MD Pass in Sub-I, should I talk to course director?

[iwanttobelieve]

So I just found out that I got a pass on my sub-i (applying to peds). Honestly devastated, as I solicited feedback multiple times during the rotation from attendings/residents and got really great verbal feedback, as well as really good written eval comments (performed at level of resident, excellent presentation skills, very engaged, etc. etc.). How much does this hurt me? US MD mid tier school, Step 1 was 234, clinical grades mix of high pass and pass, have some research (couple papers/posters), haven't taken Step 2 yet. I’m honestly so frustrated and worried right now and would really appreciate some advice. Is it a good idea to talk with the course director?

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[Redpancreas]

So I just found out that I got a pass on my sub-i (applying to peds). Honestly devastated, as I solicited feedback multiple times during the rotation from attendings/residents and got really great verbal feedback, as well as really good written eval comments (performed at level of resident, excellent presentation skills, very engaged, etc. etc.). How much does this hurt me? US MD mid tier school, Step 1 was 234, clinical grades mix of high pass and pass, have some research (couple papers/posters), haven't taken Step 2 yet. I’m honestly so frustrated and worried right now and would really appreciate some advice. Is it a good idea to talk with the course director?

Yeah definitely talk to them about it. See if you can uncover things that slipped by. You didn’t mention who evaluated you. If there are rules on who evaluates you and those rules were followed, you have a low chance of overturning the grade, but if it’s one of those “find 5 to evaluate you”-gig and only one person filled out your evaluation, you might be able to get that decision changed. It’s worth a shot.

Directors need to keep some integrity to the process. I’m sure your Peds Sub-I director would love to just change the grade but they can’t do it for everyone.

Please provide us with more detail of how you were evaluated and what you think the discrepancy was.

 

[Redpancreas]

So I just found out that I got a pass on my sub-i (applying to peds). Honestly devastated, as I solicited feedback multiple times during the rotation from attendings/residents and got really great verbal feedback, as well as really good written eval comments (performed at level of resident, excellent presentation skills, very engaged, etc. etc.). How much does this hurt me? US MD mid tier school, Step 1 was 234, clinical grades mix of high pass and pass, have some research (couple papers/posters), haven't taken Step 2 yet. I’m honestly so frustrated and worried right now and would really appreciate some advice. Is it a good idea to talk with the course director?

In terms of prognosis I suppose your Step 2 CK is going to be a net neutral unless you do very well, 250+ and that will be a boost. You may not get a shot at CHOP, but definitely the next tier down.

 

[Lawpy]

Was your sub I graded as H/HP/P/F?

 

[iwanttobelieve]

I submitted the names of 3 attendings I worked with, not sure who filled out the evals since it doesn't say. I had thought that the sub-I was graded as H/HP/P/F since that is how M3 clerkships are but I guess I don't know for sure?

 

[Lawpy]

I submitted the names of 3 attendings I worked with, not sure who filled out the evals since it doesn't say. I had thought that the sub-I was graded as H/HP/P/F since that is how M3 clerkships are but I guess I don't know for sure?

Going to tag @GoSpursGo @Oso for advice on this.

 

[GoSpursGo]

It wouldn’t hurt to ask

 

[Redpancreas]

I submitted the names of 3 attendings I worked with, not sure who filled out the evals since it doesn't say. I had thought that the sub-I was graded as H/HP/P/F since that is how M3 clerkships are but I guess I don't know for sure?

Thanks for the information. Were these the attendings who gave you the glowing comments? It doesn’t hurt to do a little more digging. First you need to talk to your clerkship director and tell him/her that your formative/verbal feedback was drastically different than your final evaluation and that you’re applying Peds. She should know a P in a subI doesn’t inspire confidence.

A couple things could happen from here. She could say the grade is final at which point I would reach the syllabi and see if there is any room for an appeal. Even if the grade is final, at least you can ask/solicit feedback on what might have made you an HP/H student because going into residency that will be important. She could offer you the opportunity to reach out to more staff to solicit evals to see if that would tilt the scale in your favor if it’s within the stated rules. If she does that, ensure this time around you try to use your connections and let attendings know of your situation. Just say my grade is in question and the Clerkship directors want some more evaluations and I was wondering if you could give me a strong one. I’m currently applying to Peds. I’m sure many would be happy to help. Also, if you’ve used all the attendings who you worked with you can consider contacting the ones who evaluated you. Double check the handbook and be absolutely sure this is appropriate because at my school it was a professionalism violation. Be very polite and just say grades were calculated and I ended up with a pass but based on my work with you I felt I did very well. If you feel that my grade warranted a pass, I’d be interested in meeting or discussing that further with you for my own education. Lastly she could also just examine the stuff herself and bump you up to a high pass if she feels you did well enough.

Could you provide us with what the syllabi or clerkship handbook says about evaluations? Take your time. You may need a day to future that out. If you don’t know as the Generic Dean of Clerkships/Clinical education, etc.

 

[Redpancreas]

I submitted the names of 3 attendings I worked with, not sure who filled out the evals since it doesn't say. I had thought that the sub-I was graded as H/HP/P/F since that is how M3 clerkships are but I guess I don't know for sure?

Edit. The first step is therefore to figure out how your grade was calculated. You should talk to the clerkship director about how many evals were filled out again because your verbal formative feedback was very positive. See above for what to do then.

 

[Lawpy]

It wouldn’t hurt to ask

But thoughts on OP's chances for matching?

 

[Redpancreas]

But thoughts on OP's chances for matching?

Of course they’ll match! The notion that they won’t is ludicrous. They’re an average US MD. They will most certainly match at a reputable pediatrics program. It may not be top 20 on Doximity, but it will likely be a great place where they can learn pediatrics and do a lot of good.

 

[iwanttobelieve]

I've emailed the course director, I'll see what she says. The attendings I selected as my evaluators were the ones I worked with the most and also the ones who gave me great verbal feedback. I don't really know how the sub-I is graded other than we get attending evals and I believe the resident(s) get some input also?

 

[Redpancreas]

I've emailed the course director, I'll see what she says. The attendings I selected as my evaluators were the ones I worked with the most and also the ones who gave me great verbal feedback. I don't really know how the sub-I is graded other than we get attending evals and I believe the resident(s) get some input also?

Unless you triggered a way for residents to give you feedback, the residents were unlikely to have a role in it. They’re definitely not having attending/resident committees sitting together to determine this.

You’ve taken the first step. Now wait to here what she says and we will go from there. Her response can be anything from a cold, “no I’m not going to change your grade, etc.” to “I’ve reviewed the grades and changed your grade to HP” to anything in between. I’m fairly certain you know how to navigate this but feel free to post updates for all of us or PM or anyone else if you want confidential advice.

 

[iwanttobelieve]

So I ended up getting to see my evals and it looks like two of my evaluators were the type who think a 3/4 on a 4 point scale is an above average score, and 2/4 means the student is performing at an appropriate level. The joys of clinical grading...

 

[Redpancreas]

So I ended up getting to see my evals and it looks like two of my evaluators were the type who think a 3/4 on a 4 point scale is an above average score, and 2/4 means the student is performing at an appropriate level. The joys of clinical grading...

So educate them? What’s gonna happen now?

 

[iwanttobelieve]

So educate them? What’s gonna happen now?

I haven't met with the course director yet (she said the person who assigns the actual grades is different). This impression is just based on me reading through the numerical evals provided to me from a clerkship scheduling person when I asked for them. I don't know if it's enough to go higher up on the chain, as I don't really know how likely it would be that they would make attendings redo evals?

 

[Dantes]

So I ended up getting to see my evals and it looks like two of my evaluators were the type who think a 3/4 on a 4 point scale is an above average score, and 2/4 means the student is performing at an appropriate level. The joys of clinical grading...

Clinical grading scales are such a joke. You would think they would get more education about this, especially for sub-Is. Sorry to hear but I agree you should be ok for matching.

 

[Gameofscones]

Just curious what is the update on this? I am wondering for me case as well. Applying for IM, got 2/9, 4/9, 6/9, 7/9. 8/9 (graded on 1-9 scale). Final grade was high pass and it's basically known here that's problematic because everyone gets honors in their 4th year here...