Medical How should I think about clinical grades and MSPE for matching?

[TheBoneDoctah]

Hi,

I go to an MD program which has switched to essentially Pass/Fail grading since March (when clerkships were halted for COVID) for clinical grades. Before that I scored a HP on medicine and a P on neurology, with poor shelf grades. In both of these clerkships, I had pretty good clinical evaluations (although none that sing of me as the next messiah or anything).

Since our clerkships were resumed, I've passed them all, but many of them have been struggling to get us patient contact due to the virus, and there were really far fewer opportunities to evaluate me. Most clinicians have much bigger things to worry about and more stressful work lives nowadays too, so I can understand that. How this has played out for me has been just an overall lack of evaluations - my main surgery residents didn't write evaluations for me, my psychiatry clerkship I only had regular contact with 1 attending and 2 fellows through zoom calls, and I don't think any attendings evaluated me for OB/Gyn. The evals I have gotten have been fairly short and have not said too many things about me which could go into the MSPE. My MSPE will likely be "bland" and have little content in it, along with poor clinical grades at the start.

I would like to apply into a surgical subspecialty like urology or orthopedics. I realize that, at the current moment, the most important things are to do my best on the remaining clerkships and do well on step 1, aways, research, etc. But to what degree do my early clinical grades and my bland MSPE hurt me for matching in these fields? Can they be overcome - and if so, how stellar would the remaining parts of my application need to be? Who should I talk to for more information? And lastly, is a gap year needed in my situation to match into these fields?

I know I have a lot of questions, but some brutal honesty would be greatly appreciated. Irl, most people I talk to are quite kind to me and encouraging (and of course that's great in it's own way), but these are people who know me well and who don't want me to give up. Thank you so much!

I am not sure about urology, but when I was interviewing for ortho, I was never asked about grades or the MSPE letter. Worry about things you can control at this point and realize most people are in the same boat. Worry about your remaining grades, boards, LOR, research and connections. These are things YOU can control with some work. I was asked about my LOR at every interview because these are people who worked with you directly.

Also, the reason for you to take an extra year before applying would be for a research year which could be very beneficial if you don’t have any to speak of.

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[AlteredScale]

Your mspe is a summary of your entire performance. So everyone else applying your year has also gone through essentially the same stuf with the same lack of clinical hands on exposure. As said above focus on your grades and doing as well as you can. I too was never asked about mspe on my interviews.