How Much Do 1st Year Grades really matter? (Prepping Step 1 early)

[Blondnuttyboy]

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Hello,

I couldn't seem to find a solid thread on this (I searched 🙂

Anyway, doing well at my school is not correlated with doing well on step 1. I've been told so by many, many 3rd-4th years. Yeah getting a good foundation is important but the push from 80-90 on tests is marginal for step 1 prep.

ALRIGHT, so I have been reviewing BRS books, etc for my entire first year now and I am sitting right in average for all of my blocks, some even slightly below average. But I am sitting pretty with where I want to be with board prep.

I would like a residency in urology, derm, or radio (I picked easy specialties I know) and I will be dropping a publication this summer.

HOW MUCH DO YEAR 1-2 GRADES REALLY MATTER?

Thanks : )

 

[JustPlainBill]

Hello,

I couldn't seem to find a solid thread on this (I searched 🙂

Anyway, doing well at my school is not correlated with doing well on step 1. I've been told so by many, many 3rd-4th years. Yeah getting a good foundation is important but the push from 80-90 on tests is marginal for step 1 prep.

ALRIGHT, so I have been reviewing BRS books, etc for my entire first year now and I am sitting right in average for all of my blocks, some even slightly below average. But I am sitting pretty with where I want to be with board prep.

I would like a residency in urology, derm, or radio (I picked easy specialties I know) and I will be dropping a publication this summer.

HOW MUCH DO YEAR 1-2 GRADES REALLY MATTER?

Thanks : )

The rest of your future relies on your grades from year 1 and 2. Yes, your value and future career as a physician ABSOLUTELY depends on your grades in freshman biochem....

In case you haven't heard the mantra - some specialties use grades and board scores as filters.....but then there's audition rotations where maybe hustle and personality help....who wants to work with a dork?......

So, as with medical school entrance, it's really a crapshoot.....

 

[Blondnuttyboy]

I dont know if i'd compare it to ugrad per se - Undergrad science gpa is one of the most important factors in applying to medical school.

Whereas, I've heard MSI-II grades in med school are at the bottom of the totem pole for residency. In comparison to letters, 3-4 grades, step I, and research...and obvi interviews

 

[thesauce]

Op: the specialties that you're looking at consider AOA very highly and it's unlikely that you'll get AOA with average grades. Grades an Step 1 are not an either/or thing, you'll likely need both to secure a position in those specialties. Good luck.

 

[ruralmd]

Year 1 and 2 grades mean very little. What does matter is step 1, third year grades and a laundry list of other things before first and second year grade. And this comes from 4th years who have matched at some of the top programs for their respective specialities.

I would also like to see how many of the AOA students in these competitive specialties are junior or senior AOA.

 

[Pinkertinkle]

Op: the specialties that you're looking at consider AOA very highly and it's unlikely that you'll get AOA with average grades. Grades an Step 1 are not an either/or thing, you'll likely need both to secure a position in those specialties. Good luck.

Some schools factor only step 1 and clerkship grades into eligibility for AOA. The OP should look up his own school's AOA policy.

 

[CorazonDoc]

I agree with a couple points above:

1) 1st year grades are very very low on the hierarchy of what most specialties look at for selecting residents. This is because schools differ in how they grade and programs get a much better objective view by just looking at your step 1 score (for better or worse).

2) AOA can play a very positive role in how you are looked at as an applicant and many schools factor ALL grades into AOA selection. So in this regard, 1st year grades could matter. check with how your school selects AOA. (for example, our school was Pass/Fail first year but kept a "secret" list of how we all did during that year that ultimately factored into AOA selection later on. seemed to defeat the purpose of pass/fail, but that's how they did it.)

 

[Law2Doc]

Hello,

I couldn't seem to find a solid thread on this (I searched 🙂

Anyway, doing well at my school is not correlated with doing well on step 1. I've been told so by many, many 3rd-4th years. Yeah getting a good foundation is important but the push from 80-90 on tests is marginal for step 1 prep.

ALRIGHT, so I have been reviewing BRS books, etc for my entire first year now and I am sitting right in average for all of my blocks, some even slightly below average. But I am sitting pretty with where I want to be with board prep.

I would like a residency in urology, derm, or radio (I picked easy specialties I know) and I will be dropping a publication this summer.

HOW MUCH DO YEAR 1-2 GRADES REALLY MATTER?

Thanks : )

A mentor I had once liked to say that the "dirty little secret" of med school is that the first two years grades don't matter, and that the school has people killing themselves studying for tests that have no bearing on their future, simply because folks coming out of undergrad are so "used to" their futures being determined by coursework. I tend to agree with this with a caveat. Yes, the third year of med school's grades and evals will dwarf your prior two years' grades, which residencies won't focus on. Heck, some med schools don't even have grades the first year. But yes, as folks have mentioned, if your school has AOA (some don't), then class rank may be involved in the determination (sometimes popularity is a bigger part of this determination though). And the MATERIAL from the first two years is important to have mastered because you are going to need it for Step 1 and for all those pimping questions during third year. So I'd say you need to pass everything and give yourself a good foundation in the material for the knowledge you are going to need in the subsequent years. It's unrealistic to coast in the first two years and then expect to nail that 260 on Step 1 -- this is the time you get all of those tidbits into your brain for use later, on things that really count. With a high step 1, and solid third year grades/evals you can do any of those specialties you described. But doing well in the things that are important is correlated with locking down the foundation in the first two years.

So yes you can do fine without great grades in the first two years. But the folks who do well tend to get there by giving themselves the foundation needed from those first two years. So I'd say treat everything as important, because you have nothing else to focus on and you need the foundation, but in reality, nothing counts much until Step 1.

 

[psipsina]

So yes you can do fine without great grades in the first two years. But the folks who do well tend to get there by giving themselves the foundation needed from those first two years. So I'd say treat everything as important, because you have nothing else to focus on and you need the foundation, but in reality, nothing counts much until Step 1.

In my experience the exams during the first two years, often full of PhD questions, don't always reflect my understanding of a subject. If I study hundreds of drugs for an exam, but there are only 75 questions, the difference between an 80 and a 90 might just be the luck of the draw of which drugs my brain dropped versus which drugs they asked questions on. So instead of fixating on honors versus high pass I focus on MY UNDERSTANDING of the material. I'm not going to have a mental breakdown if I get a 78 but I know that at least 80% of that info is in my long term memory, truly understood and not crammed. In short work hard to really understand the material, but don't fixate on the grade on exams. What's important is that you really learn and understand the information, not if you honor everything.

 

[wedogogirl]

.

 

[badasshairday]

In my experience the exams during the first two years, often full of PhD questions, don't always reflect my understanding of a subject. If I study hundreds of drugs for an exam, but there are only 75 questions, the difference between an 80 and a 90 might just be the luck of the draw of which drugs my brain dropped versus which drugs they asked questions on. So instead of fixating on honors versus high pass I focus on MY UNDERSTANDING of the material. I'm not going to have a mental breakdown if I get a 78 but I know that at least 80% of that info is in my long term memory, truly understood and not crammed. In short work hard to really understand the material, but don't fixate on the grade on exams. What's important is that you really learn and understand the information, not if you honor everything.

While I agree with you that you should focus on understanding the material not on cramming to get the honors, it seems that the people with the highest grades do best on Step 1.

 

[unsung]

In my experience the exams during the first two years, often full of PhD questions, don't always reflect my understanding of a subject. If I study hundreds of drugs for an exam, but there are only 75 questions, the difference between an 80 and a 90 might just be the luck of the draw of which drugs my brain dropped versus which drugs they asked questions on. So instead of fixating on honors versus high pass I focus on MY UNDERSTANDING of the material. I'm not going to have a mental breakdown if I get a 78 but I know that at least 80% of that info is in my long term memory, truly understood and not crammed. In short work hard to really understand the material, but don't fixate on the grade on exams. What's important is that you really learn and understand the information, not if you honor everything.

That's almost always good advice.

 

[turkeyjerky]

In my experience the exams during the first two years, often full of PhD questions, don't always reflect my understanding of a subject. If I study hundreds of drugs for an exam, but there are only 75 questions, the difference between an 80 and a 90 might just be the luck of the draw of which drugs my brain dropped versus which drugs they asked questions on. So instead of fixating on honors versus high pass I focus on MY UNDERSTANDING of the material. I'm not going to have a mental breakdown if I get a 78 but I know that at least 80% of that info is in my long term memory, truly understood and not crammed. In short work hard to really understand the material, but don't fixate on the grade on exams. What's important is that you really learn and understand the information, not if you honor everything.

I'd be pretty surprised if you could show me a person who got a 78 on an exam but understood the material better than someone who got a 98. Just sayin...

 

[Law2Doc]

I'd be pretty surprised if you could show me a person who got a 78 on an exam but understood the material better than someone who got a 98. Just sayin...

I think the point is that they might know more material that wasn't covered. Which matters more in later efforts (step 1 and rotations), but ends up a lower grade in the first year class. I think most of us have come out of exams now and then feeling like we spent a lot of time on things that weren't heavily tested. The nice thing about med school is that sometimes that kind of effort is rewarded later, when it actually counts.

 

[badasshairday]

I think the point is that they might know more material that wasn't covered. Which matters more in later efforts (step 1 and rotations), but ends up a lower grade in the first year class. I think most of us have come out of exams now and then feeling like we spent a lot of time on things that weren't heavily tested. The nice thing about med school is that sometimes that kind of effort is rewarded later, when it actually counts.

This is true. I wish my school was P/F so I didn't have to study BS that I know isn't going to help for boards. That nit-picky PhD stuff, ugh.

 

[HPSPpayissues]

In my experience the exams during the first two years, often full of PhD questions, don't always reflect my understanding of a subject. If I study hundreds of drugs for an exam, but there are only 75 questions, the difference between an 80 and a 90 might just be the luck of the draw of which drugs my brain dropped versus which drugs they asked questions on. So instead of fixating on honors versus high pass I focus on MY UNDERSTANDING of the material. I'm not going to have a mental breakdown if I get a 78 but I know that at least 80% of that info is in my long term memory, truly understood and not crammed. In short work hard to really understand the material, but don't fixate on the grade on exams. What's important is that you really learn and understand the information, not if you honor everything.

👍 There are so many people with all honors and high passes that do poorly on the Step 1, because all they did was MEMORIZE things quickly the week before without truly understanding. You will pay for it not only on the step, but throughout your rotations also

 

[HPSPpayissues]

I'd be pretty surprised if you could show me a person who got a 78 on an exam but understood the material better than someone who got a 98. Just sayin...

There are a few that MEMORIZED everything into getting high grades without TRULY UNDERSTANDING the material.

 

[thesauce]

👍 There are so many people with all honors and high passes that do poorly on the Step 1, because all they did was MEMORIZE things quickly the week before without truly understanding. You will pay for it not only on the step, but throughout your rotations also

And there are so many more with all passes that do poorly on Step 1. You can make the point that first and second year grades don't matter (besides AOA), but I highly doubt you can say that they don't correlate to doing well on Step 1 (well, you can say it, but it won't be true).

In regards to rotations, I've found that if you truly understand material in the first 2 years, and you bring it up on the wards, you end up looking like a braggart and it makes your team hate you (very team dependant).

I remember one time when my team was being pimped by an attending and they asked a question starting with the senior resident and then on down to the student (usually they ask in the opposite order). When it got to me and no one else knew the answer and I did, I just said that I didn't know so I wouldn't show up the others. I've found that doing well on rotations is less about your knowledge and more about getting along with people.

 

[87138]

I've got no data to support this, but it seems unlikely that the "just skated by with C's but smashed the boards because he/she focused on the big picture and not the details" scenario is entirely par for the course.

I have to think that if someone is consistently doing "mediocre" on exams, they probably don't understand the material quite as well as someone who is consistently doing "very well" on exams.

But again, I might be wrong. Obviously the people getting AOA aren't always the people getting 260's, but I'd be interested in seeing what kind of actual correlation first year grades have with STEP I performance.

 

[ruralmd]

I would be willing to bet that step 1 scores would be more correlated to second year grades than first year grades, depending on curriculum of course. However, the school I attend is notorious for students in the top portion of the class having average to below average step 1 scores and the average students tend to do very well. With the bottom portion of the class having the not so stellar scores. Can't say the same is true for anywhere else tho...

 

[FutureDoc4]

I think many of you are looking at this like the extreme. As a first year I've adapted this broad approach to emphasize undertanding.


For example, for Physio.. I spent my time with Big Constanzo, BRS (most of the time), and Guyton (only to clear up a subject matter)... I really focus on learning this material EXTREMELY well. Usually, before the exam, I will GLANCE at the lecture notes....(I've stopped attending class weeks ago)

My exam scores have been from uppper 80s to low 90s. Everything I got wrong were nit picky stuff that was like 3 lines in the notes about some esoteric thing. I think this approach is much more in tune with people are talking about.

I agree, that if you are getting low 70s you are still probably missing some major concepts. But, I guess this also depends on how many of the esoteric research questions PhDs put on your exams.

 

[Slack3r]

http://www.nrmp.org/data/programresultsbyspecialty.pdf

Residency directors in "All specialties combined" rank basic science courses the lowest of any deciding factor with the exception of USMLE Step III. Take that for what you will.
(**You'll also notice some more competitive specialties rank pre-clinicals realtively high, although still behind LOR's and clinical grades)

I'm assuming the multiple threads on this subject are in response to this?

...pre-clinical grades matter for less than you think. Most residency directors (yes, even competitive ones) rank clinical grades >>> pre-clinical grades. So with the exception of AOA eligibility, your first two years don't matter too much in the grand scheme of things.

Now, I'm not necessarily implying you can blow off the first two years and go to the beach everyday. I was simply arguing that if you're killing yourself to the point where (in regards to that thread) you don't have time to grocery shop, maybe you should just take the B or the HP instead of gunning for that A/H. It helps no one if you burn out the first two years, because the work-load only gets worse after that.

 

[VMSmith]

First and second year grades don't matter as much as pretty much any other part of your application. Quite a few people from my class with mediocre first and second year grades matched into good programs in very competitive specialties. As long as you don't have course failures a lot of P's probably won't hurt you very much, if at all.

But most (not all) people who did very well in the first and second years also did very well in the third and fourth years. Good students often are exactly that - good students. Good work/study habits help you in any setting. Test-taking ability is important throughout med school.

You don't need to kill yourself over getting all H's. As long as you're putting in the time and effort to learn the material you're doing what you should be doing and will be just fine.