"P" for clerkship. Still possible to match into a university-based program?

[miborovsky]

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Didn't want to post in the '12-'13 WAMC thread since I'm not applying for this year, but this is keeping me up at night so I wanted to get people's thoughts on my problem.

I'm a fresh MS3, recently finished Medicine clerkship. Long story short, despite doing fairly well on the NBME shelf (1 stndev above nat'l avg, slightly above class avg) and receiving fairly positive feedback from faculty, I received a "P" on my clerkship grade.

Other relevant info:

School: between top 20-50, I guess (US News Primary Care ranking)
Step 1: mid-240s
Pre-clinical: mostly HP, H in Physio, P in intro to medicine (missed HP by <1%)
Research: undergrad and MS1, several poster sessions, no actual publication
Volunteering: nothing spectacular

My question is: how much does the "P" hurt my chance to match into a university-based IM residency, after which I can pursue fellowship training?

Follow-up questions:

- Should I ask my Medicine clerkship preceptor to write my LOR? He did actually leave fairly good comments on my evals, but I have no idea about the numeric grade; I'm guessing my resident didn't like me too much.

- Should I talk to my Dept of Medicine Chairman and explain to him my situation (and ask him for his advice), or would I just look insecure/high-anxiety/neurotic?

- What the hell should I do for my Medicine Sub-I? I know that the logical thing to do now would be to schedule the Sub-I ASAP and ace it, but I've been so demoralized by this "P" that there's no reason for me to expect that I'll do any better for the Sub-I.

- Should I do away rotations? I was hoping to do an away rotation at a top-rank program, but mostly because it's the area where I hope to practice in the future. But now it seems like I should just forget about away rotations and forget about aforementioned program, since they're probably going to be extremely unimpressed with me...

 

[jdh71]

Didn't want to post in the '12-'13 WAMC thread since I'm not applying for this year, but this is keeping me up at night so I wanted to get people's thoughts on my problem.

I'm a fresh MS3, recently finished Medicine clerkship. Long story short, despite doing fairly well on the NBME shelf (1 stndev above nat'l avg, slightly above class avg) and receiving fairly positive feedback from faculty, I received a "P" on my clerkship grade.

Other relevant info:

School: between top 20-50, I guess (US News Primary Care ranking)
Step 1: mid-240s
Pre-clinical: mostly HP, H in Physio, P in intro to medicine (missed HP by <1%)
Research: undergrad and MS1, several poster sessions, no actual publication
Volunteering: nothing spectacular

My question is: how much does the "P" hurt my chance to match into a university-based IM residency, after which I can pursue fellowship training?

Follow-up questions:

- Should I ask my Medicine clerkship preceptor to write my LOR? He did actually leave fairly good comments on my evals, but I have no idea about the numeric grade; I'm guessing my resident didn't like me too much.

- Should I talk to my Dept of Medicine Chairman and explain to him my situation (and ask him for his advice), or would I just look insecure/high-anxiety/neurotic?

- What the hell should I do for my Medicine Sub-I? I know that the logical thing to do now would be to schedule the Sub-I ASAP and ace it, but I've been so demoralized by this "P" that there's no reason for me to expect that I'll do any better for the Sub-I.

- Should I do away rotations? I was hoping to do an away rotation at a top-rank program, but mostly because it's the area where I hope to practice in the future. But now it seems like I should just forget about away rotations and forget about aforementioned program, since they're probably going to be extremely unimpressed with me...

Dude. You're not trying to match to urology, chill.

Yes, you can still match to a university program. You might have a tough time matching to a top-10 program, but there are LOTs of university medicine programs and basically all of them will get you into fellowship.

 

[gutonc]

My question is: how much does the "P" hurt my chance to match into a university-based IM residency, after which I can pursue fellowship training?

It hurts a little...not as much as you think but it's less awesome than an Honors would have been.

Follow-up questions:

- Should I ask my Medicine clerkship preceptor to write my LOR? He did actually leave fairly good comments on my evals, but I have no idea about the numeric grade; I'm guessing my resident didn't like me too much.

No. But not because of your grade. Because it was your first (2nd?) clerkship and you probably really didn't know your head from your ass...nobody does that early in 3rd year. Besides, by the time you ask for a LOR, s/he won't have seen you for a year and won't have anything useful/helpful to say.

- Should I talk to my Dept of Medicine Chairman and explain to him my situation (and ask him for his advice), or would I just look insecure/high-anxiety/neurotic?

If you want to be "that guy" at your school (and not just on SDN), yes, do this. If you want to move on with your life (which you should) don't.

- What the hell should I do for my Medicine Sub-I? I know that the logical thing to do now would be to schedule the Sub-I ASAP and ace it, but I've been so demoralized by this "P" that there's no reason for me to expect that I'll do any better for the Sub-I.

Do it in August next year. Rock the living s**t out of it. Get an awesome LOR. The end.

- Should I do away rotations? I was hoping to do an away rotation at a top-rank program, but mostly because it's the area where I hope to practice in the future. But now it seems like I should just forget about away rotations and forget about aforementioned program, since they're probably going to be extremely unimpressed with me...

No, you shouldn't do an away. Not because you're going to flail (although you might...who knows) or because they won't like you. But because in IM they're generally a waste of time and/or money. I'm actually glad I did my away because it steered me away from a program I thought I wanted to be a part of but really kind of sucked once I had a real view of it. But it was still a bit of a waste of time...I would have nixed it based on the interview day alone.

 

[miborovsky]

It hurts a little...not as much as you think but it's less awesome than an Honors would have been.



No. But not because of your grade. Because it was your first (2nd?) clerkship and you probably really didn't know your head from your ass...nobody does that early in 3rd year. Besides, by the time you ask for a LOR, s/he won't have seen you for a year and won't have anything useful/helpful to say.



If you want to be "that guy" at your school (and not just on SDN), yes, do this. If you want to move on with your life (which you should) don't.



Do it in August next year. Rock the living s**t out of it. Get an awesome LOR. The end.



No, you shouldn't do an away. Not because you're going to flail (although you might...who knows) or because they won't like you. But because in IM they're generally a waste of time and/or money. I'm actually glad I did my away because it steered me away from a program I thought I wanted to be a part of but really kind of sucked once I had a real view of it. But it was still a bit of a waste of time...I would have nixed it based on the interview day alone.

Thanks, it's good to get another perspective on it. I guess I should also schedule my Step 2 early? I seem to do pretty well on standardized national exams...