Pass/Fail for Clerkship

[hydrophobicmed]

As far as I know, the only schools that are doing pass/fail in third-year clerkship are Vandy, UCSF and Harvard and through the grapevine, Yale is going that way too in the near future. What are the pros/cons?

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[xkcd6330]

The con that most people will cite is that residency directors care about clerkship grades, so students at P/F schools may be at a disadvantage for residency apps. I don’t buy that (for schools of the caliber that are currently doing it)—just look at the match lists for any of these schools. Also, especially at Vandy (+Harvard?) you still have 2 full years of clinical grades (i.e. the same as a student from a traditional curriculum), with the benefit of a year of P/F first to transition/ get used to clinicals.

In my mind it’s just a massive positive.

 

[Moko]

It'll be harder to differentiate those at the top vs those at the bottom. Match lists will remain impressive nonetheless.

 

[hydrophobicmed]

It'll be harder to differentiate those at the top vs those at the bottom. Match lists will remain impressive nonetheless.

is it safe to assume that at UCSF and Harvard, it is kind of meaningless to differentiate the top from the bottom? I know Step 1 will be the determining factor, but how much weight does the school name of UCSF and Harvard carry in residency application outside their home turf? Say 10 candidates with indistinguishable step 1 and research experience for a competitive subspecialty, will UCSF and Harvard people get interviews automatically?

 

[Moko]

is it safe to assume that at UCSF and Harvard, it is kind of meaningless to differentiate the top from the bottom? I know Step 1 will be the determining factor, but how much weight does the school name of UCSF and Harvard carry in residency application outside their home turf? Say 10 candidates with indistinguishable step 1 and research experience for a competitive subspecialty, will UCSF and Harvard people get interviews automatically?

There are duds at every institution including at Harvard. The selection process for medical school is not perfect. Word on the street is that Step 1 may also eventually become P/F. There's lots of opinions on how much name matters. I'm of the thought that it does matter, though not to the degree that some might believe. Being from Harvard is by no means an auto-invite.

 

[hydrophobicmed]

There are duds at every institution including at Harvard. The selection process for medical school is not perfect. Word on the street is that Step 1 may also eventually become P/F. There's lots of opinions on how much name matters. I'm of the thought that it does matter, though not to the degree that some might believe. Being from Harvard is by no means an auto-invite.

Name alone is not enough. I understand that. But my question was if everything else were pretty much equal, would the name of the school bump you up significantly?

 

[wagonwheel23]

My friend is on residency selection at a top residency program and said that at P/F clinical schools there is usually coded language for each clerkship evaluation that unofficially puts you in honors/high pass/pass. That is N = 1, but the program director in this case sends out information regarding each school to help you "guess" what the applicants grades would have been.

 

[hydrophobicmed]

My friend is on residency selection at a top residency program and said that at P/F clinical schools there is usually coded language for each clerkship evaluation that unofficially puts you in honors/high pass/pass. That is N = 1, but the program director in this case sends out information regarding each school to help you "guess" what the applicants grades would have been.

well at this point, there is one school which has graduated a class with p/f clinical, that's Harvard, so I guess it's fairly easy to guess. But in two years time, there will probably be 3 or 4 schools like that. That's kind of weird...

 

[xkcd6330]

well at this point, there is one school which has graduated a class with p/f clinical, that's Harvard, so I guess it's fairly easy to guess. But in two years time, there will probably be 3 or 4 schools like that. That's kind of weird...

Vanderbilt has also, right? I think their latest curriculum update was in 2013

 

[aldol16]

There are more schools than those few with P/F clinicals.

Medical school reputation matters more for residency than people like to let on because everybody wants to pretend like this is a meritocracy. It's not. But reputation matters more for some cases than others. I'll list examples.

Say you want to match into IM at Harvard. That's competitive because of the institution. It's a super academic place. Top academic places tend to like other top academic places. So going to a top academic med school is going to help you. It's not going to make up for a low Step score but it'll be another component of your application.

Say you want to match into neurosurgery at Harvard. That's super competitive. Because of the field and because of the institution. The same rules apply. You have to have a high Step score and they tend to like people from top programs.

Say you want to match into neurosurgery but you don't care where. Then your med school will matter less. Because if you don't care if you go to a program that isn't a top academic place, they're not going to care as much. Still need the Step scores though because neurosurgery is competitive.

Just take a look at the PGY1's at the top places. You'll find that many if not most of them will have gone to top med schools.

 

[Blueprint Med School]

Those are some big name schools you mentioned. Just one conspiracy theory, but I can imagine a world where the biggest schools are removing a stratification tool so that the bottom 50th percentile isn't getting penalized with average grades and can use the name of the school to elevate their resumes while still pushing their top students with a Dean's letter full of colorful adjectives.

Too much tinfoil, or not enough?

David D, MD - USMLE and MCAT Tutor
Med School Tutors

 

[hydrophobicmed]

Vanderbilt has also, right? I think their latest curriculum update was in 2013

not sure when they started. Didn't interview there.

 

[hydrophobicmed]

There are more schools than those few with P/F clinicals.

Medical school reputation matters more for residency than people like to let on because everybody wants to pretend like this is a meritocracy. It's not. But reputation matters more for some cases than others. I'll list examples.

Say you want to match into IM at Harvard. That's competitive because of the institution. It's a super academic place. Top academic places tend to like other top academic places. So going to a top academic med school is going to help you. It's not going to make up for a low Step score but it'll be another component of your application.

Say you want to match into neurosurgery at Harvard. That's super competitive. Because of the field and because of the institution. The same rules apply. You have to have a high Step score and they tend to like people from top programs.

Say you want to match into neurosurgery but you don't care where. Then your med school will matter less. Because if you don't care if you go to a program that isn't a top academic place, they're not going to care as much. Still need the Step scores though because neurosurgery is competitive.

Just take a look at the PGY1's at the top places. You'll find that many if not most of them will have gone to top med schools.

it's a pro or con? depending on which school you are at?

 

[xkcd6330]

Those are some big name schools you mentioned. Just one conspiracy theory, but I can imagine a world where the biggest schools are removing a stratification tool so that the bottom 50th percentile isn't getting penalized with average grades and can use the name of the school to elevate their resumes while still pushing their top students with a Dean's letter full of colorful adjectives.

Too much tinfoil, or not enough?

David D, MD - USMLE and MCAT Tutor
Med School Tutors

Makes sense to me. Maybe the slightly more innocent explanation is just that big name schools can afford to get rid of the stratification tool without harming their students, while others can’t. But same effect in the end.

 

[aldol16]

it's a pro or con? depending on which school you are at?

I mean it depends on if you're at one of the well reputed schools or not, doesn't it? If you are, then you reap the benefits.

 

[hydrophobicmed]

I mean it depends on if you're at one of the well reputed schools or not, doesn't it? If you are, then you reap the benefits.

for sure.

 

[Angus Avagadro]

My former residency program would trip over themselves when we had an application from one of the Ivys. The 2 most memorable "Duds: were from Hopkins and UCSF. Both had personality issues.
I love it when writing a LOR for one of my students that I can mention that they are in the top third or even better, top 10%. It will be noticed by PDs. If they are in the bottom third, I dont mention class rank. If in the bottom half, to mention it I would try to note an upward trend. P/F would not allow me to do this
Many schools have very subjective grading for clinical rotations, I think P/F is helpful as there can be wide variability in clinical grades. Graded clinical rotations might not reflect the students performance accurately.

 

[Pluto98]

My former residency program would trip over themselves when we had an application from one of the Ivys. The 2 most memorable "Duds: were from Hopkins and UCSF. Both had personality issues.
I love it when writing a LOR for one of my students that I can mention that they are in the top third or even better, top 10%. It will be noticed by PDs. If they are in the bottom third, I dont mention class rank. If in the bottom half, to mention it I would try to note an upward trend. P/F would not allow me to do this
Many schools have very subjective grading for clinical rotations, I think P/F is helpful as there can be wide variability in clinical grades. Graded clinical rotations might not reflect the students performance accurately.

Was your former residency program a top program or mid/low tier?

 

[Angus Avagadro]

Was your former residency program a top program or mid/low tier?

Many consider it a top 10. Its hard to rank programs. We often have the most number of research papers and posters at the national meeting.
Last ranked in us news, which is considered by many a popularity contest, in the top 10

Love your screen name

 

[Pluto98]

Many consider it a top 10. Its hard to rank programs. We often have the most number of research papers and posters at the national meeting.
Last ranked in us news, which is considered by many a popularity contest, in the top 10

Love your screen name

Hahaha thanks. Why would a top ten program fawn over an ivy candidate (one would assume a top 10 gets many such applicants)

 

[Blueprint Med School]

Makes sense to me. Maybe the slightly more innocent explanation is just that big name schools can afford to get rid of the stratification tool without harming their students, while others can’t. But same effect in the end.

I buy this.

 

[hydrophobicmed]

My former residency program would trip over themselves when we had an application from one of the Ivys. The 2 most memorable "Duds: were from Hopkins and UCSF. Both had personality issues.
I love it when writing a LOR for one of my students that I can mention that they are in the top third or even better, top 10%. It will be noticed by PDs. If they are in the bottom third, I dont mention class rank. If in the bottom half, to mention it I would try to note an upward trend. P/F would not allow me to do this
Many schools have very subjective grading for clinical rotations, I think P/F is helpful as there can be wide variability in clinical grades. Graded clinical rotations might not reflect the students performance accurately.

LOL on the duds comment. That's after the interviews?

 

[Angus Avagadro]

Hahaha thanks. Why would a top ten program fawn over an ivy candidate (one would assume a top 10 gets many such applicants)

Upper tier schools, the Ivys are very pedigree oriented. If you have seen any of my past posts, I've commented many times about pedigree bigotry. Usually with respect to DOs. It happens with MDs too. Some residencies believe it enhances their stature if they have upper tier grads in their residency.

 

[hydrophobicmed]

Upper tier schools, the Ivys are very pedigree oriented. If you have seen any of my past posts, I've commented many times about pedigree bigotry. Usually with respect to DOs. It happens with MDs too. Some residencies believe it enhances their stature if they have upper tier grads in their residency.

but are upper tier grads are noticeably better candidates? that's a real question.

 

[Angus Avagadro]

but are upper tier grads are noticeably better candidates? that's a real question.

Not always. We had a couple memorable Duds.

 

[Goro]

Upper tier schools, the Ivys are very pedigree oriented. If you have seen any of my past posts, I've commented many times about pedigree bigotry. Usually with respect to DOs. It happens with MDs too. Some residencies believe it enhances their stature if they have upper tier grads in their residency.

There's more inbreeding at Brown than in an Alabama trailer park.

 

[Angus Avagadro]

LOL on the duds comment. That's after the interviews?

Yes. I didnt interview either. Both had wonderful letters. Gee, I wonder why? Were they trying to pawn them off on another program? No way they weren't a problem at their home school. This is why I often say every applicant that didnt rotate on our service is an unknown and why i take any red flag seriously. Had to deal with these guys for 3 yrs.

 

[hydrophobicmed]

Yes. I didnt interview either. Both had wonderful letters. Gee, I wonder why? Were they trying to pawn them off on another program? No way they weren't a problem at their home school. This is why I often say every applicant that didnt rotate on our service is an unknown and why i take any red flag seriously. Had to deal with so guys for 3 yrs.

foisted on you lol.