Most Important Clerkship Grades

[RadicalRadon]

What clerkship grades are most important for matching into radiology? Also, what is the relative importance of your comments for a clerkship vs the grade itself.

Specifically, I received an honors in medicine and had generally outstanding performance but five of my seven preceptors thought I was "outstanding" while the others thought I was "good."

I just want to get a sense of what's important for program directors... the grades or comments and in which clerkships. I know this has been discussed before in the context of high pass vs. pass... while I want to focus this more on honors w/ perfect comments vs. honors with some critical comments. Thanks!

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[onyx667]

Although I'm currently interviewing now, the general consensus is that honors in medicine and surgery are most important for radiology. Obviously if you can honor every core rotation, that will just be another thing that separates you from the pack if you're going for top 10 programs. The only one that I think doesn't matter much is ER, since most PDs (at least the one at my school) know that some schools do this rotation during 4th year. And with regards to the comment section, I don't think it matters what specific attendings said. As long as you get an "H", that's all that really matters. The only "comments" that programs are able to see will be whatever is in your MSPE. I've read mine, and there are only a couple sentences about each clerkship, and I doubt your school would put anything remotely negative in your MSPE.

 

[CWUDoc]

I doubt your school would put anything remotely negative in your MSPE.

This is school specific. Our school copies our comments word for word.

 

[RadicalRadon]

Although I'm currently interviewing now, the general consensus is that honors in medicine and surgery are most important for radiology. Obviously if you can honor every core rotation, that will just be another thing that separates you from the pack if you're going for top 10 programs. The only one that I think doesn't matter much is ER, since most PDs (at least the one at my school) know that some schools do this rotation during 4th year. And with regards to the comment section, I don't think it matters what specific attendings said. As long as you get an "H", that's all that really matters. The only "comments" that programs are able to see will be whatever is in your MSPE. I've read mine, and there are only a couple sentences about each clerkship, and I doubt your school would put anything remotely negative in your MSPE.

Thanks for the reply. That makes a lot of sense. Yeah, I guess this was more directed towards what's key for the top 10 programs. Obviously, getting a 250+ on step 1 and honoring everything will put you in a good position. Haha, now the key is making that happen! It's good to know that how awesome your comments are isn't quite as important as the grade itself. I hated one of my attendings on medicine. I'm glad mostly outstanding comments won't be marred by one insecure jerk.

 

[drizzt3117]

Comments are supposed to be put on verbatim, but I doubt they'd make/break anything.

I'd focus on honoring, medicine/surg > the rest, I'm not sure how important honoring rads is.

Thanks for the reply. That makes a lot of sense. Yeah, I guess this was more directed towards what's key for the top 10 programs. Obviously, getting a 250+ on step 1 and honoring everything will put you in a good position. Haha, now the key is making that happen! It's good to know that how awesome your comments are isn't quite as important as the grade itself. I hated one of my attendings on medicine. I'm glad mostly outstanding comments won't be marred by one insecure jerk.

 

[ar2388]

and how bad is it to HP surgery? as the very first rotation

 

[Adam638]

You'll get plenty of interviews if the following aren't honored. Try to honor something though. If your goal is MGH or Michigan, the story is different. You can more than make up with for lack of honors with Step score and extracurriculars.

 

[drizzt3117]

I think a mix of HP/H is fine, generally ppl look at med/surg and # of total m3 honors. Our school doesn't have neuro as a core m3 rotation, which kinda sucks bc it's generally considered as such. Some places don't have a fam med rotation.

 

[RadicalRadon]

I think a mix of HP/H is fine, generally ppl look at med/surg and # of total m3 honors. Our school doesn't have neuro as a core m3 rotation, which kinda sucks bc it's generally considered as such. Some places don't have a fam med rotation.

Definitely glad we now have rads and neuro as core rotations at my school. We still have family med as a 4wk though...

It's strange to me that surgery is such a key clerkship for rads. Idk, doesn't seem all that relevant to rads beyond the anatomy.

 

[RadicalRadon]

I think schools actually have the choice of putting comments in verbatim vs. editing for length/grammar vs. editing for content. (see link). I think letters at my school are probably only positives, unless there are glaring flaws (or so I've heard).
http://www.feinberg.northwestern.edu/AWOME/current-students/residency/documents/Sample%20MSPE-2010.pdf (SAMPLE MSPE)

I'm so grateful to be done with medicine. I don't know how people put up with the constant BS and wasted time for >12hrs*6days/wk. The study material is phenomenally interesting, but medicine is probably one of the most boring/horrible specialities day to day. COPD/CHF/Diabetes/Infections are pretty much >90% of what you see and it's terrible...

Comments are supposed to be put on verbatim, but I doubt they'd make/break anything.

I'd focus on honoring, medicine/surg > the rest, I'm not sure how important honoring rads is.

 

[drizzt3117]

Definitely glad we now have rads and neuro as core rotations at my school. We still have family med as a 4wk though...

It's strange to me that surgery is such a key clerkship for rads. Idk, doesn't seem all that relevant to rads beyond the anatomy.

A large % of your interactions as a radiologist will be with surgeons, then there's the anatomy.

 

[ar2388]

yea def dont have a fam med rotation lol

 

[shark2000]

In order to be a good radiologist you need to have a good understanding of many disease processes, many surgical procedures and ....

After starting your radiology residency, you will find out that the best radiologists are those who understand the disease entities better and in more depth.
Surgery is a key rotation. But whatever you learn as a medical student is not enough. You will end up with a CT abdomen from ED in a patient who has history of Whipple procedure, 3 different bowel anastomosis, and ileal pouch. And now has bowel obstruction and you have to read the CT.

The best MSK radiologists are those who know the concept of many ortho procedures, their indications and the technique.
The same is going for Neurology, Neurosurgery, ortho, GI, OB, ENT, .. .

The best radiologists I have ever seen are not the best film readers and are not the ones who do not miss the small apical lung nodule. They are the ones with best clinical knowledge in addition to imaging skills.

Many 2nd year residents by the end of the year become very good at describing the findings and not missing important ones. But when it comes into the IMPRESSION part of the report which is the clinical judgement, then you see why they are 2nd years and are not attending. It is comparable to clinical medicine. A PA can easily prepare an H&P or a progress note. But when it comes to the assessment/plan part, they lack the skill.

 

[Radiologyreviews2015]

In order to be a good radiologist you need to have a good understanding of many disease processes, many surgical procedures and ....

After starting your radiology residency, you will find out that the best radiologists are those who understand the disease entities better and in more depth.
Surgery is a key rotation. But whatever you learn as a medical student is not enough. You will end up with a CT abdomen from ED in a patient who has history of Whipple procedure, 3 different bowel anastomosis, and ileal pouch. And now has bowel obstruction and you have to read the CT.

The best MSK radiologists are those who know the concept of many ortho procedures, their indications and the technique.
The same is going for Neurology, Neurosurgery, ortho, GI, OB, ENT, .. .

The best radiologists I have ever seen are not the best film readers and are not the ones who do not miss the small apical lung nodule. They are the ones with best clinical knowledge in addition to imaging skills.

Many 2nd year residents by the end of the year become very good at describing the findings and not missing important ones. But when it comes into the IMPRESSION part of the report which is the clinical judgement, then you see why they are 2nd years and are not attending. It is comparable to clinical medicine. A PA can easily prepare an H&P or a progress note. But when it comes to the assessment/plan part, they lack the skill.

I agree with this but how can you assess a medical student on this clinical stuff when clerkship grades are so variable and subjective? It feels like Step 2 would be a better indicator