Making progress? Or not?

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So I'm back. My last post here was received quite viciously but let me assure you, I am not a troll. Just an overanxious student 😳

(Last thread) http://forums.studentdoctor.net/showthread.php?t=436696

So I had a mixed start to the year. I finished with a 4/5 which is not what I wanted. But upon reading my actual evaluation, it was pretty good. I even debated whether or not to argue for the extra point considering what they had written about me on paper, but I figure it would make me look like more of an uptight freak than I already am. (Yup...I'm self aware 😛)

So I took the overwhelming advice from the last thread to take it easy and stop being so neurotic.

Another rotation went by where I felt I did much better.

And now I'm onto my 3rd one: internal medicine. So far, I'm feeling pretty confident. I've gotten good evals so far, even an offer for a letter of recommendation. (We have many, many evals in our internal med rotation)

But grade day today knocked some more air out of me.

Rotation #1 (psychiatry): 4/5
Rotation #2 (ob/gyn): 4/5
Rotation #3 (internal medicine): still pending

So my question is this. If I continue to rack up 4/5s but manage to get positive written comments on my evals and possibly some sparkling LORs, would I still remain a competitive applicant?

I've got some pretty nice 1st and 2nd year grades and Step 1 board scores. Still leaning toward something competitive like derm/rads. Thanks for the help. Let me apologize in advance if this kind of post rubs anyone the wrong way.

 

[Blade28]

Are you worried about your "4/5" grades? Isn't that really good?

I'm confused. 😕 Are you worried because you're not getting "Honors" on your rotations?

Derm and Rads are tough - how good, exactly, is your Step 1 score? Unfotunately I fear that your pre-clinical grades won't count for too much.

Edit: I just searched and found your Step 1 score. Uh...that's around 2-3 standard deviations above the mean, no? I wouldn't worry then. 🙂 Any plans for research or other extra-curriculars?

 

[discontinuebed]

Oh don't get me wrong. I realize 4/5 is pretty good and I don't want to come off like the whining baby I must have sounded like in my very first post.

But I'm always hearing these horror stories about how competitive one has to be to get into these fields nowadays and my concern is exactly what you listed. Those greades are good but not great. (like honors great)

I don't have much right now in terms of research or extra-curriculars. I'm guessing I would probably need something outstanding in that realm as well to help with the overall application package?

Thanks for the advice. 🙂

 

[Blade28]

It's true that 4/5 is not as good as 5/5 - but what's done is done. You're still going to apply for Derm and/or Rads, right? So it's water under the bridge now.

If there's an opportunity, I'd definitely consider research - if only to network and meet others in the field.

 

[Tired]

So my question is this. If I continue to rack up 4/5s but manage to get positive written comments on my evals and possibly some sparkling LORs, would I still remain a competitive applicant?

Does your school rank?

 

[OHMAN0125]

Does your school rank?

OP are u shooting for a Top tier derm program /Hopkins RADS or something? With your board scores and horrible 4/5s you shouldnt have ANY problem matching somewhere for Rads. Why don't you look at charting outcomes? Most interviewed ppl 220-230 matched Rads. You really should talk with your schools advisers. I'd even say that for Derm your chances would be VERY good with some research unless you have to go to UPenn or something. Stop with your OCD. You're gonna get an ulcer.

 

[discontinuebed]

Does your school rank?

Hmm...I'm not really sure.

I would guess yes. I'm not entirely sure they go by "this is #1, this is #2, this is #3" but maybe they go by percentiles "top 10%", etc... etc...

There is also the rumor that our 3rd year grades are weighted more heavily so if there is rank, I'm probably moving the wrong way on that scale.

 

[t33sg1rl]

Does your school give any guidance on these ratings? How many students get 5/5? What is the average? For example, my school has guidelines specifying that no more than 10% of the class can get honors... so having one or two honors out of six med 3 rotations is still considered excellent. On our numerical ratings, to get the top score, the description is that the student functions ABOVE the level of the intern... so I highly doubt any student has actually got the top rating.

 

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OP are u shooting for a Top tier derm program /Hopkins RADS or something? With your board scores and horrible 4/5s you shouldnt have ANY problem matching somewhere for Rads. Why don't you look at charting outcomes? Most interviewed ppl 220-230 matched Rads. You really should talk with your schools advisers. I'd even say that for Derm your chances would be VERY good with some research unless you have to go to UPenn or something. Stop with your OCD. You're gonna get an ulcer.

Oh I'm sorry. Forgot to mention. I would be very happy to just get into any program. Definitely not looking for a top tier. If I had my pick, I'd certainly choose based on more desirable locations (not a country kid so I'm not looking to be stuck somewhere desolate) but I'd be more than happy with anything resembling a city.

I'll definitely stop by my school's advisors as well. (They generally don't meet with us until later in the year and I'm trying to spare my poor dean from any freakouts. I prefer the anonymity of the internet 😛)

But thanks again for the reassuring advice! I'm sure I'll look back at this a couple of months later much like I look back at my very first post.

 

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Does your school give any guidance on these ratings? How many students get 5/5? What is the average? For example, my school has guidelines specifying that no more than 10% of the class can get honors... so having one or two honors out of six med 3 rotations is still considered excellent. On our numerical ratings, to get the top score, the description is that the student functions ABOVE the level of the intern... so I highly doubt any student has actually got the top rating.

Hmm...I'm not entirely sure to be honest.

I would guess anywhere from the top 10-20% would receive 5/5s.

I do know that it's rather hard to finish with something below a 3/5 based on past students' remarks.

 

[Tired]

Hmm...I'm not entirely sure to be honest.

I would guess anywhere from the top 10-20% would receive 5/5s.

This is what you need to find out to adequately answer your question. Talking about 3/5, 4/5 whatever is basically pointless without some reference to what proportion of students get each grade. Residency directors aren't stupid, they know that schools artificially pump-up clerkship grades to make their students look better. Class rank and AOA mean far more than the actual grades because they allow students to distinguish themselves from their peers.

In other words: if only 20% of students get a 4/5 or 5/5, then you're looking good; but if half the class is getting 5/5 while you're getting 4/5, then no, you're not looking very good.

 

[discontinuebed]

This is what you need to find out to adequately answer your question. Talking about 3/5, 4/5 whatever is basically pointless without some reference to what proportion of students get each grade. Residency directors aren't stupid, they know that schools artificially pump-up clerkship grades to make their students look better. Class rank and AOA mean far more than the actual grades because they allow students to distinguish themselves from their peers.

In other words: if only 20% of students get a 4/5 or 5/5, then you're looking good; but if half the class is getting 5/5 while you're getting 4/5, then no, you're not looking very good.

So in talking to some classmates, the general consensus is that it differs from rotation to rotation with some being tougher than others but a 4th year reported:

10-20% of students receive 5/5
30-40% receive 4/5
Almost everyone else receives a 3/3

 

[Tired]

10-20% of students receive 5/5
30-40% receive 4/5
Almost everyone else receives a 3/3

It doesn't matter what your classmates think, because (1) they're probably wrong anyway, and (2) all that matters is what's in your Dean's letter. At my school, an explanation of the grading system was accompanied by a graph showing exactly what proportion of my class received what grade on each rotation.

You need to find out what's in your Deans letter. Honestly, if your school doesn't rank, and they don't specify what percetage get what grade, then it basically devalues all your MS3 grades. I'm not saying it makes them unimportant, but it will probably make the PDs of the programs you apply to look a lot harder at your Step 1 and AOA status.

 

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Directly from the Dean's Letter

5/5 Among top 10-15% of students
4/5 Among top 30% of students
3/5 At expected level of average student

So I guess 4/5 isn't that bad? I took a look at my eval today for the 2nd rotation. In doing so, I tried to take all your advice in stride. (Stop OCDing. Stop whining. Stop asking for ulcers. 😛) But it's hard to read nothing but positive comments and then have them turn around and slap a 4/5.

I should start asking for purely negative feedback to find out what I really need to work on and where I really need to improve. 😛

 

[LuckyBambooGirl]

A 4/5 is not bad! Stop worrying and be happy about it. My school only gives you 5/5 if you function at the level of an intern and if they put 5/5 on your evaluation they have to write tons of comments justifying why they gave it. If they don't back it up sufficiently, the 5 is changed to a 4. These evaluations are so subjective anyway, so there's no point in stressing. A 4/5 will not ruin your life!

 

[Tired]

5/5 Among top 10-15% of students
4/5 Among top 30% of students
3/5 At expected level of average student

Looks like you're in good shape then, especially if you do have a great Step 1 score.

 

[Final]

get a life

 

[Law2Doc]

get a life

Agreed. OP, you need to get past this 4/5 hangup, rather than ask the identical question after each rotation. You are claiming to be in the top third of your class with a high Step 1. If you can't figure out if that is good, then it's hard to imagine you actually got those grades.🙄

 

[discontinuebed]

Thanks for the advice! I'll stop whining then. Just merely concerned about the slight dropoff in grades but if this is considered to be normal for a 3rd year student, then I guess I should stop being a worrywart and stressing after each rotation.

Thanks again for the help.