How much do grades REALLY matter for residency?

[hopefullyafutureDOstudent]

it's my first semester of school, and my school grades with Z scores. it's pretty much impossible to get an A in a class unless you get high 90's across the board on every test, which isn't happening for me. I'm pretty sure I'm getting straight B's, maybe one C and one A this semester and was wondering how much residencies weigh grades? thank you

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[DO2015CA]

Very low. It’s hard to standardize what grades from each institution mean. Compare an A from a top tier medical school to an A from the newest DO school. Board scores will tell you all you want about academic preparation. Pass your class and do your best on boards.

 

[AnatomyGrey12]

Just don’t fail anything and don’t be at the bottom of your class. Even PDs if our programs in competitive specialties have said middle third is as far as they look, and then it is all about boards.

 

[SpartanWolverine]

Agree with the others -- not much weight on preclinical grades. Have only ever had PDs flip right past my transcript without even giving it a second glance. Much, much more weight on board scores. Had one brief question about class ranking but that was it.

 

[Goro]

it's my first semester of school, and my school grades with Z scores. it's pretty much impossible to get an A in a class unless you get high 90's across the board on every test, which isn't happening for me. I'm pretty sure I'm getting straight B's, maybe one C and one A this semester and was wondering how much residencies weigh grades? thank you

They don't.

Board scores do.

 

[MrWonderful]

They don't. Only thing that matters "grade wise" is COMLEX/USMLE, secondarily your grade in the clerkship of the specialty to which you are applying.

Boards > LORs >> Clerkship grade in specialty = application theme consistent with specialty > everything else

 

[DrMcLovin]

Grades are a less important part of you app but it’s a lot more important when youre competing for a competitive residency. Every interview/audition I’ve been on has asked about class ranking. Good grades + good boards is the best but you could probably get by with average grades + good/excellent boards if you can explain why during an interview. Its competitive out here if you’re shooting for a specialty like ortho.

 

[MightBeACylon439]

Good grades means you learned the material well the first time.

Learning the material the first time makes it easier when studying for boards.

This means better board scores.

Those who struggle with classes and get low grades traditionally get lower board scores.

 

[Postictal Raiden]

They don't no matter at all. I'd argue that if you have a USMLE score, your comlex scores won't matter either (I'm doing my interviews now and no one mentions my comlex).

With that said, a failure grade brings a lot of attention.

 

[sdhere1234]

Good boards + good grades > good boards + bad grades > bad boards + good grades > bad boards and bad grades

 

[68PGunner]

Good boards + good grades > good boards + bad grades > bad boards + good grades > bad boards and bad grades

Did you get that from the outspoken OMSII kids who are still stuck in premed mode? Here're the top four things that PDs care about:

1) Board Scores
2) Clinical Grades (Not PRECLINCIAL GRADES)
3) LORs
4) Research
5) Away rotations

 

[Lexdiamondz]

Did you get that from the outspoken OMSII kids who are still stuck in premed mode? Here're the top four things that PDs care about:

1) Board Scores
2) Clinical Grades (Not PRECLINCIAL GRADES)
3) LORs
4) Research
5) Away rotations

Not all PDs are the same though, and different institutions will value different things based on tier, institutional culture, geography, patient population. All the things you mentioned matter, but the order of precedence will vary from program to program.

 

[sdhere1234]

Did you get that from the outspoken OMSII kids who are still stuck in premed mode? Here're the top four things that PDs care about:

1) Board Scores
2) Clinical Grades (Not PRECLINCIAL GRADES)
3) LORs
4) Research
5) Away rotations

Ok? I was comparing grades and board scores. Tell me my ranking is wrong.

 

[Jinxapotato]

The actual number of your grade doesn't really matter. However, preclinical performance is a good indicator for board performance. It is much more likely for a 3.7 student to score 600+ on COMLEX than a 3.0 student (which is pretty much the average student in your class). I know I know...we all know that one guy who scored 700 with a 3.0, but let's face it, it's rare.

 

[freecitizen]

There is data to answer you question. #1 is Step score. Marks do matter however. See the following link: http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

 

[IslandStyle808]

The actual number of your grade doesn't really matter. However, preclinical performance is a good indicator for board performance. It is much more likely for a 3.7 student to score 600+ on COMLEX than a 3.0 student (which is pretty much the average student in your class). I know I know...we all know that one guy who scored 700 with a 3.0, but let's face it, it's rare.

I'd say be careful of this line of thought. There are multiple people on here who were below average in class but did rather well on the USMLE. I'm being taught year 3 material currently at the same time with year 2 material. So I can see my class grades not correlating well to step 1.

 

[Carbon090]

I'd say be careful of this line of thought. There are multiple people on here who were below average in class but did rather well on the USMLE. I'm being taught year 3 material currently at the same time with year 2 material. So I can see my class grades not correlating well to step 1.

I think what it means is that if you study 12+ hours daily for med school exams and still barely pass or so, than that is a possible indication you won't do well on USLME. However, just because you do get A's on these exams doesn't necessarily mean you'll do well on USLME either.

I believe too many variables are involved (one's own motivation, lifestyle, mindset, etc) to really make this black and white.

 

[Kkshake]

Standardized exams all come down to luck imo, not grades or intelligence.

 

[AshNiffler]

I guess I’m the outlier then, the PD in my last interview said he selected me for an IV because of my “grades”

 

[osteopathicmedstudent]

it's my first semester of school, and my school grades with Z scores. it's pretty much impossible to get an A in a class unless you get high 90's across the board on every test, which isn't happening for me. I'm pretty sure I'm getting straight B's, maybe one C and one A this semester and was wondering how much residencies weigh grades? thank you

Z Scores? Sounds like yopu go to touro com. Just know that most of the class will get Bs. Dont try to hard because the z scores are based on the last few class years. But they dont tell you that exams have changed drastically over the years

 

[68PGunner]

I guess I’m the outlier then, the PD in my last interview said he selected me for an IV because of my “grades”

Nice biased post for someone w/ 260+ on both Step 1 and Step 2.

 

[831929]

I think what you hear is much of the same. Everyone medical student on here says grades don't matter. However, as a few have mentioned, I think doing fairly well in class reflects on your boards (unless you are solely studying for boards and doing great on qbanks). But if that was the case I'd imagine you'd still be doing fairly well in class. Just try to high pass (80+). I'd aim to be a few standard deviations above the mean every once in a while. It will make it easier to study for step later on.

But I am also a medical student who has not yet gone through the match. This is just what I think from my personal experience and from what I've heard from older student (however, a few of them made class rank seem like a big factor but they are also really great students).

 

[yanks26dmb]

Z Scores? Sounds like yopu go to touro com. Just know that most of the class will get Bs. Dont try to hard because the z scores are based on the last few class years. But they dont tell you that exams have changed drastically over the years

You sure about that? Fairly certain z scores are for one specific test, not multiple years

 

[IntheClouds4ever]

If you aren't looking at competitive residencies, then aim to pass everything first attempt and to do better than just "getting by". If you have all Cs, I'd be concerned about how you will do on boards.. if you have all Bs, you'll be fine and just keep chugging along. Don't even think about rank if you are getting Bs and above in class - FYI the difference between the 25-75% is usually very small in terms of percentage points in this range and is usually heavily weighted by certain classes.. so don't let it fluster you. just keep your focus on board prep and it'll all work out

 

[Goro]

I'd say be careful of this line of thought. There are multiple people on here who were below average in class but did rather well on the USMLE. I'm being taught year 3 material currently at the same time with year 2 material. So I can see my class grades not correlating well to step 1.

There will always be outliers. But right now preclincial GPA is the best predictor for Step I and Level I performance. At my school, NBME shelf exams are also good predictors of Level I performance.

Below avg in class also means nothing if the class is excellent to begin with. A median of 86 and the bottom student with an 80 is going to mean that the student will do fine on Boards. it's the students who are barely passing who are in the most trouble.

 

[IslandStyle808]

There will always be outliers. But right now preclincial GPA is the best predictor for Step I and Level I performance. At my school, NBME shelf exams are also good predictors of Level I performance.


Below avg in class also means nothing if the class is excellent to begin with. A median of 86 and the bottom student with an 80 is going to mean that the student will do fine on Boards. it's the students who are barely passing who are in the most trouble.

Based on the responses here it is more common than not.

Some schools don't use NBME shelf exams, if they did, what your saying would be 100% correct. For medical schools who don't use NBME exams, problems come from several areas. PhD professors who have a tough time writing clinical vingettes. MD/DO professors who are who write vignettes that are level II/step II type questions. The worst problem being poorly vetted questions. So these confounders are coming into play.

There are also schools were the mean can be between 78-80% (like my school). So how does one know if one is going do poorly when half the class is getting below a 80%. So until an NMBE exam is taken (this is a more standardized measure), one cannot count oneself out of taking the UMSLE .

Not saying you don't have any good points, you definitely do, but I'm just stating there is more shades of gray in the answer to the question.

 

[1Cor1557]

it's my first semester of school, and my school grades with Z scores. it's pretty much impossible to get an A in a class unless you get high 90's across the board on every test, which isn't happening for me. I'm pretty sure I'm getting straight B's, maybe one C and one A this semester and was wondering how much residencies weigh grades? thank you

they matter, do your best to have the best grades possible, if its a B average so be it, but dont allow it to be any lower due to lack of effort, give it everything youve got

 

[AnatomyGrey12]

There are also schools were the mean can be between 78-80% (like my school). So how does one know if one is going do poorly when half the class is getting below a 80%. So until an NMBE exam is taken (this is a more standardized measure), one cannot count oneself out of taking the UMSLE .

I agree. The majority of our means have been mid 70s. It’s hard to know where you stand when half the class is getting a C or failing.

 

[vm26]

it's my first semester of school, and my school grades with Z scores. it's pretty much impossible to get an A in a class unless you get high 90's across the board on every test, which isn't happening for me. I'm pretty sure I'm getting straight B's, maybe one C and one A this semester and was wondering how much residencies weigh grades? thank you

Graduated back in 2007 so things may have changed. Grades do matter from all years as they determine your class ranking (which was part of our deans letter). If you want AOA, need to be top 10-20% in your class.

 

[AnatomyGrey12]

Graduated back in 2007 so things may have changed. Grades do matter from all years as they determine your class ranking (which was part of our deans letter). If you want AOA, need to be top 10-20% in your class.

We are talking about DO schools, which don’t have AOA. Our equivalent is SSP and it doesn’t have the same weight as AOA.

 

[Spectreman]

Can I just use this to quickly mention how upset I am about my first semester? I crushed Anatomy (top 5 in a class of 250) and Histo (more like top 20). I had just shy of a 90 coming into my last Biochem exam and then got destroyed by it causing me to end that class with a 80, hoping for a bit of a curve ends me with like an 83, but that’ll still be right at or below class average. I feel like whatever good I did for myself by working my butt off all semester got totally ripped apart by that one exam. Just so frustrated.

 

[Chibucks15]

Can I just use this to quickly mention how upset I am about my first semester? I crushed Anatomy (top 5 in a class of 250) and Histo (more like top 20). I had just shy of a 90 coming into my last Biochem exam and then got destroyed by it causing me to end that class with a 80, hoping for a bit of a curve ends me with like an 83, but that’ll still be right at or below class average. I feel like whatever good I did for myself by working my butt off all semester got totally ripped apart by that one exam. Just so frustrated.

That's how my semester went too. The first exam in biochemistry I battled the second guessing bug that happens to people and it screwed me out of an A. Part of the deal I've heard

 

[Spectreman]

That's how my semester went too. The first exam in biochemistry I battled the second guessing bug that happens to people and it screwed me out of an A. Part of the deal I've heard

Thanks ChiBucks. Hopefully next semester we can crush every exam.

 

[zero0]

There is data to answer you question. #1 is Step score. Marks do matter however. See the following link: http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

I'm surprised MSPEs are ranked that high up. Aren't all MSPEs basically the same mushy gushy drivel about how awesome the student is and how the program should take them? It's kind of hard to imagine a school saying anything about a student that would jeopardize their chances of matching since that makes everybody look bad.

 

[68PGunner]

I'm surprised MSPEs are ranked that high up. Aren't all MSPEs basically the same mushy gushy drivel about how awesome the student is and how the program should take them? It's kind of hard to imagine a school saying anything about a student that would jeopardize their chances of matching since that makes everybody look bad.

That’s incorrect. You can certainly have a bad MSPE by having a mediocre letter. Why the hell do so many DO students go online on sdn to vent their frustration if the school is receptive to their concerns?

 

[IslandStyle808]

I'm surprised MSPEs are ranked that high up. Aren't all MSPEs basically the same mushy gushy drivel about how awesome the student is and how the program should take them? It's kind of hard to imagine a school saying anything about a student that would jeopardize their chances of matching since that makes everybody look bad.

From what I have seen they can use "code terms" to show how well a student is doing in comparison to the class. If you got told, you are a "good student" in your MSPE. You may think you are doing fine, but they are banking on your ignorance to what "good" really means. When the code terms instead go from "good student" (average), "great student" (above average), and "excellent student" (top of class).

You can also get comments from your clinical evaluations written on your MSPE as well. Which are subjective as f***.

Don't underestimate how much you can get f***ed over on your MSPE.

 

[68PGunner]

From what I have seen they can use "code terms" to show how well a student is doing in comparison to the class. If you got told, you are a "good student" in your MSPE. You may think you are doing fine, but they are banking on your ignorance to what "good" really means. When the code terms instead go from "good student" (average), "great student" (above average), and "excellent student" (top of class).

You can also get comments from your clinical evaluations written on your MSPE as well. Which are subjective as f***.

Don't underestimate how much you can get f***ed over on your MSPE.

Just to expand on this, they will put you on a bell curve of your preclinical grades and your clinical grades relative to your class. Fortunately for everyone here, Step 1, Step 2, clinical grades, and LORs are the main criteria that PDs use. 3 of those things are in your control as in your Step 1, Step 2, and LORs. Your clinical grades might be in your control depending on how hard you work as well as how well liked you are by people in your workplace.

So, the morals of my story are to keep your mouth shut at school and do your things. Ruffling feathers at school will certainly have repercussion. A mediocre MSPE won’t sink your application but a red flag MSPE labeling you as a trouble maker as being unprofessional will sink your application to the unmatched pile.

 

[recycledpaper]

If you're competing at a high level, and are going after a competitive specialty, everything matters.

 

[zero0]

From what I have seen they can use "code terms" to show how well a student is doing in comparison to the class. If you got told, you are a "good student" in your MSPE. You may think you are doing fine, but they are banking on your ignorance to what "good" really means. When the code terms instead go from "good student" (average), "great student" (above average), and "excellent student" (top of class).

You can also get comments from your clinical evaluations written on your MSPE as well. Which are subjective as f***.

Don't underestimate how much you can get f***ed over on your MSPE.

Yeah didn't realize clinical evals went on there. I see how that can go wrong.

 

[CajunMedic]

From what I have seen they can use "code terms" to show how well a student is doing in comparison to the class. If you got told, you are a "good student" in your MSPE. You may think you are doing fine, but they are banking on your ignorance to what "good" really means. When the code terms instead go from "good student" (average), "great student" (above average), and "excellent student" (top of class).

You can also get comments from your clinical evaluations written on your MSPE as well. Which are subjective as f***.

Don't underestimate how much you can get f***ed over on your MSPE.

Yep. They didn't tell us until midway through 3rd year about what was needed for each classification. Class rank killed me. I met all the other requirements for "Excellent" and "Very Good".

On the bright side. Only 1 of my EM interviews has said anything about my grades, and it was "Eh, B&C student, but you've got great SLOE's and board scores"

 

[canuckmdphd]

From what I have seen they can use "code terms" to show how well a student is doing in comparison to the class. If you got told, you are a "good student" in your MSPE. You may think you are doing fine, but they are banking on your ignorance to what "good" really means. When the code terms instead go from "good student" (average), "great student" (above average), and "excellent student" (top of class).

You can also get comments from your clinical evaluations written on your MSPE as well. Which are subjective as f***.

Don't underestimate how much you can get f***ed over on your MSPE.

Agree. At our school (M.D.) the MSPE has one paragraph on preclinical grades and then a paragraph for each clerkship. The paragraph for the clerkship is summary statement that each clerkship director wrote at the end of the rotation. It also includes NBME shelf exam percentiles for each clerkship. Our dean's then write a summary statement about you which is where the "good, great, excellent" etc. and why you would be an asset to residency progams, comes in. Our school eliminated class rank a few years ago and our preclinical years are P/F now. AOA for us is solely determined by 3rd year clerkship grades for nomination and then a personal statement/CV after that for selection.