How Much Do Shelf Exams Count?

[Poiu86]

How much do shelf exams count toward the final grade at your school?

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[DrBowtie]

Varies widely from rotation to rotation and whether or not they curve the exam in house.

 

[astrocreep96]

Approximately 30-40% of the grade, such that doing well on the final is necessary to do well in the course.

 

[2012mdc]

How much do shelf exams count toward the final grade at your school?

varies by rotation. some have it count 35-40%. others the shelf will completely make or break your grade.

you could be perfect on the floors/OR but if you don't reach the minimum score, no honors for you. if you do reach the minimum score you are essentially guaranteed honors unless you were absolutely awful on the floors/OR (not just really incompetent, but often absent as well)

 

[turkeyjerky]

ranges from 10 to 40% for us.

 

[drizzt3117]

Not enough.

 

[quepatho]

25% on this rotation.

 

[DocEspana]

10% on all of our rotations. We're all about the subjective evaluation.

 

[bioteach]

Way to much! For us it is 40% of our grade. That's based on our nbme percentile, not raw score. Our evals are essentially meaningless in determining our grade (unless your attending/residents all completely hated you). If your evals are within the normal range, your shelf score ends up determining whether you honors, high pass, pass, or fail at our school.

 

[2012mdc]

Way to much! For us it is 40% of our grade. That's based on our nbme percentile, not raw score. Our evals are essentially meaningless in determining our grade (unless your attending/residents all completely hated you). If your evals are within the normal range, your shelf score ends up determining whether you honors, high pass, pass, or fail at our school.

That's a good thing. Objective grading >>>> subjective grading any day of the week. also removes the impetus to ass kiss and throw classmates under the bus and you can focus on learning while on the floors/clinic/OR in a lower pressure environment.

I can't imagine how much more 3rd year would have sucked in a system that really valued evals

 

[beansprouts1]

That's a good thing. Objective grading >>>> subjective grading any day of the week. also removes the impetus to ass kiss and throw classmates under the bus and you can focus on learning while on the floors/clinic/OR in a lower pressure environment.

I can't imagine how much more 3rd year would have sucked in a system that really valued evals

I disagree. 3rd year is more about how well you work as part of a team, your abilities in pt care, which isn't dependent only on clinical knowledge, and overall success in a hospital environment which often depends on your ability to maneuver in the "system." We've had all 1st and 2nd year to be graded on objective knowledge, I actually think its more important that 3rd year evaluate you on more vague and subjective terms.

Coincidentally, our shelves are worth 10% of our grade lol, making our clinical grades completely subjective

 

[drizzt3117]

Way to much! For us it is 40% of our grade. That's based on our nbme percentile, not raw score. Our evals are essentially meaningless in determining our grade (unless your attending/residents all completely hated you). If your evals are within the normal range, your shelf score ends up determining whether you honors, high pass, pass, or fail at our school.

That would be awesome...

 

[drizzt3117]

I disagree. 3rd year is more about how well you work as part of a team, your abilities in pt care, which isn't dependent only on clinical knowledge, and overall success in a hospital environment which often depends on your ability to maneuver in the "system." We've had all 1st and 2nd year to be graded on objective knowledge, I actually think its more important that 3rd year evaluate you on more vague and subjective terms.

Coincidentally, our shelves are worth 10% of our grade lol, making our clinical grades completely subjective

That'll make it even more awesome when you get a pedestrian eval from an attending you've never met with vague comments and a mediocre numeric eval. Subjective grading would be great if the attendings/residents cared about evaluating you even 1/100 as much as you cared about your eval.

 

[2012mdc]

I disagree. 3rd year is more about how well you work as part of a team, your abilities in pt care, which isn't dependent only on clinical knowledge, and overall success in a hospital environment which often depends on your ability to maneuver in the "system." We've had all 1st and 2nd year to be graded on objective knowledge, I actually think its more important that 3rd year evaluate you on more vague and subjective terms.

Coincidentally, our shelves are worth 10% of our grade lol, making our clinical grades completely subjective

clinical knowledge is important but did you actually say it's important to be evaluated in vague terms? really?

That'll make it even more awesome when you get a pedestrian eval from an attending you've never met with vague comments and a mediocre numeric eval. Subjective grading would be great if the attendings/residents cared about evaluating you even 1/100 as much as you cared about your eval.

Exactly.

 

[DocEspana]

That'll make it even more awesome when you get a pedestrian eval from an attending you've never met with vague comments and a mediocre numeric eval. Subjective grading would be great if the attendings/residents cared about evaluating you even 1/100 as much as you cared about your eval.

apparently though this is rather uncommon. Sucks when it happens (sucks a lot) but studies suggest its not all that common at all, despite rumors otherwise.*

*= at least for the numeric grading end. vague comments are a whole different thing.

 

[im4ever]

between 30-50% for our rotations which I think it is fair. Subjective evals matter for certain rotation but overall it is the shelf that may break or make you. Just show up, do your job, don't piss everyone off then you will be fine. Work hard on your specialty interest clerkship of course!

 

[drizzt3117]

apparently though this is rather uncommon. Sucks when it happens (sucks a lot) but studies suggest its not all that common at all, despite rumors otherwise.*

*= at least for the numeric grading end. vague comments are a whole different thing.

It happens pretty commonly at a lot of institutions. I mean it just is what it is, but when you're carrying 6-8 patients and pretty much running a service, it's frustrating to get comments from someone you've never heard of that say "Appeared competent when observed." and a pass.

 

[DocEspana]

It happens pretty commonly at a lot of institutions. I mean it just is what it is, but when you're carrying 6-8 patients and pretty much running a service, it's frustrating to get comments from someone you've never heard of that say "Appeared competent when observed." and a pass.

"A description and four-year analysis of a clinical clerkship evaluation system"
Littlefield, J H, et. al.

the rate of students being unusually graded low is 14%. Similarly 13% of docs will give an A out no matter what (barring catastrophe). The remaining 73% show remarkable consistency, when compared to the evaluations of their peers of the same students.

Maybe I should be more clear. Low grades happen, but they're in no way common. 14% sucks, but its not nearly as common as people seem to imply it is, especially when counterbalanced by 13% always giving A's.

 

[drizzt3117]

The issue isn't unusually low grading. It's the arbitrariness and lack of analysis, consistency, and really, thought that goes into the clinical grades.

I am not speaking out of bitterness, I've honored essentially everything throughout med school, I'm just annoyed by the ridiculousness of the subjective evals, how long it takes for them to be done, and the lack of equivalence. There's many examples of it, and I'm actually working on a manuscript with one of our deans about the topic.

"A description and four-year analysis of a clinical clerkship evaluation system"
Littlefield, J H, et. al.

the rate of students being unusually graded low is 14%. Similarly 13% of docs will give an A out no matter what (barring catastrophe). The remaining 73% show remarkable consistency, when compared to the evaluations of their peers of the same students.

Maybe I should be more clear. Low grades happen, but they're in no way common. 14% sucks, but its not nearly as common as people seem to imply it is, especially when counterbalanced by 13% always giving A's.

 

[DocEspana]

The issue isn't unusually low grading. It's the arbitrariness and lack of analysis, consistency, and really, thought that goes into the clinical grades.

I am not speaking out of bitterness, I've honored essentially everything throughout med school, I'm just annoyed by the ridiculousness of the subjective evals, how long it takes for them to be done, and the lack of equivalence. There's many examples of it, and I'm actually working on a manuscript with one of our deans about the topic.

well, again, i cant disagree if the evaluation written portions are pathetic. But the study was saying that if you were evaulated by multiple doctors. Both those who had worked with you and those who had only seen videos or read descriptions of you: 73% of them at in any given test group would give you effectively the same grade (be it high or low or medium). 14% of docs always graded below what everyone else gave and 13% always graded very high (with the group if you deserved a high grade). I'm just trying to note that the dreaded "terrible subjective grader" isnt that common of a thing.

If he's lazy, dont ask him for a recommendation. But overwhelming chances say he's either grading you too leniently or you're getting the grade you deserve, even if he is lazy with his word choice in the open answer areas. Though obvious hard graders, top to bottom, do happen 14% of the time.

 

[beachbunny]

50% at our school. Evaluation and exam are weighted equally. You have to pass both to pass the rotation. And if you get honors on your eval, and you only get a pass (between 70-79%) on the exam, the grade for your whole rotation is only a pass. Basically the lower of the two scores (eval and exam) wins.

 

[2012mdc]

well, again, i cant disagree if the evaluation written portions are pathetic. But the study was saying that if you were evaulated by multiple doctors. Both those who had worked with you and those who had only seen videos or read descriptions of you: 73% of them at in any given test group would give you effectively the same grade (be it high or low or medium). 14% of docs always graded below what everyone else gave and 13% always graded very high (with the group if you deserved a high grade). I'm just trying to note that the dreaded "terrible subjective grader" isnt that common of a thing.

If he's lazy, dont ask him for a recommendation. But overwhelming chances say he's either grading you too leniently or you're getting the grade you deserve, even if he is lazy with his word choice in the open answer areas. Though obvious hard graders, top to bottom, do happen 14% of the time.

the study is 30 years old

 

[DocEspana]

the study is 30 years old

its also a study based on human interactions in a system that hasnt changed in about 60 years. So i dont see any reason why it wouldnt still be relevant. Its cited in modern literature on the topic of clinical year education all the time.

 

[Poiu86]

I disagree. 3rd year is more about how well you work as part of a team, your abilities in pt care, which isn't dependent only on clinical knowledge, and overall success in a hospital environment which often depends on your ability to maneuver in the "system." We've had all 1st and 2nd year to be graded on objective knowledge, I actually think its more important that 3rd year evaluate you on more vague and subjective terms.

Coincidentally, our shelves are worth 10% of our grade lol, making our clinical grades completely subjective

This would be a good point if we were actually graded during MS1 and MS2. With our pass/fail curriculum it's a joke to just pass.

 

[drizzt3117]

its also a study based on human interactions in a system that hasnt changed in about 60 years. So i dont see any reason why it wouldnt still be relevant. Its cited in modern literature on the topic of clinical year education all the time.

30 years ago the usmle was essentially pass fail. Residency selection wasn't anywhere near the same 30 years ago.

 

[DocEspana]

30 years ago the usmle was essentially pass fail. Residency selection wasn't anywhere near the same 30 years ago.

That's USMLE though. I was saying that the 3rd and 4th year curriculums and grading have remained essentially unchanged. They'd need to have changed in a major way (they havent) for this to not be relevant because this is more a measure of human nature coincidentally in a specific system rather than of the system itself.

Also, and this is just my take: if the USMLE was more "pass or fail" back then, wouldn't the evaluations be more important then and less important now if suddenly the USMLE rises in importance as an evaluation tool. Being more or less important wont effect the human nature of 13% always being a hard ass grader, but it should make that 13% less of a travesty if it matters less. I know in the 80's the USMLE was not a requirement for graduation and not everyone took it, but thats all I know about how it was different back then.

 

[turkeyjerky]

That's USMLE though. I was saying that the 3rd and 4th year curriculums and grading have remained essentially unchanged. They'd need to have changed in a major way (they havent) for this to not be relevant because this is more a measure of human nature coincidentally in a specific system rather than of the system itself.

Also, and this is just my take: if the USMLE was more "pass or fail" back then, wouldn't the evaluations be more important then and less important now if suddenly the USMLE rises in importance as an evaluation tool. Being more or less important wont effect the human nature of 13% always being a hard ass grader, but it should make that 13% less of a travesty if it matters less. I know in the 80's the USMLE was not a requirement for graduation and not everyone took it, but thats all I know about how it was different back then.

You seem to be focused on the idea of some attendings being very difficult graders--that's not what most people get pissed about. We get pissed about the out of touch grader, the guy who just runs down the list and gives you an average grade in each section no matter what you do. Believe me, it sucks to bust your @ss for 80-90 hrs a week on a rotation, ace the shelf and then get an eval that says you were a "good team player" and get a pass in the rotation.

There shouldn't be any such thing as "getting unlucky" in who grades you; I pay about 3 grand per rotation, can't they spend 5 minutes to actually grade me?

 

[2012mdc]

You seem to be focused on the idea of some attendings being very difficult graders--that's not what most people get pissed about. We get pissed about the out of touch grader, the guy who just runs down the list and gives you an average grade in each section no matter what you do. Believe me, it sucks to bust your @ss for 80-90 hrs a week on a rotation, ace the shelf and then get an eval that says you were a "good team player" and get a pass in the rotation.

There shouldn't be any such thing as "getting unlucky" in who grades you; I pay about 3 grand per rotation, can't they spend 5 minutes to actually grade me?

Exactly.

"The remaining 73% show remarkable consistency, when compared to the evaluations of their peers of the same students."

That's because a large majority of them are grading the same lazy way.

 

[DocEspana]

Exactly.

"The remaining 73% show remarkable consistency, when compared to the evaluations of their peers of the same students."

That's because a large majority of them are grading the same lazy way.

So all you're saying here is only the 13 percent who give high pass no matter what are in touch with reality and what you deserve, and 87 percent of people are screwing you over by not autokaticaly giving you the A. You're paranoid, man.

That's not even hyperbole to make a point. Thats the logical conclusion of what you said. I'm not so much stuck on the grade as I am aware that the grade is what matters. The comments are nonsense. If one or two preceptors in two years just mails it in.... Chances are you 1) still got the grade you deserved, just not the personalized attention on the written evaluative part and 2) you weren't going to ask that guy for a LOR anyway so just take his half asked comments and ignore them.

Idk, I don't see half assing the open evaluative potion as some big travesty. Clearly he doesn't think your the next big thing in his field. Whatever. Move on. It happens but saying this is a light on he system for grading is exaggerating the frequency and saying its a travesty of evaluations is just arrogant. If you didn't get a good evaluative you didst earn one. Harder to do with some people but he fact remains.

And yes it does suck. No denying it. But its also the reality of life. Doing enough to be good, or even recognized, is not always enough to be lauded when other peoples perception of merit is different from yours.

P.s. this is getting silly and ill let you thus end this tangent I started if you want. I understand your feelings of anger on this. I just think they're overstated.

 

[2012mdc]

So all you're saying here is only the 13 percent who give high pass no matter what are in touch with reality and what you deserve, and 87 percent of people are screwing you over by not autokaticaly giving you the A. You're paranoid, man.

That's not even hyperbole to make a point. Thats the logical conclusion of what you said. I'm not so much stuck on the grade as I am aware that the grade is what matters. The comments are nonsense. If one or two preceptors in two years just mails it in.... Chances are you 1) still got the grade you deserved, just not the personalized attention on the written evaluative part and 2) you weren't going to ask that guy for a LOR anyway so just take his half asked comments and ignore them.

Idk, I don't see half assing the open evaluative potion as some big travesty. Clearly he doesn't think your the next big thing in his field. Whatever. Move on. It happens but saying this is a light on he system for grading is exaggerating the frequency and saying its a travesty of evaluations is just arrogant. If you didn't get a good evaluative you didst earn one. Harder to do with some people but he fact remains.

And yes it does suck. No denying it. But its also the reality of life. Doing enough to be good, or even recognized, is not always enough to be lauded when other peoples perception of merit is different from yours.

P.s. this is getting silly and ill let you thus end this tangent I started if you want. I understand your feelings of anger on this. I just think they're overstated.

Dude, I'm not even upset. I've honored every rotation. I never mentioned anything about getting screwing over.

I'm just commenting on the fact that at my school at least the grading is lazy. Me and my classmates have gotten carbon copy evals in situations where it was clear there were differences in work ethic and interest.

I'm not saying 87% are screwing me over. I'm saying that the system is broken from the people who always give honors/passes to the people who think every single student is the same

 

[DrBowtie]

I agree with the guys that say that there is no uniqueness to the grading of you individually. On ward months where there are 2-3 students per team, the comments are almost all the same. The grading does sometimes differ a little bit, but when the attending has to fill out evals for our residents, interns, and then 3 medical students, they tend to go light on the written feedback.

On neuro, we're pretty sure this one attending has a cut and paste wordbank full of comments.

An ideal system would be one where in order to get honors or an A, you have to excel on either the shelf, or truly excel on your clinical evals. The only problem is that since we're competing nationally it serves the school and you better to have easier A/Hs.

 

[2012mdc]

I agree with the guys that say that there is no uniqueness to the grading of you individually. On ward months where there are 2-3 students per team, the comments are almost all the same. The grading does sometimes differ a little bit, but when the attending has to fill out evals for our residents, interns, and then 3 medical students, they tend to go light on the written feedback.

On neuro, we're pretty sure this one attending has a cut and paste wordbank full of comments.

An ideal system would be one where in order to get honors or an A, you have to excel on either the shelf, or truly excel on your clinical evals. The only problem is that since we're competing nationally it serves the school and you better to have easier A/Hs.

that's how the system is at my school, just most everyone relies on exceling on the shelf

 

[drizzt3117]

The other issue is the actual evaluation form. At least at my school, it's not like the attending checks a box that says "pass, fail, or honors" but has specific things you're evaluated on, such as "takes a good history" etc, and in each one, you're given essentially a grade on a 4 pt scale (unacceptable, needs improvement, competent, advanced). However, the issue is that if taken literally, every student should receive "needs improvement" right? Haha. I don't know how other schools do it, but at least part of the fault here is with our eval forms. There's a lot of "attending education" that needs to go on to tell them what a grade even means, and it seems like the people that did best just told the attendings "if you think i did a good job, put advanced for everything or else I'll get a bad grade." My point is that your grading on the wards shouldn't be based on how well you can teach your attending to evaluate you, it should be based on how well you can take care of patients. I think pass/fail in the clinical years is very appropriate. Either you can do what's expected, or you can't.

I agree with the guys that say that there is no uniqueness to the grading of you individually. On ward months where there are 2-3 students per team, the comments are almost all the same. The grading does sometimes differ a little bit, but when the attending has to fill out evals for our residents, interns, and then 3 medical students, they tend to go light on the written feedback.

On neuro, we're pretty sure this one attending has a cut and paste wordbank full of comments.

An ideal system would be one where in order to get honors or an A, you have to excel on either the shelf, or truly excel on your clinical evals. The only problem is that since we're competing nationally it serves the school and you better to have easier A/Hs.

 

[ArcGurren]

The other issue is the actual evaluation form. At least at my school, it's not like the attending checks a box that says "pass, fail, or honors" but has specific things you're evaluated on, such as "takes a good history" etc, and in each one, you're given essentially a grade on a 4 pt scale (unacceptable, needs improvement, competent, advanced). However, the issue is that if taken literally, every student should receive "needs improvement" right? Haha. I don't know how other schools do it, but at least part of the fault here is with our eval forms. There's a lot of "attending education" that needs to go on to tell them what a grade even means, and it seems like the people that did best just told the attendings "if you think i did a good job, put advanced for everything or else I'll get a bad grade." My point is that your grading on the wards shouldn't be based on how well you can teach your attending to evaluate you, it should be based on how well you can take care of patients. I think pass/fail in the clinical years is very appropriate. Either you can do what's expected, or you can't.

So my school grades from 1-5 and the grade of 5 actually corresponds to a bit less than 100%... because in their logic it is impossible to be 100% good on a rotation, so you can't get that.

Regarding evals... I think that for the most part there's always gonna be a few residents or attendings (particularly on very busy services) which don't give a crap and will grade everyone the same no matter how much work they do, but in my experience those people are rare. Most of the attendings I know generally are fair in their grading OR in fact end up giving people much higher grades than they deserve. Plus we have multiple evals per rotation so even if someone gives an average eval repeatedly the others usually help to balance it out.

Also the consensus seems to be that the shelf is a "better" way of evaluating someone's performance on a rotation... I actually disagree with this general line of thought. I think that you can be an incredible doctor and just struggle with standardized exams like shelfs and boards. This is where if you are a good doctor, it should be reflected in your performance as a clinician, which is best reflected in your clinical evals, however flawed the system of it might be. I just always get the impression that SDN is full of academic nerds (myself included) who are great with grades (not always of course) but tend to struggle keeping up on rotations with the clinical stuff, but that's what being a doctor is about... not standardized exams.

So in general... sure it's not a perfect system but I'd rather be evaluated based on how I work as a doctor than whether I memorized the atypical presentation and buzzwords of some stupid rare disease. I absolutely agree that there needs to be (at least in some places) a general overhaul of how people grade or how they assign grades, but giving LESS weight to the clinical stuff, IMO, is not the right way to go.

 

[ArcGurren]

I agree with the guys that say that there is no uniqueness to the grading of you individually. On ward months where there are 2-3 students per team, the comments are almost all the same. The grading does sometimes differ a little bit, but when the attending has to fill out evals for our residents, interns, and then 3 medical students, they tend to go light on the written feedback.

On neuro, we're pretty sure this one attending has a cut and paste wordbank full of comments.

An ideal system would be one where in order to get honors or an A, you have to excel on either the shelf, or truly excel on your clinical evals. The only problem is that since we're competing nationally it serves the school and you better to have easier A/Hs.

I guess it's dependent largely on the institution you're in, but at my school most places (except for a couple notable sites) seem to do a good job of grading you based on your actual clinical performance, as well as how you present, what your knowledge base is, etc. I just don't feel like I've run into that situation or ever heard of people running into the situation at my school where the attending is a large dick who gives everyone middle/average grades because he can't remember names.

 

[drizzt3117]

Most programs do that simply bc it's in their students' best interest for as many ppl as possible to get honors, which screws over people at schools that grades with honors to only the top 10%.

So my school grades from 1-5 and the grade of 5 actually corresponds to a bit less than 100%... because in their logic it is impossible to be 100% good on a rotation, so you can't get that.

Regarding evals... I think that for the most part there's always gonna be a few residents or attendings (particularly on very busy services) which don't give a crap and will grade everyone the same no matter how much work they do, but in my experience those people are rare. Most of the attendings I know generally are fair in their grading OR in fact end up giving people much higher grades than they deserve. Plus we have multiple evals per rotation so even if someone gives an average eval repeatedly the others usually help to balance it out.

Also the consensus seems to be that the shelf is a "better" way of evaluating someone's performance on a rotation... I actually disagree with this general line of thought. I think that you can be an incredible doctor and just struggle with standardized exams like shelfs and boards. This is where if you are a good doctor, it should be reflected in your performance as a clinician, which is best reflected in your clinical evals, however flawed the system of it might be. I just always get the impression that SDN is full of academic nerds (myself included) who are great with grades (not always of course) but tend to struggle keeping up on rotations with the clinical stuff, but that's what being a doctor is about... not standardized exams.

So in general... sure it's not a perfect system but I'd rather be evaluated based on how I work as a doctor than whether I memorized the atypical presentation and buzzwords of some stupid rare disease. I absolutely agree that there needs to be (at least in some places) a general overhaul of how people grade or how they assign grades, but giving LESS weight to the clinical stuff, IMO, is not the right way to go.

 

[2012mdc]

I guess it's dependent largely on the institution you're in, but at my school most places (except for a couple notable sites) seem to do a good job of grading you based on your actual clinical performance, as well as how you present, what your knowledge base is, etc. I just don't feel like I've run into that situation or ever heard of people running into the situation at my school where the attending is a large dick who gives everyone middle/average grades because he can't remember names.

Consider yourself fortunate but those people are out there. That's not even the big problem though. The process is too subjective and not standardized enough. The 1-5 scale means different things to different people, attendings have differing expectations and the like.

Most programs do that simply bc it's in their students' best interest for as many ppl as possible to get honors, which screws over people at schools that grades with honors to only the top 10%.

I thought schools were required to put their grade breakdown in the Dean's Letter to prevent grade inflation from having a major effect. In theory grade inflation would hurt the top students because their honors will mean less.

What's the highest amount of honors you've heard given out? I always hear 10 or 20%

 

[drizzt3117]

Consider yourself fortunate but those people are out there. That's not even the big problem though. The process is too subjective and not standardized enough. The 1-5 scale means different things to different people, attendings have differing expectations and the like.



I thought schools were required to put their grade breakdown in the Dean's Letter to prevent grade inflation from having a major effect. In theory grade inflation would hurt the top students because their honors will mean less.

What's the highest amount of honors you've heard given out? I always hear 10 or 20%

I've heard 50-75% at certain schools (most of which don't have AOA, so you can figure out which ones pretty easily)

 

[2012mdc]

I've heard 50-75% at certain schools (most of which don't have AOA, so you can figure out which ones pretty easily)

wow that's f'in crazy

 

[mbe36]

My school requires us to score in the top 10% in order to be considered for Honors, regardless of how well we are graded by the clinical eval.

I really disagree with this policy.

Besides making honors very difficult to obtain, I think it lowers personal expectations for all students who don't strive for the "H". It seems like people assume the top 10% is impossible and default the stench of mediocrity that is the "just pass attitude".

I understand our school wanting to make honors seem special by making is difficult. However, I think they pulled the rug out from underneath themselves when it comes to overall student performance.

 

[username456789]

I thought schools were required to put their grade breakdown in the Dean's Letter to prevent grade inflation from having a major effect. In theory grade inflation would hurt the top students because their honors will mean less.

What's the highest amount of honors you've heard given out? I always hear 10 or 20%

Well, in theory, yes. But there's still the very subjective visceral response that I imagine a program director or other person in a higher-up position has when seeing "honors" in one/multiple rotation(s), regardless of school's grade distribution.

Anecdotally, I've heard of PDs that will "screen" based on number of clinical Honors (i.e. "fewer than 3 = doesn't make the cut" or what have you). How true that is and to what degree their criteria would waver based on a school's distribution of grades, I really don't know. But I think most would agree that at best it's mitigated by the included score distribution of your grades vs. your classmates', and at worse it could put you at a noticeable disadvantage.


FWIW, my school gives honors to 10% as a general rule, although there are one or two rotations in which they pride themselves on "almost never giving honors." It's silly, and as I mentioned above has really no positive benefits to the students whatsoever.

 

[drizzt3117]

That sounds pretty unbelievable. Most PDs care about medicine, surgery, and their specialty if they're in peds, psych, ob, or family med. Furthermore, at my school honoring two clerkships, HP the rest, plus all preclinical honors is easily AOA, and there's only one specialty where AOA makes up 50% of matched applicants, much less 100%.

Well, in theory, yes. But there's still the very subjective visceral response that I imagine a program director or other person in a higher-up position has when seeing "honors" in one/multiple rotation(s), regardless of school's grade distribution.

Anecdotally, I've heard of PDs that will "screen" based on number of clinical Honors (i.e. "fewer than 3 = doesn't make the cut" or what have you). How true that is and to what degree their criteria would waver based on a school's distribution of grades, I really don't know. But I think most would agree that at best it's mitigated by the included score distribution of your grades vs. your classmates', and at worse it could put you at a noticeable disadvantage.


FWIW, my school gives honors to 10% as a general rule, although there are one or two rotations in which they pride themselves on "almost never giving honors." It's silly, and as I mentioned above has really no positive benefits to the students whatsoever.