Impact of not honoring IM on IM match

[000_]

So it looks like I'm going to end up with an HP in my IM clerkship. Coming from a mid/upper-mid tier MD school, how much does this tank my chances of matching at a T30 program? Excluding the top 4, let's say, because I don't plan on applying to those anyway. Can Step 2 and sub-I honors reasonably make up for this or is it more or less a black mark on my transcript?

Unfortunately I also HP'd my last 2 clerkships so I'm looking at a maximum of 2 honors in 3rd year (my school only has 5 clerkships that are graded) assuming I can honor all my other clerkships. That means I'm out of AOA per my school's criteria as well. On paper it looks like my chances of matching at a T30 are pretty bleak unless everything else is significantly above average. Is it as bad as it seems?

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[GoSpursGo]

Why do you care about matching at a T30 program?

Anyways, no this does not doom you because other than the top 4, IM isn't super competitive. But whether it's your step 2 score, or research, or something else, there needs to be something that a potential program will latch onto that will make them think you're interesting.

 

[NotAProgDirector]

It also depends on how many people get H vs HP vs P at your school. If 80% of people get H and you don't, then that doesn't look good. if only 10%, then less of a concern.

 

[000_]

It also depends on how many people get H vs HP vs P at your school. If 80% of people get H and you don't, then that doesn't look good. if only 10%, then less of a concern.

I don't know the exact distribution but our grading document says they expect 35-45% to get honors by the end of the year. 45-55% HP. They say the same thing for all clerkships though so I don't know if IM is different.

 

[NotAProgDirector]

So you've gotten an HP in the three clerkships you've completed. Given that distribution, that places your performance in the bottom half of your class. It's less likely that top programs are going to be interested. At many places, everyone gets H on their SubI, making it meaningless. Regardless, you'll still be competitive for an IM spot at good programs.

 

[000_]

So you've gotten an HP in the three clerkships you've completed. Given that distribution, that places your performance in the bottom half of your class. It's less likely that top programs are going to be interested. At many places, everyone gets H on their SubI, making it meaningless. Regardless, you'll still be competitive for an IM spot at good programs.

What tier of top programs am I more or less out at? I know top 4 is out, and T10s like Columbia, Penn, etc. What about programs like Sinai, UPMC, BU, etc.? What are some programs I can be competitive for?

What do you define as a good program?

Is there anything that can be done to make up for the high passes or is it pretty much done at those programs?

 

[NotAProgDirector]

I think the best way to assess this is to ask your school. They hopefully track where prior grads have gone, and can show you where people with your performance have ended up.

 

[voxveritatisetlucis]

You’ll be fine. Even ppl from my low tier school match to top 40 IM all the time. I’m sure it’s much easier from a good school

 

[voxveritatisetlucis]

It also depends on how many people get H vs HP vs P at your school. If 80% of people get H and you don't, then that doesn't look good. if only 10%, then less of a concern.

Yes but isn’t there a program that allows PDs to
filter by clerkship grade? In that case they might not even see the MSPE. That’s why everybody who wants to do any type of surgery panics about surgery grade

 

[NotAProgDirector]

Yes but isn’t there a program that allows PDs to
filter by clerkship grade? In that case they might not even see the MSPE. That’s why everybody who wants to do any type of surgery panics about surgery grade

You can't filter by clerkship grade in ERAS itself. Perhaps Thalamus Cortex but I haven't used it, and the last time I tried it I wasn't impressed.

 

[000_]

I think the best way to assess this is to ask your school. They hopefully track where prior grads have gone, and can show you where people with your performance have ended up.

I scheduled a meeting with an advisor to talk about my app overall, which will include the questions I have about my grades. But from your perspective, what aspects of an app - if anything - would make you think "okay, this person messed up in the beginning, but they've proved themselves since then."

My understanding is step 2 doesn't matter after 260 and as you said, honoring your sub-I is the baseline expectation. I take it honoring the rest of the clerkships is simply too little too late and is an expectation rather than a positive.

What are some other things that can show growth? Would strong LORs make up for the poor 3rd year performance, and if so, how strong would they need to be?

To answer the why T30s question from above, it's not really T30s as a whole as it is one specific program I really like which happens to be a T30 in a desirable location. There are a number of other schools in the T30-40 ranking which seem to be a good fit, but I haven't looked into them much because there are more immediate things to focus on right now and I'm unlikely to match there anyway.

 

[NotAProgDirector]

Hard to say.

In general, most LOR's state that the student is in the top 5% of everyone they have ever worked with. Obviously this is impossible. A letter from someone I know definitely can have more weight as I'm more likely to believe it. In some fields, LOR's may be one of the most important aspects of your application -- often small fields where "everyone knows everyone else".

My only advice is to try to do as well as you can on upcoming clerkships. And of course as good a score on S2 as possible. And then SubI's in your field of interest which hopefully will lead to a good LOR.

Realistic program targets will also help. It's quite possible that this T30 program you're talking about will be a stretch/reach for you. So apply and shoot your shot, but explore other programs and don't hang your happiness on this single program.

 

[000_]

I suppose that’s the only thing that can be done at this point, but it seems like those things won’t make much of an impact anyway based on what I’m reading? As in, they avoid “negative points” but don’t add anything to the application now that the most important part has passed. Is there even anything I can work towards right now that will actually boost my application rather than just keeping it from getting worse?

 

[Redpancreas]

You’re performance seems consistent with an HP performance so extrapolating that to your remaining application, you’ll likely end up at a program with similar prestige as what you’re at meaning the midwest state schools or better privates outside of Chicago (safety) and Ann Arbor (reach). Doing better on the others puts you in contention for top 20 meaning the highly ranked east coast private schools +/- ivy status or good programs on the west coast.

I really concur with @GoSpursGo. I know this seems like the end all be all now but if you just want to match a competitive fellowship or to have really good training, you’re likely going to be fine even if I dare I say you match at a lower tier university program (which won’t happen). I know that doesn’t register to you now, but in 5 years it may.