M4s trying to match...what would you have done differently?

[SandP]

Just want to get some perspective. Thanks!

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[Anti-PD1]

Kill shelf exams. Everyone is 'wonderful to have on the service'. Clinical grades > MSPE.

Date. A lot.

 

[failedatlife]

Tops of my list:

1) Drop out of medical school while it was still early.
2) Set my hopes up for family medicine.
3) NEVER have done research.
4) Study for step 1 every moment of my life that two years. Become a book worm for the boards.

5) Or just have blown med school off completely. Get drunk every night, hit on ugly girls at seedy bars, expressed how I truly feel about my classmates, etc.

Bottomline: I would have either put my life and soul into Step 1 or just not give a f- and p=md my way into family medicine.

I regret deeply the past three years of life.

 

[ortnakas]

Probably better to ask us in March after the match.

Biggest tip that applies to everyone: save lots of money, this stuff is expensive. First ERAS, then a new suit if you need it, then audition travel/living expensive, then interview travel expenses (flights, rental cars/Ubers, hotels, mealos out, etc). It adds up fast.

 

[Crayola227]

and remember all the residency relocation cash you're going to need before you get that first "sweet" residency paycheck

 

[Osteoth]

Kill shelf exams. Everyone is 'wonderful to have on the service'. Clinical grades > MSPE.

Date. A lot.

Lol.

Tops of my list:

1) Drop out of medical school while it was still early.
2) Set my hopes up for family medicine.
3) NEVER have done research.
4) Study for step 1 every moment of my life that two years. Become a book worm for the boards.

5) Or just have blown med school off completely. Get drunk every night, hit on ugly girls at seedy bars, expressed how I truly feel about my classmates, etc.

Bottomline: I would have either put my life and soul into Step 1 or just not give a f- and p=md my way into family medicine.

I regret deeply the past three years of life.

Well **** man.

 

[WhiteCoatWonder]

Probably better to ask us in March after the match.

Biggest tip that applies to everyone: save lots of money, this stuff is expensive. First ERAS, then a new suit if you need it, then audition travel/living expensive, then interview travel expenses (flights, rental cars/Ubers, hotels, mealos out, etc). It adds up fast.

first, this.

then, less amazon for "school supplies."

also, i would have had a strategic 4-year plan coming into school. being the second person in my family to even attend college, i had no idea about so many medical school things before starting. im not speaking in reference to career choice, just having an idea of what the 4 years would look like and when to insert things i.e:

-knowing how much of which disbursements to save for step/eras/coffee stockpiling
-remembering that everything that you learn can CYA one day, for a pimp session or for a patient
-realizing that the order of m3 rotations matters a lot less than i thought
-definitely studying for step 1 on day 1...not neurotically, just never ever forgetting that beast (big up to whomever already said that)

 

[Milotic]

If you have location/prestige preference, do whatever you can to get AOA.

 

[tellmemore2020]

.

 

[Lya]

1) Shadow early to narrow down your specialties of interest. Get to know residents and attendings early. It's much easier for you to stand out among the applicants if you show interests as a first year student and then come back to rotate as a third year student showing your commitment to the specialty.

2) Find a supportive mentor and start research early. Research is probably one of the best ways for your attending to get to know you. Once you demonstrate your work ethic and research skills as a medical student, your mentor will give you not just a great letter, but also can support you and offer advice for your lifetime. The mentor may even help you with getting interviews and jobs down the road. Also as you do research, appreciate the breadth and depth of the specialty along the way. Appreciate how research questions change and evolve over the years as we know more answers. Even if you know you are not going to do research as an attending, it's still important for you to stay updated with research and realize where your field is going. Lastly, it's better to have one completed project that led to a manuscript than having five unfinished projects that led to five posters.

3) As mentioned above, start studying for step 1 early. People who tell you otherwise are the ones who actually go home and do opposite of what they said and watch sketchy/pathoma/do questions. Number one regret that people have after finishing the exam is that they wished they started studying early. No one says that they studied too much and wished they prepared less.

 

[el_duderino]

1) Make connections to faculty (not residents) in your anticipated specialty. They should know your name and say hi in the hallways.

2) Get your name on publications.

 

[MrTaco92]

Tops of my list:

1) Drop out of medical school while it was still early.
2) Set my hopes up for family medicine.
3) NEVER have done research.
4) Study for step 1 every moment of my life that two years. Become a book worm for the boards.

5) Or just have blown med school off completely. Get drunk every night, hit on ugly girls at seedy bars, expressed how I truly feel about my classmates, etc.

Bottomline: I would have either put my life and soul into Step 1 or just not give a f- and p=md my way into family medicine.

I regret deeply the past three years of life.

I appreciate this post

 

[WhiteCoatWonder]

Have a more concrete plan on approaching my studying for Step 2. I was super burned out and couldn't finish UWorld. Ended up dropping from my Step 1 score, which makes sad given how hard I prepped for Step 1.

Approach every 2-week span with an evaluator as if they're writing you a recommendation. My school makes it difficult to get recommendations as we spend almost no time with attendings because they rotate us too much.

yep. always gotta be "on".

 

[masaraksh]

I think I should have applied neurosurg rather than ortho :/

 

[Redpancreas]

Just want to get some perspective. Thanks!

If I came in primed from day 1 I'd have done many things differently and did not realize how competitive some IM programs could be.

1.) I would not have settled for just passing in Years 1 & 2. Class rank is a pretty big deal even if there are no honors. I really put a lot of effort into it and struggled mightily but going back I think I could have done some personal wellness things like restart my hobbies that could have improved my performance.
2.) I would have found a way to churn out more research and strive for a publication.
3.) I would have "played the game" on clerkships. Overall HP or Clinical honors/commendation is not only highly subjective but game-able. I would have suspended evaluations I knew were going to be straight 3's while getting a resident I was cush-cush with to evaluate me and give the clerkship director no choice but to base my clerkship grade on that one evaluation. This particularly hurt me on my first rotation putting me on the bottom 30% of my class for that clerkship.

------------------------------------------

Things I think I did fairly well:

1.) I don't regret investing more time in board exams/shelf exams to maximize my performance.
2.) Got involved in leadership activities. I know it's a checkbox for many, but I was very engaged in certain activities, made a quantifiable difference, and learnt quite a bit.

-------------------------------------------

If I were to do it all again somehow go through it again with the knowledge of what it took, I probably would never have gotten AOA regardless, but I could have definitely made myself look better in a few areas.

 

[Barbecue]

Spend more than 1.5 days studying for CS

 

[Coupd'Cat]

Would've found a study method that consistently worked, earlier. Turns out I am no good with flashcards.

 

[Osteoth]

If you have location/prestige preference, do whatever you can to get AOA.

Hadn't heard this one before.

I think I should have applied neurosurg rather than ortho :/

Why?

 

[bobjonesbob]

I think I should have applied neurosurg rather than ortho :/

Also would like to know why as a current MS-2 interested in both of these fields

 

[MrTaco92]

Also would like to know why as a current MS-2 interested in both of these fields

I think its because neurosurg is a lifestyle specialty

 

[Shams al Deen]

Kill shelf exams. Everyone is 'wonderful to have on the service'. Clinical grades > MSPE.

Date. A lot.

I didn't realize how hard that was. You actually gotta come home every night from the hospital and study your ass off. Ms1/2 was too easy, made me lazy. Step 1 made me over confident in nbme. Those shelfs are no joke. Harder than step1 imo

 

[SandP]

I didn't realize how hard that was. You actually gotta come home every night from the hospital and study your ass off. Ms1/2 was too easy, made me lazy. Step 1 made me over confident in nbme. Those shelfs are no joke. Harder than step1 imo

is there no time to study at the hospital? how much downtime is there?

 

[jurisburger]

is there no time to study at the hospital? how much downtime is there?

Depending on what rotation you're on there could be some downtime here and there. But even if there is "downtime"...studying at the hospital, likely at the computer station where all your residents are also sitting, is inefficient and you'll likely be continuously distracted by people bustling around you. If you're on a rotation like surgery good luck finding downtime during the day.

 

[sinombre]

Clinical grades > MSPE.

Not sure that's true. I had a PD tell me that he didn't care at all about ms3 grades because they were so subjective. Also I had a lot of good comments in my MSPE and they were brought up in multiple interviews. YMMV.

 

[Milotic]

Hadn't heard this one before.

Probably more common at lower tier MD schools since we don't have the prestige factor and need AOA to match at the big names in desirable coastal cities.

 

[Stagg737]

Don't be complacent. I would have busted my butt first year instead of coasting. Not like I didn't work, but most days I'd go to class, then go home and study for 2-3 hours and be done by 4 or 5 in the afternoon. Floated around average first year so I wasn't too concerned, then second year hit really hard and just passing became a struggle. If I'd busted my butt first year I might have had a better knowledge base, at the very least I'd already have been used to busting my butt and not had to try and catch up to my classmates. Made up a lot of ground during clinical rotations (worked really hard, had a good attitude, and did much better on shelf exams) and things are working out now, but it would have been nice to not have to freak out about my mediocre pre-clinical performance and boards.

I didn't realize how hard that was. You actually gotta come home every night from the hospital and study your ass off. Ms1/2 was too easy, made me lazy. Step 1 made me over confident in nbme. Those shelfs are no joke. Harder than step1 imo

I actually had the opposite experience and didn't study nearly as much for the shelfs at home as I did during pre-clinical years. I just paid attention on rotation, read a chapter a day from my selected text for the rotation, and did all the UWorld questions (only did UWorld for IM). Scored well above the 50th percentile for every shelf other than one, and I'd likely have done much better but circumstances I won't go into for anonymity caused me to not do as well as I would have (scored about 30% higher on practice NBMEs). Not saying I thought they were a joke, but our preclinical tests were a lot harder than the NBMEs.

 

[masaraksh]

Also would like to know why as a current MS-2 interested in both of these fields

I think its because neurosurg is a lifestyle specialty[/

Its because ortho call has a bunch of BS. Like spinting grandma's arm, or waiting 2hrs to sedate a kid to reduce a small inconsequential fracture. And sports patients are high maintenance and hope to return to playing sports just like they were before.

Neurosurgery - patients ****ting themselves because they dont wanna die... or, more often - "intubated, sedated, icu". less BS. You can order 3% saline from home, ask the nurse to poke their cornea, and if you need to come in its because grandma needs a haircut and an EVD or someones getting their skull cut open. Also, you're god

 

[kb1900]

Don't be complacent. I would have busted my butt first year instead of coasting. Not like I didn't work, but most days I'd go to class, then go home and study for 2-3 hours and be done by 4 or 5 in the afternoon. Floated around average first year so I wasn't too concerned, then second year hit really hard and just passing became a struggle. If I'd busted my butt first year I might have had a better knowledge base, at the very least I'd already have been used to busting my butt and not had to try and catch up to my classmates. Made up a lot of ground during clinical rotations (worked really hard, had a good attitude, and did much better on shelf exams) and things are working out now, but it would have been nice to not have to freak out about my mediocre pre-clinical performance and boards.



I actually had the opposite experience and didn't study nearly as much for the shelfs at home as I did during pre-clinical years. I just paid attention on rotation, read a chapter a day from my selected text for the rotation, and did all the UWorld questions (only did UWorld for IM). Scored well above the 50th percentile for every shelf other than one, and I'd likely have done much better but circumstances I won't go into for anonymity caused me to not do as well as I would have (scored about 30% higher on practice NBMEs). Not saying I thought they were a joke, but our preclinical tests were a lot harder than the NBMEs.

Do you think studying over he summer be ms1-2 would have offset part 1 if ur post?

 

[DrMcLovin]

If that's how you feel about ortho, you absolutely should not apply for it. You will be a miserable if you match.

Its because ortho call has a bunch of BS. Like spinting grandma's arm, or waiting 2hrs to sedate a kid to reduce a small inconsequential fracture. And sports patients are high maintenance and hope to return to playing sports just like they were before.

Neurosurgery - patients ****ting themselves because they dont wanna die... or, more often - "intubated, sedated, icu". less BS. You can order 3% saline from home, ask the nurse to poke their cornea, and if you need to come in its because grandma needs a haircut and an EVD or someones getting their skull cut open. Also, you're god

 

[Barbecue]

If that's how you feel about ortho, you absolutely should not apply for it. You will be a miserable if you match.

Might be a little late for that now though

 

[Stagg737]

Do you think studying over he summer be ms1-2 would have offset part 1 if ur post?

Nah, I actually don't think my foundation from first year was all that bad in reality (just pointing out it may have been). I think the biggest thing was that it would have been nice to have more of a GPA cushion and be used to studying a ton more hours. Second year was much more of an adjustment for me than it should have been, and I think that's where my problem was.

 

[ihazquestionz]

I would have stopped trying so hard in the hospital. I did really great clinically and loved being at the hospital and taking care of patients. But when it's 1 week to go to shelves and you still have a million uworld questions to go...not the best thing.

The students that did the best in my school grades wise did the bare minimum clinically and peaced out. If they didn't get clinical honors as a result, they "appealed" their grade and ended up with clinical honors. Something you can't do-miss the shelf honors cutoff by a point (cough cough annoyed) and appeal the shelf score. So...the best way to do well in my school was to be a **** med student clinically and try to get out of responsibilities as much as possible.

I personally don't think this is an appropriate way to go through school, but these students know that the system is a game and played it well. I'm just ranting now.

EDIT: I take it back I don't regret a single second of my hospital time haha. this post was entirely unhelpful.

 

[Osteoth]

Probably more common at lower tier MD schools since we don't have the prestige factor and need AOA to match at the big names in desirable coastal cities.

What does low tier mean to you?

 

[SpartanWolverine]

What would I have done differently?

Eh, not a whole lot. Maybe would have studied more efficiently for Step 1, but it's a tough exam and I'm sure I did the best I could at the time. However, I would certainly have spent less time doing fruitless research during M1/M2 and studied for boards instead (or been less 'dedicated' to an overambitious project and found something more bite-sized). Felt like my M3 and M4 years have been pretty good as was Step 2 and the whole ERAS/app process so far.

Oh, and as @Anti-PD1 said, date more.

 

[Coupd'Cat]

Also, you're god

Haha yes. I remember spending most of my time scrubbed in on my neurosurgery selective staring at the chief resident think-screaming, "YOU DO THIS EVERYDAY??"

Froke out each time she asked me to irrigate the patient's brain. Their brain. Just chillin' there. It was closed a moment (lol like 5 hours) ago and now I'm squirting water on it. Cool.

 

[SpartanWolverine]

Haha yes. I remember spending most of my time scrubbed in on my neurosurgery selective staring at the chief resident think-screaming, "YOU DO THIS EVERYDAY??"

Froke out each time she asked me to irrigate the patient's brain. Their brain. Just chillin' there. It was closed a moment (lol like 5 hours) ago and now I'm squirting water on it. Cool.

I like that. Will have to use it going forward...

 

[Milotic]

What does low tier mean to you?

Means jack to me but means a lot to higher tier IM programs. There is definitely a prestige factor when applying to those upper echelons. Coming from a top 40 medical school is a huge plus unfortunately. Subjectively speaking though a low tier MD is unranked etc.

 

[Coupd'Cat]

The students that did the best in my school grades wise did the bare minimum clinically and peaced out. If they didn't get clinical honors as a result, they "appealed" their grade and ended up with clinical honors. Something you can't do-miss the shelf honors cutoff by a point (cough cough annoyed) and appeal the shelf score. So...the best way to do well in my school was to be a **** med student clinically and try to get out of responsibilities as much as possible.

Yeah. We knew who those people were. It's a bit self-fulfilling, because I see others avoiding them now and--in the end--they probably didn't care about camaraderie or how it might affect others' respect for them in the first place.

In reality, I can only think of one of my classmates who did this unashamedly and to an extreme. He would sit in the team room with his notes in his lap while there were crises happening on the entire floor--but because his patient wasn't involved (whom he chose because they were one of the few clinically stable people on the floor) he didn't lift a finger to help anyone else. Also made up excuses to to skip days to study. I'm all for mental health days--but he would make up elaborate stories of why he had to be out for days in a row, then other classmates would see him studying in the library that same day.

I feel icky for even sharing this, but hopefully it can be a cautionary tale. Yes, take your time to study, but try to remember that medical school would ideally be about more than test-taking. I know plenty of people who stayed late just to help other students, team members, or patients even when they'd have one less hour to study and still had Honors at the end of the day.

Sorry for getting preachy. You do you! It's all about balance.

 

[Foot Fetish]

My face when waiting for someone to say they regret studying for boards really early

 

[Stagg737]

The students that did the best in my school grades wise did the bare minimum clinically and peaced out. If they didn't get clinical honors as a result, they "appealed" their grade and ended up with clinical honors. Something you can't do-miss the shelf honors cutoff by a point (cough cough annoyed) and appeal the shelf score. So...the best way to do well in my school was to be a **** med student clinically and try to get out of responsibilities as much as possible.

I personally don't think this is an appropriate way to go through school, but these students know that the system is a game and played it well. I'm just ranting now.

Yeah. We knew who those people were. It's a bit self-fulfilling, because I see others avoiding them now and--in the end--they probably didn't care about camaraderie or how it might affect others' respect for them in the first place.

In reality, I can only think of one of my classmates who did this unashamedly and to an extreme. He would sit in the team room with his notes in his lap while there were crises happening on the entire floor--but because his patient wasn't involved (whom he chose because they were one of the few clinically stable people on the floor) he didn't lift a finger to help anyone else. Also made up excuses to to skip days to study. I'm all for mental health days--but he would make up elaborate stories of why he had to be out for days in a row, then other classmates would see him studying in the library that same day.

I feel icky for even sharing this, but hopefully it can be a cautionary tale. Yes, take your time to study, but try to remember that medical school would ideally be about more than test-taking. I know plenty of people who stayed late just to help other students, team members, or patients even when they'd have one less hour to study and still had Honors at the end of the day.

Sorry for getting preachy. You do you! It's all about balance.

This is exactly why I'm against using only shelf grades to determine clinical grades. Sure, they're the best form of standardization, but at the same time some people get a lot more time to study for them than others and they don't do anything to actually measure clinical skills or ability to treat the patient.

One thing I DON'T regret is how much effort I put in during clinical years in terms of treating the patient and working with the team. The people that blew off other responsibilities and only focused on studying may have better scores and a higher class rank, but they won't be getting referrals from their peers when it ends up mattering (ie when they start getting paid).

 

[ActinicKeratosis]

This is exactly why I'm against using only shelf grades to determine clinical grades. Sure, they're the best form of standardization, but at the same time some people get a lot more time to study for them than others and they don't do anything to actually measure clinical skills or ability to treat the patient.

One thing I DON'T regret is how much effort I put in during clinical years in terms of treating the patient and working with the team. The people that blew off other responsibilities and only focused on studying may have better scores and a higher class rank, but they won't be getting referrals from their peers when it ends up mattering (ie when they start getting paid).

Ahhhh...good old third year grades. I'm glad I never have to go through that again.

 

[ihazquestionz]

This is exactly why I'm against using only shelf grades to determine clinical grades. Sure, they're the best form of standardization, but at the same time some people get a lot more time to study for them than others and they don't do anything to actually measure clinical skills or ability to treat the patient.

One thing I DON'T regret is how much effort I put in during clinical years in terms of treating the patient and working with the team. The people that blew off other responsibilities and only focused on studying may have better scores and a higher class rank, but they won't be getting referrals from their peers when it ends up mattering (ie when they start getting paid).

Well I think it would be fair if people couldn't "appeal" their clinical grades. If that's allowed then people should get an "appeal" of the NBME too. I know clinical grades are more subjective than the NBME but if someone thought you were bad in the hospital then that opinion is a valid evaluation (unless of course there was malignancy involved). A school admin who has never seen you in the hospital should not get to override that evaluation.

I'm also a big proponent of both clinical and shelf grades being reported separately on transcripts. That gives importance to both evals equally.

 

[Coupd'Cat]

One thing I DON'T regret is how much effort I put in during clinical years in terms of treating the patient and working with the team. The people that blew off other responsibilities and only focused on studying may have better scores and a higher class rank, but they won't be getting referrals from their peers when it ends up mattering (ie when they start getting paid).

Plus, I would think you probably came out with more experience working well with staff & patients--or more practical lessons learned that will come in handy for residency.

 

[Mad Jack]

My face when waiting for someone to say they regret studying for boards really early

Studied late, no ragrets

 

[Stagg737]

Well I think it would be fair if people couldn't "appeal" their clinical grades. If that's allowed then people should get an "appeal" of the NBME too. I know clinical grades are more subjective than the NBME but if someone thought you were bad in the hospital then that opinion is a valid evaluation (unless of course there was malignancy involved). A school admin who has never seen you in the hospital should not get to override that evaluation.

I'm also a big proponent of both clinical and shelf grades being reported separately on transcripts. That gives importance to both evals equally.

Appealing clinical grades is something I was completely unaware of before this thread, as my school grades completely based off of shelf score. However, so long as schools aren't handing out higher grades after appeals like candy, I think there are times when it would be valid and completely necessary. I do think appeals should be based off of exceptional circumstances though, and not something anyone can just do because they don't like their grade.

 

[ihazquestionz]

However, so long as schools aren't handing out higher grades after appeals like candy, I think there are times when it would be valid and completely necessary. I do think appeals should be based off of exceptional circumstances though, and not something anyone can just do because they don't like their grade.

Agreed. Unfortunately not how it works out for us. Student gets a low clinical grade --> whines and complains and appeals --> continues to whine and complain to administration --> gets either an automatic honors bump or is required to write a 1-2 page essay on a topic from the rotation and gets honors.

It's honestly an infuriating process and hurts students who are amazing clinically and have a harder time with exams. One of my good friends was paired with a med student who slacked off (actually said he was sick half the the ENTIRE rotation). She was always there and was deeply involved in the team's workflow. She was asked to help on the night before the shelf because the intern was overwhelmed and a patient ran off the floor under the intern's care. Patient was found unconscious and not breathing in another area of the hospital at like 3 am and she had to help with the code blue and the aftermath. I was on night float on a different service (my shelf wasn't until a month later) and heard the code blues called. The code blue team went to the wrong location and the med student literally saved this man's life by herself while the intern ran around the hospital trying to find the code blue team. School didn't let her reschedule her shelf. Other student made honors cut off, she missed the honors cutoff by 2 points. Other student ended up honoring the rotation, she did not. Other student ended up with AOA, she missed AOA by one honors grade. Which student do you think is more competent and which student do you want on your team taking care of you or your loved ones? Not to mention, the girl in this case is hugely involved in the school in really impressive ways whereas the guy has been #ortho from day one and has only focused on honoring rotations, being condescending, and successfully getting younger med students to do all his chart review so that he could nag more first author publications.

The answer might be obvious to us. However, when residency programs look at the two students, which student is more likely to get an interview? Which student is given more opportunities? This is my issue with the system. The way we select our future leaders in medicine and healthcare is so flawed.

 

[kb1900]

Agreed. Unfortunately not how it works out for us. Student gets a low clinical grade --> whines and complains and appeals --> continues to whine and complain to administration --> gets either an automatic honors bump or is required to write a 1-2 page essay on a topic from the rotation and gets honors.

It's honestly an infuriating process and hurts students who are amazing clinically and have a harder time with exams. One of my good friends was paired with a med student who slacked off (actually said he was sick half the the ENTIRE rotation). She was always there and was deeply involved in the team's workflow. She was asked to help on the night before the shelf because the intern was overwhelmed and a patient ran off the floor under the intern's care. Patient was found unconscious and not breathing in another area of the hospital at like 3 am and she had to help with the code blue and the aftermath. I was on night float on a different service (my shelf wasn't until a month later) and heard the code blues called. The code blue team went to the wrong location and the med student literally saved this man's life by herself while the intern ran around the hospital trying to find the code blue team. School didn't let her reschedule her shelf. Other student made honors cut off, she missed the honors cutoff by 2 points. Other student ended up honoring the rotation, she did not. Other student ended up with AOA, she missed AOA by one honors grade. Which student do you think is more competent and which student do you want on your team taking care of you or your loved ones? Not to mention, the girl in this case is hugely involved in the school in really impressive ways whereas the guy has been #ortho from day one and has only focused on honoring rotations, being condescending, and successfully getting younger med students to do all his chart review so that he could nag more first author publications.

The answer might be obvious to us. However, when residency programs look at the two students, which student is more likely to get an interview? Which student is given more opportunities? This is my issue with the system. The way we select our future leaders in medicine and healthcare is so flawed.

I refuse to believe that one can miss half a rotation and still get honors

 

[ihazquestionz]

I refuse to believe that one can miss half a rotation and still get honors

It's honestly absurd. Our minds were blown when the student was successful in his appeal. But that's exactly why I don't think it's fair for school admins who have not actually seen the student in the clinical setting to change a clinical grade unless extreme circumstances.

Anyway, was just using this case as an example. It's the most extreme example I know but lots of people at my institution get "sick" right before shelves for 3-4 days or "sick" once a week. People need to suck it up and realize that being in the hospital and taking care of people is part of the package of getting an MD and staying an MD. There are alternative careers for those who like to "work from home."

End rant.

 

[doyouhaveaflag]

It's honestly absurd. Our minds were blown when the student was successful in his appeal. But that's exactly why I don't think it's fair for school admins who have not actually seen the student in the clinical setting to change a clinical grade unless extreme circumstances.

Anyway, was just using this case as an example. It's the most extreme example I know but lots of people at my institution get "sick" right before shelves for 3-4 days or "sick" once a week. People need to suck it up and realize that being in the hospital and taking care of people is part of the package of getting an MD and staying an MD. There are alternative careers for those who like to "work from home."

End rant.

That's nuts that you can just not show up and say you're sick that often!

We needed a doctor's note to be able to take even one sick day, which I think is also a bit extreme. I mean, if someone is vomiting, I prefer if they don't go to the doctor's office and get their norovirus everywhere. I was so annoyed about needing a doctor's note to prove I was sick that I came in febrile one day instead. Resident response was "you should just wear a mask".

To comment on OP's question, I wish I had known that I wanted to do a competitive surgical subspecialty earlier so I could have done more research in it. However, there's really no way of determining that before third year. On the upside, even though I was aiming for something much less competitive, I had still done well enough in preclinical years to be able to be competitive for my new specialty of choice.

Moral of the story: even if you think you want to do something that isn't competitive, still try to do the best you can in med school so you have the option to change your mind to something competitive.

 

[Osteoth]

Means jack to me but means a lot to higher tier IM programs. There is definitely a prestige factor when applying to those upper echelons. Coming from a top 40 medical school is a huge plus unfortunately. Subjectively speaking though a low tier MD is unranked etc.

Interesting. I wonder why its top 40 instead of 50, 25, 30, etc.

Yeah. We knew who those people were. It's a bit self-fulfilling, because I see others avoiding them now and--in the end--they probably didn't care about camaraderie or how it might affect others' respect for them in the first place.

In reality, I can only think of one of my classmates who did this unashamedly and to an extreme. He would sit in the team room with his notes in his lap while there were crises happening on the entire floor--but because his patient wasn't involved (whom he chose because they were one of the few clinically stable people on the floor) he didn't lift a finger to help anyone else. Also made up excuses to to skip days to study. I'm all for mental health days--but he would make up elaborate stories of why he had to be out for days in a row, then other classmates would see him studying in the library that same day.

I feel icky for even sharing this, but hopefully it can be a cautionary tale. Yes, take your time to study, but try to remember that medical school would ideally be about more than test-taking. I know plenty of people who stayed late just to help other students, team members, or patients even when they'd have one less hour to study and still had Honors at the end of the day.

Sorry for getting preachy. You do you! It's all about balance.

But... its not. Your test scores define your ability to get into the residency of your choice. Your clinical skills may or may not.

This is exactly why I'm against using only shelf grades to determine clinical grades. Sure, they're the best form of standardization, but at the same time some people get a lot more time to study for them than others and they don't do anything to actually measure clinical skills or ability to treat the patient.

One thing I DON'T regret is how much effort I put in during clinical years in terms of treating the patient and working with the team. The people that blew off other responsibilities and only focused on studying may have better scores and a higher class rank, but they won't be getting referrals from their peers when it ends up mattering (ie when they start getting paid).

Do you really believe that? Doesn't matter how you feel about that orthopod if he's the only one in the county doing hips.

Well I think it would be fair if people couldn't "appeal" their clinical grades. If that's allowed then people should get an "appeal" of the NBME too. I know clinical grades are more subjective than the NBME but if someone thought you were bad in the hospital then that opinion is a valid evaluation (unless of course there was malignancy involved). A school admin who has never seen you in the hospital should not get to override that evaluation.

I'm also a big proponent of both clinical and shelf grades being reported separately on transcripts. That gives importance to both evals equally.

Until you get that malignant attending who says he's going to fail 1/4 of the kids on the team bc he recently got a divorce but is tenured so there's nothing the admin can do about it.

Appealing clinical grades is something I was completely unaware of before this thread, as my school grades completely based off of shelf score. However, so long as schools aren't handing out higher grades after appeals like candy, I think there are times when it would be valid and completely necessary. I do think appeals should be based off of exceptional circumstances though, and not something anyone can just do because they don't like their grade.

Can't tell if I'm happy or sad about knowing now.

Agreed. Unfortunately not how it works out for us. Student gets a low clinical grade --> whines and complains and appeals --> continues to whine and complain to administration --> gets either an automatic honors bump or is required to write a 1-2 page essay on a topic from the rotation and gets honors.

It's honestly an infuriating process and hurts students who are amazing clinically and have a harder time with exams. One of my good friends was paired with a med student who slacked off (actually said he was sick half the the ENTIRE rotation). She was always there and was deeply involved in the team's workflow. She was asked to help on the night before the shelf because the intern was overwhelmed and a patient ran off the floor under the intern's care. Patient was found unconscious and not breathing in another area of the hospital at like 3 am and she had to help with the code blue and the aftermath. I was on night float on a different service (my shelf wasn't until a month later) and heard the code blues called. The code blue team went to the wrong location and the med student literally saved this man's life by herself while the intern ran around the hospital trying to find the code blue team. School didn't let her reschedule her shelf. Other student made honors cut off, she missed the honors cutoff by 2 points. Other student ended up honoring the rotation, she did not. Other student ended up with AOA, she missed AOA by one honors grade. Which student do you think is more competent and which student do you want on your team taking care of you or your loved ones? Not to mention, the girl in this case is hugely involved in the school in really impressive ways whereas the guy has been #ortho from day one and has only focused on honoring rotations, being condescending, and successfully getting younger med students to do all his chart review so that he could nag more first author publications.

The answer might be obvious to us. However, when residency programs look at the two students, which student is more likely to get an interview? Which student is given more opportunities? This is my issue with the system. The way we select our future leaders in medicine and healthcare is so flawed.

#AOAorkillyourself.

I refuse to believe that one can miss half a rotation and still get honors

Until you get sick and half to miss half a rotation but still want to graduate on time.

It's honestly absurd. Our minds were blown when the student was successful in his appeal. But that's exactly why I don't think it's fair for school admins who have not actually seen the student in the clinical setting to change a clinical grade unless extreme circumstances.

Anyway, was just using this case as an example. It's the most extreme example I know but lots of people at my institution get "sick" right before shelves for 3-4 days or "sick" once a week. People need to suck it up and realize that being in the hospital and taking care of people is part of the package of getting an MD and staying an MD. There are alternative careers for those who like to "work from home."

End rant.

Doctors get sick days too.