Panicky third year needs some advice/encouragement

[worker_bee]

I'm a third year hoping to apply to IM next year. I just found out that I got a pass in my school's primary care clerkship - no idea how, I thought I did decently well in it. To make matters worse I still don't know how I did on my school's subspecialties clerkship (rotate 1 week through different specialties like ophtho, ent, etc.), but I have a bad feeling about that one too. I have decent grades on my first couple clerkships (honors in neuro/pysch, HP in medicine) and a good step I.

Its weird - third year started out quite well for me but the last couple rotations I've just tripped up. And these are supposed to be the "easy" rotations at my school.

I guess what I want to know is how much a couple of passes third year will hurt me. I'm hoping that PD's look more at the major clerkships like inpatient medicine and surgery, but I'm sure getting passes in anything looks bad. I'm definitely not shooting for a top IM program, just a decent one where I'll have a chance at fellowships down the line.

Any sincere advice is deeply appreciated. Last couple days I've been feeling like I might have permanently screwed myself over with these last couple grades, and its been tough to get out of bed and go back to the hospital everyday.

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[Scottish Chap]

What are you worried about? You received a high pass in medicine and you did well on Step 1. Third year is definitely a little unpredictable at times but, as long as you keep doing your best and as long as you to well in your medicine sub-internship, you'll be fine. Hang in there, and good luck!

 

[bof]

I assume that by primary care medicine you mean something like family medicine. If so, then I don't think a pass will really hurt you very much. For IM residencies, programs are going to be looking at how you did in your internal medicine clerkship, first and foremost. Then things like your sub-i in medicine, letters of recommendations, etc. Just try to get good grades in most of your clerkships and a pass here and there isn't going to kill you. To be honest with you, most programs don't really care if you honor your surgery clerkship either. If all that you aspire to is a decent IM program ("not shooting for a top IM program"), then rest assured that there are plenty of spots avaliable and you'll likley match in one of your top choice.

 

[worker_bee]

I assume that by primary care medicine you mean something like family medicine. If so, then I don't think a pass will really hurt you very much. For IM residencies, programs are going to be looking at how you did in your internal medicine clerkship, first and foremost. Then things like your sub-i in medicine, letters of recommendations, etc. Just try to get good grades in most of your clerkships and a pass here and there isn't going to kill you. To be honest with you, most programs don't really care if you honor your surgery clerkship either. If all that you aspire to is a decent IM program ("not shooting for a top IM program"), then rest assured that there are plenty of spots avaliable and you'll likley match in one of your top choice.

This was actually separate from our family med clerkship; my school has an extra clerkship where you follow around community IM and peds docs for a couple months... which is why I'm shocked about this grade, thought this would be a pretty benign clerkship.

I definitely don't have any ego or desire for prestige, but also don't want my career options to be limited - I'm interested in cards or heme/onc, which is why I've been shooting for a mid tier univ. program. Just hard to know how competitive places like that are since most SDN posters seem to be top tier candidates.

 

[bof]

This was actually separate from our family med clerkship; my school has an extra clerkship where you follow around community IM and peds docs for a couple months... which is why I'm shocked about this grade, thought this would be a pretty benign clerkship.

I definitely don't have any ego or desire for prestige, but also don't want my career options to be limited - I'm interested in cards or heme/onc, which is why I've been shooting for a mid tier univ. program. Just hard to know how competitive places like that are since most SDN posters seem to be top tier candidates.

That sounds like a pretty non traditional clerkship and I would probably discount it even more than if it were family medicine. I think that if you are geographically flexible that a mid tier university IM program is achievable for most people (assuming that you went to med school in the US, do well in your clerkships, and get an above score on your steps). Always remember that there are always other things that you can do to improve your chances of getting in specific programs (eg. away rotations, letters of recommendation from faculty on away rotations, etc).

Oh, don't even get me started on those "top tier candidate" SDN posters....

 

[jdh71]

I'm a third year hoping to apply to IM next year. I just found out that I got a pass in my school's primary care clerkship - no idea how, I thought I did decently well in it. To make matters worse I still don't know how I did on my school's subspecialties clerkship (rotate 1 week through different specialties like ophtho, ent, etc.), but I have a bad feeling about that one too. I have decent grades on my first couple clerkships (honors in neuro/pysch, HP in medicine) and a good step I.

Its weird - third year started out quite well for me but the last couple rotations I've just tripped up. And these are supposed to be the "easy" rotations at my school.

I guess what I want to know is how much a couple of passes third year will hurt me. I'm hoping that PD's look more at the major clerkships like inpatient medicine and surgery, but I'm sure getting passes in anything looks bad. I'm definitely not shooting for a top IM program, just a decent one where I'll have a chance at fellowships down the line.

Any sincere advice is deeply appreciated. Last couple days I've been feeling like I might have permanently screwed myself over with these last couple grades, and its been tough to get out of bed and go back to the hospital everyday.

is this a troll post?

 

[GopherUDoc]

Check out this link: http://www.nrmp.org/data/programresultsbyspecialty.pdf

It will give you an idea of the relative importance program directors give to different aspects of your application, including third year clerkships that aren't in your specialty.

I wouldn't worry about a couple passes. You will be competing against mostly people with similar transcripts and many who have less glamorous grades.

 

[worker_bee]

is this a troll post?

Honestly, no. I hope I didn't come across that way. What seemed trollish about it?

Anyway I found out that the private practice docs that precepted me just circled "average" all the way down my evaluation. After all the hard work we put in as med students, its really frustrating to get an evaluation like that.

 

[jdh71]

Honestly, no. I hope I didn't come across that way. What seemed trollish about it?

Anyway I found out that the private practice docs that precepted me just circled "average" all the way down my evaluation. After all the hard work we put in as med students, its really frustrating to get an evaluation like that.

What was trollish? That you were complaining about passing.

There is this strange phenomenon in the medical student world where almost everyone thinks they are god's gift to the rotation and find themselves all bent out of shape when they are marked as "normal" and not "superstar". You've seen the bell curve, right? 67% fall within the first SD, and 95% with the next, why would you be so surprised to get a "pass" or think that a "pass" is somehow knocking on death's door in regards to your career? Based on the statistics and deductive logic it would appear that MOST people in medicine got a "pass" - even those doing Cards and GI eek

You are NOT a special and unique flower, you are a ubiquitous medical student. If you show up on-time, do your work, and learn something, you get to pass - as a resident I now appreciate what makes an awesome medical student and the truth is . . . MOST medical students are not "excellent," they are steady, solid performers who do what they are supposed to - "appropriate for level of training".

So, snap out of it, and welcome to the real world. Good luck with your journey.

 

[worker_bee]

What was trollish? That you were complaining about passing.

There is this strange phenomenon in the medical student world where almost everyone thinks they are god's gift to the rotation and find themselves all bent out of shape when they are marked as "normal" and not "superstar". You've seen the bell curve, right? 67% fall within the first SD, and 95% with the next, why would you be so surprised to get a "pass" or think that a "pass" is somehow knocking on death's door in regards to your career? Based on the statistics and deductive logic it would appear that MOST people in medicine got a "pass" - even those doing Cards and GI eek

You are NOT a special and unique flower, you are a ubiquitous medical student. If you show up on-time, do your work, and learn something, you get to pass - as a resident I now appreciate what makes an awesome medical student and the truth is . . . MOST medical students are not "excellent," they are steady, solid performers who do what they are supposed to - "appropriate for level of training".

So, snap out of it, and welcome to the real world. Good luck with your journey.

Given my performance during the first half of third year, in which I was evaluated by 15 residents/attendings and never received a grade lower than HP, I think I was justified in being surprised by this eval and wanting to know how much of an impact it would have on my applications. I never claimed to be a unique flower or god's gift to anything.

 

[worker_bee]

So here's a follow-up question: when we're talking about decent IM programs that would be open to someone with an average performance third year, can someone give me an example of what kind of programs?

What about programs like Jeff or BU - what kind of credentials does it normally take to end up at places like that?

 

[dragonfly99]

I think with a good Step 1 and average 3rd year performace, if you honor your medicine subI you'd be very competitive at mid-tier IM programs, and I'd encourage you to try for even higher-tier ones, particularly if the rest of 3rd/4th year goes pretty well. Just try for a few dream programs if you like...let them reject you if they will. IM is nothing like some of the other specialties...they need a lot of interns and there aren't that many solid US graduate applicants trying for them. Try to get 230-240's on Step II also if you can swing it.

I'm surprised this was your first experience with seemingly random grading during 3rd year...LOL!

Don't worry...you'll be fine, and you can do hem/onc or cards.

 

[mlcatl]

The reality is that you simply have to get into SOME internal medicine residency that is at an academic center. From there, do well in residency and any medical school issues will long forgotten, regardless of what you want to do later. Similarly, once you finish fellowship and are out in practice, no one cares anymore. It's all reputation, both of the patients and other doctors.

Will you necessarily get exactly the position at exactly the hospital you want? Probably not. But docs from Harvard and docs from Galveston (where I went) get to do what they want to do, get into competitive fellowships and so forth.

So relax. Just get in. You are fine for internal medicine.