If a school is pass/fail with internal ranking, does class rank matter for residency?

[and 99 others]

My school has P/F pre clinical and class ranking is only visible to the administration, it is not publicized anywhere. If this is the case, does being ranked in the bottom of the class make one less competitive for residency? As it stands, I'm interested in a competitive specialty but very much am only interested in passing, I don't care much about acing every exam. This is because my school's in-house exams are not boards style and diverge a lot from boards material, so I spend most of my time studying third party resources to make sure I do well on step, but this means I score lower (but still pass) my in house exams. I also use this freed up time to do more research.

Am I missing something here and inadvertently shooting myself in the foot because I often see people remarking that just barely passing is a bad idea and will make one very uncompetitive for residency.

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[GoSpursGo]

Most of the time the "internal ranking" is disclosed in your MSPE when you apply to residency. It is also used as determining factor for AOA, if your school has it. So yes, class rank matters.

This can potentially be counterbalanced by school prestige, mostly honors on clinical rotations, high step 2, and/or research output. How to best balance these important factors when applying to a competitive field is something only you can determine.

 

[and 99 others]

Do MSPEs directly state my class rank? And if so, how much of an impact do the letters have on one's competitiveness? I feel like with the way my school's curriculum is structured, I would have a hard time excelling in both Step 2 AND in-house exams. It feels like choosing which one to prioritize matters. Also, my school doesnt do AOA if that changes much.

 

[gyngyn]

Do MSPEs directly state my class rank?

Ask your Student Affairs dean how your rank will appear in the MSPE at your school. It will often appear in a graph.

 

[GoSpursGo]

Do MSPEs directly state my class rank? And if so, how much of an impact do the letters have on one's competitiveness? I feel like with the way my school's curriculum is structured, I would have a hard time excelling in both Step 2 AND in-house exams. It feels like choosing which one to prioritize matters. Also, my school doesnt do AOA if that changes much.

Yes usually. Often as a graph as mentioned by @gyngyn , but also occasionally through a “code” word in the last sentence. For example, “In summary, @and 99 others is an outstanding/excellent/great/very good applicant,” where each of those adjectives corresponds to 1st/2nd/3rd/4th quartiles respectively and that is either spelled out explicitly or is known from historical precedent from your school. The MSPE is hugely important for your residency application, as it basically explains what all of your grades mean since each school grades differently.

Only you can know what makes the most sense for you to prioritize, and this is where connecting with mentors in your field of interest at your institution is incredibly important. Maybe they would agree that the curriculum at your school is so esoteric that you need to just focus on step 2. But keep in mind that nobody is forcing you to apply to a competitive specialty, and nobody is entitled to match in their field of interest. By definition you will be compared against other very competitive applicants.

 

[deleted1095841]

Please correct me if I'm wrong, but I think the internal ranking at most schools is based on clinical grades much much more than preclinical, in which case OP would have nothing to worry about.

 

[gyngyn]

Please correct me if I'm wrong, but I think the internal ranking at most schools is based on clinical grades much much more than preclinical, in which case OP would have nothing to worry about.

It is entirely variable.

 

[GoSpursGo]

Please correct me if I'm wrong, but I think the internal ranking at most schools is based on clinical grades much much more than preclinical, in which case OP would have nothing to worry about.

Agree with @gyngyn , there is more or less no rhyme or reason for how much weight preclinical grades play a role. The OP really needs to figure out the story for their specific school

 

[voxveritatisetlucis]

My school separates it into preclinical and clinical rankings but both count for AOA so class rank during preclinical is still extremely important

I believe that there is significant overlap between students who rank highly on each part so there really isn’t much room for error

Also depends on school rank. I would say that any higher than brown/jefferson/einstein schools, rank doesn’t matter much at all

 

[and 99 others]

Agree with @gyngyn , there is more or less no rhyme or reason for how much weight preclinical grades play a role. The OP really needs to figure out the story for their specific school

And the way to do this is by just asking Student Affairs Dean? Seems like the details of that info aren't something that schools would necessarily tell students outright. But that's just my sense.

 

[GoSpursGo]

And the way to do this is by just asking Student Affairs Dean? Seems like the details of that info aren't something that schools would necessarily tell students outright. But that's just my sense.

I think so. Even if you don’t get the full details, you should be able to get a yes/no answer of how class rank is disclosed in MSPE

 

[operaman]

Can also look up your school here. It’s a bit old now but you can at least see what your school did before. I can’t see the file at the moment but in the pest they linked their database in the full text version with info broken down by school.

A program director's guide to the Medical Student Performance Evaluation (former dean's letter) with a database - PubMed

The authors recognize that this database is incomplete and that the individual institutions will alter their ranking system from time to time. But this database is offered in an open format so that it can be continuously updated by users.

pubmed.ncbi.nlm.nih.gov

 

[aldol16]

It really depends on the school and you should ask this question to the upper years in your school. While rankings may be "internal" in the sense that they don't get reported numerically anywhere, your school might take this into consideration when writing your dean's letter for residency. They might use different adjectives to describe different tiers of student or even outright state your general position in the class (e.g., top third, middle third, bottom third). You won't know this unless you talk to students who have gone through the match and have seen their dean's letters.

 

[collegestud2013]

sted in a competitive specialty but very much am only interested in passing, I don't care much about acing every exam. This is because my school's in-house exams are not boards style and diverge a lot from boards material, so I spend most of my time studying third party resources to make sure I do w

Can also look up your school here. It’s a bit old now but you can at least see what your school did before. I can’t see the file at the moment but in the pest they linked their database in the full text version with info broken down by school.

A program director's guide to the Medical Student Performance Evaluation (former dean's letter) with a database - PubMed

The authors recognize that this database is incomplete and that the individual institutions will alter their ranking system from time to time. But this database is offered in an open format so that it can be continuously updated by users.

pubmed.ncbi.nlm.nih.gov

This. Totally school-dependent. Some schools won't have any way to distinguish students at all as long as they pass; this tends to be the higher-ranking research schools that already carry a degree of brand name and prestige and hence these would be the true pass/fail medical schools. Others will indirectly or directly state your quartile, and some may even disclose your exact numerical rank. The latter tends to be more common at mid-tier and lower tier medical schools.

 

[gyngyn]

Seems like the details of that info aren't something that schools would necessarily tell students outright.

We are required to disclose this information to students.

 

[and 99 others]

Okay, I've spoken to my school and actually it turns out that our rank is not disclosed in the MSPE at all, not even through adjectives. They just mention if we remediated any course. Internal preclinical ranking is only used for departmental awards. So, it seems like a true P/F with no externally visible ranking. Clinical grades are also just mentioned in the MSPE, but we are also just P/F clinical.

So, given that there is no ranking and no AOA, is there anything else I may be missing about class rank? I would love to stop caring about scoring in the top percentiles and just allow myself to focus on third party material even if it means a lower grade for in-house exams.

 

[Mr.Smile12]

Okay, I've spoken to my school and actually it turns out that our rank is not disclosed in the MSPE at all, not even through adjectives. They just mention if we remediated any course. Internal preclinical ranking is only used for departmental awards. So, it seems like a true P/F with no externally visible ranking. Clinical grades are also just mentioned in the MSPE, but we are also just P/F clinical.

So, given that there is no ranking and no AOA, is there anything else I may be missing about class rank? I would love to stop caring about scoring in the top percentiles and just allow myself to focus on third party material even if it means a lower grade for in-house exams.

It seems that your school told you how it handles class rank. If they aren't going to signal, message, or infer your rank in your MSPE, then being in the lower ranks will not be communicated for your applications. You have to trust the process and the faculty here unless you think there is covert communication occurring where hundreds of PD's ask your faculty about the actual rank of you and your classmates. I don't see that being done routinely.