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So I posted about this problem before with unfair grading during one of my rotations. The site director was totally biased in the evaluation and gives everyone proficients. Did not bother to take a look at the evaluations I got from others. This problem has been occuring since this site director began there a few months ago. A classmate of mine previously tried to get his grade changed, and nothing was done. The clerkship director has not been helpful at all. I have been trying to reasonably explain how the site director saw me about 3 times out of the whole 6 week rotation and how this is a repetitive grading problem at this site. I got nowhere! Now the clerkship director tells me how the evaluations are used as "supplemental" elements to figure out our grade and what's really important is how the site director perceives us and that the site director's perception may or may not be a reflection of our overall evaluations. How the heck can a site director that sees you 3 times during the rotation and you has never seen you interview, has never seen you present, do a PE, or anything else evaluate you and not take into account anything that tons of other residents and attendings who have worked with you for over 100hrs have said?
Should I ultimately go to the dean? Does the dean have any power over grades or am I stuck with a totally unfair grade here?
Honestly, the best you can do at this point is take you and your friends cases to your schools Dean or Grading/Promotions and bring up the issues you're having with the rotation. The chances of you getting your grade changed at this point are probably nil, but the best you can do is help other people and make the rotation better.
For one of my rotations, the person who graded me saw me about 5 times in 4 weeks compared to another person incharged of the clerkship but was new who saw me everyday, and I was stuck with a less than desirable grade (but passed). Decided to keep quiet about it, and have scored very much better on my other rotations.
My advice to you is to do better and impress in the other rotations, you don't hjave to work for over 100 hours, just work smart. Be SEEN doing work and buzz around
The reason I think it will be difficult for you to get a grade changed (maybe nil was too strong) is because as you outlined your original, this is something that has been going on since this site director started. To go back and change your grade may invite everybody who she has made feel shafted return and ask for a reevaluation, especially if they too have good evaluations from others as you do. She may be opening the floodgates or pride herself as being a "difficult" grader and wants to maintain that position.
Personally, I'd wait until the site director comes back and renders her decision, and if you don't think the clerkship director is sick of you, go to her again with your concerns that the site director is being deficient in her duties. When handling these situations, you've got to follow the chain of command. You've made your opinion known with the person itself (the site director) her superior (the clerkship director), before going up the chain. Only after you feel you've exhausted your options do you go the Dean. (This is typically what's done. If you school has a different policy, perhaps a special office/comittee you should appeal to, I'd check).
As for overriding grades...I'm not sure. Your school may have an arbitration system set up where a third party looks at everything your evaluations and the site director wrote about you and sees if they agree disagree. Or a decision may be final. Got to check with your school's policies.
You may have more success with the clerkship director if you focus on having narrative evaluations from attendings and residents that worked with you be part of your final eval, and thus find their way into your MSPE.
It's easy for a course director to say "I can only give out so many H's and all of you are excellent" but harder to say "sorry I am not interested in the qualitative evaluations by people you worked with when I have this vague eval from someone who never saw you working."
Plus then your school will look stupid when they write:
Medicine:
Medstudentquest was a "proficient" student on the Internal Medicine service at ______. One attending raved that his write-ups were superb and that his presentations were polished and informative. Another stated that Medstudentquest went out of his way to improve patient care by ____, _____, and even _________. "One of the best students on this rotation." His resident wrote that he was an asset to the team and that "I hope he goes into Internal Medicine." His shelf exam score was above the 90th national percentile, earning him a final grade of Pass.
Yeah, what I'm saying is that getting those good evals included in your final assessment should be your priority. Once you achieve that, perhaps you could point out the absurdity of the passing grade.
Lol. I must admit that that made me laugh. 🙂 Well I did get awsome comments on the evaluations. They all talked about what a fantastic Dr. I would be, what great communication skills I had, what great knowledge base I showed, how good with patients I was, etc. The site director since she saw me about 3 hours for the whole thing put that I had done a commendable job. She did not include ANY of the comments made by the residents or other attendings! I am feeling so wronged here, and I am tired of the abuse, especially when it's something that happens repetitively and not just with me you know? Also, how can the clerkship director ignore all these complaints? ?
You are really getting yourself worked up over this, the site director isn't losing any sleep, the dean isn't losing any sleep. Look, the site director is like a kid in the playground who is playing "king of the hill" and will push down anyone who tries to stand up to them. Med schools are full of bullies who like to push around students, and impose their often times warped sense of the world. You are NOT living in some fantasy world where everybody treats everybody else with respect and gives timely feedback. For alot of clerkship directors and site directors, the fact that they decide grades in a certain way and hence, in their eyes have a great power over the future production of doctors, means *everything* to them. You can't expect anyone to roll over and give you what you want. No one is going to "wake up" to reality, but be prepared for retaliation from people who hear your comments. I personally would not pursue a "proficient" with honors in everything else, but would if there was significant medical student abuse and very unfairly/abusive training environment. Take justice by not helping out with alumni affairs after you graduate, and tell your classmates to do likewise, that is the only way the school will learn, you have negative 20 points of power now, because you need them more than they you need you. The longer you drag this out, if you are communicating with school officials, the more you look like a problem. School officials will not step in and stop even the most abusive attendings, why? because they would have to admit they did something wrong, which they rarely do. Frankly, you are overestimating how much other people would care about your problems, I care about my patient in the ICU right now, even if I met you and heard your story face-to-face I might not be especially moved consider what we all see everyday. what you see as a great injustice, they just see as business as usual. . .
Well I am getting extremely angry about this! I have been terribly abused in 2 rotations already. My OB rotation I suffered tremendous abuse, and yes I know OB sucks, but this was taken to a whole other level of abuse. Now this rotation. Where do I draw the line? Where the hell am I going to get being continuously screwed over with grades like these? Also, I want her punished. I don't think it's impossible to do. The school has nothing to do with appointing attendings at hospitals, but they sure as heck can pull their students from sites. In my school particularly, I know of 2 sites that have been pulled out already due to inappropriateness. Further, I think the school is going to start looking pretty bad if people keep complaining about this site.
Do you just propose no one do anything ever when abuse occurs? It's as if I see a patient being mistreated and I say nothing because of the big bad attending. Attendings come and go, no one is that special.
I would encourage you to let your anger go about this. If you want to effect change, start a paper trail that articulates your position in a very professional manner. Enlist the help of the residents and your fellow students if things are as dire as you outline above. Courtesy-copy everything that you write to the rotation director to the dean of students and the dean of education. Encourage other students to do the same and work with members of your student government. As with any letters that outline a problem, offer several solutions and be sure to attempt to see the situation from the opposite point of view.
Getting angry is not going to get your problem solved. Open, mature discussion will get the problem identified. Offering solutions will greatly help your cause. The other thing to avoid with this problem is personalizing it. If this is something that affects the entire class (and classes to come), don't make it a personal crusade but make it an issue that will help the school.
I remember when I was a first-year student, a group of third-year students found that my school's policy of administration of all shelf exams on the same day, overwhelming. They outlined the problem, offered several solutions and outlined how it would benefit all students. It was too late for a change in policy to affect the students who effected the change but everyone who came behind them benefited from their actions. They worked with administration and the student government and change happened. It was difficult but they hung with it and saw the project through until the end. Those of us who came behind them benefited both from their example of how to effect change and from the actual change in policy.
Throwing out words like "abuse" and "punishment" keep you in a negative situation that will tend to snowball. The first thing that you can change about any situation is to change your thinking. In the end, your career will be better for taking the most professional route. Whether your school is right or wrong on this issue, don't let this "poison" your entire third year because you cannot let go of anger. Good luck !
Thank you for your comment. Me saying I am angry about is merely to address the other poster. Obviously, I would never write anything in a rage. I have been writing very professional and polite emails to the site director and overall director. The previous student who actually complained said the same thing and nothing was done for him either. I have offered them several solutions to both the site and the overall director, but they don't seem to want to listen. I realize that this is not a personal thing per se, and that it's happened to every student that has rotated through this site since the new site director. However, I am an individual who really dislikes abuse and that is what is happening here, and I am sufficiently persistant to do something about it. I even talked explained the situation to my advisor and she herself told me she had heard the same type of complaint from students from other schools about this site. It also is exhausting to deal with these problems, and many people just feel it's easier to let it go and get a crappy grade as opposed to doing something about it. Unfortunately student government can't do anything about this situation.
I am not only trying to change this for me, but I am also trying to help future students who will have the same end result if they rotate through this site. I would like them to receive appropriate grades. Like they say, "be the change you want to see in the world." I am tired of inappropriate situations occurring.
When people who have personal issues because of their past let them affect their objectivity, that becomes a problem. It's as if I became a director in the future and I gave all people who wanted to do OB proficients just because I hated OB. It wouldn't be fair if the student was a good worker and earned a better grade. That's what I am trying to accomplish-fairness. Why is that too much to ask for?
If it was an individual case, maybe. But it's a repetitive problem. Giving everyone proficients without working with the students and looking at the evaluations is absurb, and shows bias and ill intent. Otherwise, that should be announced from the get go so people can make informed decisions. The department has all of my evaluations! I agree that if it's going to be shady like this, then they should change to P/F. This goes beyond unfair. It's not a grading problem at other sites, since in other sites, all the directors look at the evaluations and then sort of put them together. This individual is simply biased.
I am not getting a letter from this rotation, and I have more than enough people willing to write me good letters from things I am actually interested in going into. I also think that if a person wants to see change, then they should do something about it. If no one speaks up, nothing gets done.
I believe you are misunderstanding. I never said everyone at my school gets Pass for the rotation. I said that everyone who rotates at this particular site under this director has gotten a pass. My advisor who I recently talked to said I should bring this up to the dean. I think I will. Enough is enough.
Well no worries I am not planning on going in to talk to the dean like a deranged lunatic. 🙂 I am going to go to the dean with my evaluations in hand and explain the situation. There is nothing any of the directors can say because the clerkship director does not work with us, the site director already gave the "evaluation" so the least I could get is what I already have, and all the evaluations i got from people who actually saw me are remarkable. I will go in to talk probably with my classmate in a very rational and calm manner. Although I think it would be great that a new site director were put there, I doubt it that will happen and if it does, it certainly will take time. Also, that is not my end goal here. I would love to help not only myself, but future classes as well.
I am afraid that I seriously doubt that your grade will be changed, although perhaps it should. Medical school is not a democracy as one attending said, it is more like the mafia or organized crime (maybe it really is organized crime as there are many uninsured people in the US, but healthcare is made to be profitable in this country). You don't have any rank, no leverage, and they know where you live and can destroy your plans for providing healthcare. . . I hate to say it, but, you really don't know who you are dealing with, no one is going to have an epiphany and change your grade, they will pretend to care, and try to weave a story or fake plan about doing something that will go nowhere, . . . you really don't understand how low down on the totem pole you are . . . good luck because the dean ain't gonna change nothing unfortunately, it is sad because you probably don't realize that you have already lost if the school has dragged their feet this long. There isn't going to be any "explaining the situation" to the dean, he/she already knows, and has declined to do anything about it, trust me, the deans know all about the nasty little attendings that are pissing in their sandbox, and if they are still there it is because they have official sanction. You need to read about political history and about how sloppy and amoral governmental agencies work, because this sort of crap happens all the time elsewhere, medicine is probably worse though because alot have a god complex, or were attracted to medicine for power and prestige. Just because your upset about being treated unfairly doesn't mean that anybody has to do anything to help you, especially that you are now talking to a dean about one of your miscreant attendings.
Again the dean has no idea about rotations. Deans have no knowledge of what goes on. Clerkship directors sometimes don't even know what's going on. Dean has done plenty for other people in similar situations and for me in the past. Abuse and unfairness needs to be addressed. If you feel ok with it, that's your perogative. Change is forged. Otherwise, there would also not be any women in medical school, residents would still work hundreds of hours a week, etc.
That's true that things can change, very slowly though. Most deans do have a fairly good idea of what is going on, and most clerkship directors do have a good idea of what is going on, it is nice though to have plausible deniability and say that you don't have any idea what is going on. One dean, I knew, had a very good picture of an abusive attending, but wouldn't acknowledge that she knew anything of what is going on, it is in their own self-interest to pretend not to know what is going on, but believe me, they see a ton of students, and even a *****ic dean would be able to figure out which clerkship directors/site directors were causing problems. Most medical schools are rumor mills, the upper-level gossip, i.e. behind closed doors where attendings talk frankly about problems in various clerkship is made invisible to medical students. There are more than a couple things that your dean knows that would make your eyes bulge like a herniated disc. Most deans are not optimistic physicians who want to change the world and make the medical school better for students, but career bureaucrats that get ahead by stabbing people in the back, any attendings who has risen to that level in any medical school makes me nervous, why aren't they out there helping people in developing countries or even practicing medicine when instead they decide to dictate behind a desk and coverup for their corrupt and abusive friends? They may talk the talk about doing good things for medicine, but they don't walk the walk , , ,
man, just be glad you passed
when i was in my 4th year of med school, i had still had 2 cores to do: family medicine and peds. of course these were both scheduled during the months i had interviews. and both were req'd rotations at our school(i went to a primary care 'shove it down your throat' kind of school)
so when i had to take off to do interviews? were my residents understanding? hell no...what about the preceptors? again nope...what about the clerkship directors? well for peds, the director told me because i pissed off the residents by not being there a few days due to my interviews, i would have to "make up " time by redoing a week of the rotation...and in fm, they told me that i "didn't participate enough" in small group sessions so i would have to make that up by redoing one of those as well..
the point im trying to make is, if theyre out to get you, they have the power to do it. just don't rock the boat and youll be fine. there are a ton of malignants a$$wipes in the world, not just in medicine. so its time to grow a tough hide and take the lashings in stride...hey that rhymes!!
peace,
green
i already won against the freaks at OB.
You're my new personal hero if you were able to change a malignant OB rotation! Maybe why ob/gyns have such hard times with malpractice insurance/numerous lawsuits is because alot of physicians, ob/gyn included, had such an abusive experience on some ob/gyn clerkships. I heard one ob/gyn lecture who was on a committee to prosecute fellow ob/gyns, you could tell he enjoyed wrecking their careers, even if common sense said they didn't do anything wrong. There are alot of good medical students who would be good care providers and advocates of women health, but they turned off from ob/gyn during the clerkship IMHO
You're my new personal hero if you were able to change a malignant OB rotation! LOL, it is funny because it is true. Maybe why ob/gyns have such hard times with malpractice insurance/numerous lawsuits is because alot of physicians, ob/gyn included, had such an abusive experience on some ob/gyn clerkships. I heard one ob/gyn lecture who was on a committee to prosecute fellow ob/gyns, you could tell he enjoyed wrecking their careers, even if common sense said they didn't do anything wrong. There are alot of good medical students who would be good care providers and advocates of women health, but they turned off from ob/gyn during the clerkship IMHO. I was harassed both physically and mentally during ob/gyn, and probably should have filed a lawsuit.
Yes it was one of the most satisfying experiences of my existence! 🙂 I was like little medical student me: 1, OB: 0! And some grade modification was involved because of the crazyness that occured and some of the evil things done during the rotation were changed and even a new policy was put in place. One of the advisors was like: the only reason this is happening is because you were very persistent. Most people would have given up by now. Every time I tell about my OB rotation, everyone looks at me like no way! I also would absolutely help on committees to prosecute malignant OB's to be honest. I think the amount of abuse that goes on in OB is absurd, and that not only turns off people who would have initially liked to go into the field, but will ultimately affect patients. Even hard core surgery rotations are not as bad as OB though. And the worst in my experience: OB's who are DO's! That's like the kiss of death.
Easy now. Anecdotal comments are seldom right or appreciated.
On a side note, I hope you get your grade changed. I've been reading your story and would have backed you up 100% if I was at your school. Never accept the status quo just b/c it's convenient. Keep us updated!
G'luck..🙂
i didn't do a bad job on my rotations, i think i did an excellent job, and did very well on the shelf exams. but what ppl disliked was that i was doing the rotations in my 4th year and had to leave on some days when i had interviews for residencies. they thought was disruptive and it was my fault for doing it, so basically they would have been happier if i didn't go on interviews, didn't match but didn't miss a single day of the rotation
the point is even if you think you did "honors" level work but they just give a pass, you can't do anything about it. what it will do is allow the administration to flag you as being a "trouble student", one who doesnt listen to authority,etc. and that create trouble later on. so just let it go and do better on your other rotations
no that's not it. it's not that i think i did awsome, it's that i got almost 10 awsome evals saying so! it's just the site director is difficult and has this chip on the shoulder that bc she was average, everyone else must be. she even told me that the residents/attendings said awsome things about me and stuff, but she gives the final grade. she's never given anything other than a proficient. she keeps refusing to look at other people's evals. she either needs to start working with us or else rely on other attending's/residents' opinions. she can;t just do what she wants because she feels like it.
Medstudentquest, you're beginning to worry me.
I do hope you find a balance between going absolutely nuts with the director and having your grades changed.
Try discussing it with your tutor (if you have one). Evals are probably one of the most subjective issues a student goes through and sometimes, you will never get what you think you should be getting
Medstudentquest, you're beginning to worry me.
What I find particularly worrisome is when someone listens to ChildNeuro so much. Yikes.
No need to worry about me. I do have a right to be upset at things that are unfair. I also have showed the most absolute delicacy and professionalism when addressing the director. Again, the evals I have gotten are absolutely awsome. The problem is that the site director refuses to look at them or take them into account because she wants to give eveyrone proficients. I am not an isolated case.
What I find particularly worrisome is when someone listens to ChildNeuro so much. Yikes.
All the best then, keep us updated, but don't do something crazy which I would read in the papers![]()
She is kinda hot..😛
She is kinda hot..😛
Keep it comin' boys, a girl can't get too many compliments 😀