stanford etc).

Hi fatboy,

Welcome to the path forum! 👍

I am still in the application process, but I received passes in all of my clinical rotations and got offered interviews at all the big name places you mentioned. Of course, that doesn't mean I would match there, but at least I got my foot in the door with an interview. Like you, I did well on Step 1 and did research. So I think you will be fine.

Edit: Maybe I am being naive, but I don't think that you necessarily have to go to one of the institutions of the caliber you mentioned to have a career in academic pathology. I actually declined interviews at all the places you mentioned, solely for personal reasons. I am looking at solid programs like UTSW, UVA, Iowa, Michigan, Utah, Indiana, etc. (in no particular order 🙂 ) and think I will be able to have a successful career in academics coming from any of these places. Especially after having been on the interview trail, I am convinced that you can get really solid pathology training at any number of places.

 

[yaah]

Pedes and psych? Those are the hardest to get good grades in. VERY subjective. Surgery you get a good grade by being enthusiastic, showing up on time, and saying "yes sir" a lot.

Third year grades are not really important in isolation. Generally, people with good third year (and preclinical also) grades have transcripts that are good in other areas, so it's kind of hard to control for it.

 

[fatboy]

Thank you for all your comments and advice! You guys are AWESOME!! As much as it might kill me, I will continue to keep plugging away in the clerkships and let the chips fall where they may...

 

[AngryTesticle]

Pedes and psych? Those are the hardest to get good grades in. VERY subjective. Surgery you get a good grade by being enthusiastic, showing up on time, and saying "yes sir" a lot.

Third year grades are not really important in isolation. Generally, people with good third year (and preclinical also) grades have transcripts that are good in other areas, so it's kind of hard to control for it.

It also helps when your surgery interns and senior residents were the same folks you went out to the bars with back during the first few years of med school 😉 😉