Pre-Clinical Grades/Class Rank and Residency?

[charmiedermie]

Many/most schools stratify the way they do, and residency programs are well aware of this.

If you see the link above from MSPEs from all med schools, you'll see the stratification amongst MSPE adjectives doesn't stratify the way with the leeway that UCSF does theirs.

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[Guero]

If you see the link above from MSPEs from different schools, you'll see the stratification amongst MSPE adjectives doesn't stratify the way with the leeway that UCSF does theirs.

We've tried to explain this to you several times. If you still don't get it after the last explanation by @SouthernSurgeon, I'm afraid you're on your own.

 

[username456789]

If you see the link above from MSPEs from different schools, you'll see the stratification amongst MSPE adjectives doesn't stratify the way with the leeway that UCSF does theirs.

What you don't see me understand is that residency programs are familiar with many/most medical schools, especially ones in their geographic region, when it comes to these adjectives. Anyone who is been in this game for more than a couple years understands what different words from different schools mean. Not to mention, most schools include the breakdown and percentages of different adjectives that they use. They're not being fooled, so don't lose any sleep over it.

 

[charmiedermie]

The word doesn't matter. The percentage does. The MSPE gives a breakdown in the appendix of what each adjective refers to. They could call them supercalafragalistic, as long as they give the corresponding class %'s.

Residencies aren't stupid...it's not like they are going to read the UCSF kids and compare him to someone from another school and say...oh, but UCSF's said "excellent"...

I'm not talking about the actual word they use as their MSPE adjective, but I'm pretty sure you knew that. The point is that at that third adjective, they could be anywhere from the 67th percentile to the 2nd percentile - and still get the same category, since only the last 1 percent gets a lower category.

You think it is just some big coincidence that all the students who happened to go for derm from UCSF who were all at the third MSPE adjective (which is anywhere from the 67th percentile all the way down to the 2nd percentile, but no way to tell where in such a huge gap), with an average Step 1 of 234, matched? Would they have matched with those same stats at a med school not called UCSF, like UC-Irvine, UC-Davis, or UC-San Diego?

http://meded.ucsf.edu/sites/meded.u...edical-education/postmatch2014dermatology.pdf

 

[Guero]

I'm not talking about the actual word they use as their MSPE adjective, but I'm pretty sure you knew that. The point is that at that third adjective, they could be anywhere from the 67th percentile to the 2nd percentile - and still get the same category, since only the last 1 percent gets a lower category.

You think it is just some big coincidence that all the students who happened to go for derm from UCSF who were all at the third MSPE adjective (which is anywhere from the 67th percentile all the way down to the 2nd percentile) with an average Step 1 of 234, matched? Would they have matched with those same stats at a med school not called UCSF, like UC-Irvine, UC-Davis, or UC-San Diego?

http://meded.ucsf.edu/sites/meded.u...edical-education/postmatch2014dermatology.pdf

Before this gets out of hand, I'd like to provide you with a friendly pointer that by continuing to argue rather than taking the advice given for its face value, you're now likely encroaching a danger zone and attracting more attention than you likely want...

Again, just a friendly pointer based on what I've seen happen in the past in situations like these. It's often best to agree to disagree and move on, letting others jump in on the thread later.

 

[charmiedermie]

Before this gets out of hand, I'd like to provide you with a friendly pointer that by continuing to argue rather than taking the advice given for its face value, you're now likely encroaching a danger zone and attracting more attention than you likely want...

Again, just a friendly pointer based on what I've seen happen in the past in situations like these. It's often best to agree to disagree and move on, letting others jump in on the thread later.

I have used this same exact same example before. If you are unable to understand the example with the question, then I can't help you. It's demonstrating a very clear point, that top schools tend to hide very well how their students do in comparing them to eachother that other non-top med schools don't. See slackr's point above.

Thanks for your "friendly pointer" but I can defend myself and my views even if you disagree or can't understand them.

 

[TwinsFan]

Not sure I agree with no one caring if someone is 66th or 32nd percentile. As around these parts "top half" is the qualifier for all things competitive and top quartile plus aoa is the gold standard. However, we do match a number of very competitive fields and programs from the 3rd quartile every year and sometimes the bottom.

It seems a few of the top schools have discovered that differentiating amazing students hurts them more than it helps (no ranking or aoa)

 

[charmiedermie]

I think you're looking at it backwards. People want to be able to discriminate at the top, not the bottom. No one is going to care if you are 66th percentile or 32nd percentile.

Think of it like clerkship grades. You have honors, high pass, pass, and fail. People care about honors and to a lesser extent high pass...once you hit that pass level - no one really cares where you are within that low level, unless you manage to actually hit the true bottom of the barrel.

What you are seeing is evidence that yes, school prestige probably does matter quite a bit especially for competitive specialties, if a bunch of average UCSF students match derm. Welcome to the real world.

But they would care if you were 67th percentile vs. 2nd percentile right? Surely you're not saying someone at the 67th percentile is relatively the same as someone at the 2nd percentile.

Your point in your third paragraph is exactly my point. I'm also saying that school prestige (name) protects more those who are not at the top of the class, as seen on their MSPE. Lower schools stratify with not such huge ranges, which are much tighter, on their MSPEs. They don't hide it out of view.

 

[Guero]

I have used this same exact same example before. If you are unable to understand the example with the question, then I can't help you. It's demonstrating a very clear point, that top schools tend to hide very well how their students do in comparing them to eachother that other non-top med schools don't. See slackr's point above.

Thanks for your "friendly pointer" but I can defend myself and my views even if you disagree or can't understand them.

Well, I tried, sincerely and magnanimously. But I'm not arguing with you.

 

[charmiedermie]

You're picking out literally one word as if that's all the information residency programs get. They also get grades and a histogram with the breakdown of how many students get what grade in each course. And that's just the MSPE.

Give residencies a little more credit.

I know that MSPEs have histograms and grades - with numerous different grading systems to keep track of. But that MSPE gives a final summary of how you did overall. Programs don't always have the luxury of picking thru it with a fine tooth comb for every single course and clerkship before offering an interview. It would take forever. This probably varies by specialty though.

Difference between 67th to 32nd percentile, maybe not, although some here disagree. 67th percentile to 2nd percentile both with the same MSPE adjective, probably would make a difference if they could tease it out.

 

[charmiedermie]

Not sure I agree with no one caring if someone is 66th or 32nd percentile. As around these parts "top half" is the qualifier for all things competitive and top quartile plus aoa is the gold standard. However, we do match a number of very competitive fields and programs from the 3rd quartile every year and sometimes the bottom.

It seems a few of the top schools have discovered that differentiating amazing students hurts them more than it helps (no ranking or aoa)

Thank you.

 

[22031 Alum]

I know that MSPEs have histograms and grades - with numerous different grading systems to keep track of. But that MSPE gives a final, all-encompassing place of where you stand as a summary of how you did. Programs don't always have the luxury of picking thru it with a fine tooth comb for every single course and clerkship before offering an interview. It would take forever.

Difference between 67th to 32nd percentile, maybe not, although some here disagree. 67th percentile to 2nd percentile both with the same MSPE adjective, probably would make a difference if they could tease it out.

The misunderstanding here may be that you are overestimating the role of the MSPE adjective. I have never once thought of the MSPE as all-encompassing when looking over ERAS application packages. You may also be underestimating just how much time programs dedicate to picking over things with a fine-tooth comb. If someone is 2nd percentile in their class, it will manifest in other ways on the app. One descriptive word that spans 2/3 of the class isn't going to make up for everything.

 

[operaman]

Regardless of what any school puts on an MSPE, it's pretty easy to tell where people shake out. Maybe they have to a little more work to figure it out, but you still could.

I would be willing to bet you could give me all the ERAS apps with LORs, transcripts, etc -- the exact stuff that residency programs get -- from any school that doesn't stratify, and I could probably arrange them in order of true class rank with very few errors. I could certainly place people in quintiles, and would only probably make some minor errors with people on the borders.

I actually did this a bit when we had AOA elections this year. We were sent the CVs over the top 25% of the junior and senior class for review (everyone had consented to this), but were not given info on grades/rank until the actual meeting. Purely on the basis of CV and board score (was on most CVs and available to all residency programs), I made my list of top people for junior and senior election and my personal lists were almost 100% aligned with the grades/rank list (in order, no less!!!) and ultimately the list of those elected. It's incredibly easy to stratify people -- even within a narrow percentile -- without code words or percentiles or even grades.

Yes, the name factor from top schools will especially benefit those in the middle, but not because their MSPE was super encoded.

 

[charmiedermie]

The misunderstanding here may be that you are overestimating the role of the MSPE adjective. I have never once thought of the MSPE as all-encompassing when looking over ERAS application packages. You may also be underestimating just how much time programs dedicate to picking over things with a fine-tooth comb. If someone is 2nd percentile in their class, it will manifest in other ways on the app. One descriptive word that spans 2/3 of the class isn't going to make up for everything.

I will readily admit I have not read an MSPE in the role of a faculty member. But I have heard people and read many people here on SDN say that the MSPE is useless. I don't know if that is just pent-up frustration or because the MSPE is felt to genuinely be too long to sift thru, or what exactly. Why do u think faculty don't like about the MSPE?

I know the people interviewing me didn't have the histogram or individual grades on their interviewing summary sheet.

 

[charmiedermie]

Regardless of what any school puts on an MSPE, it's pretty easy to tell where people shake out. Maybe they have to a little more work to figure it out, but you still could.

I would be willing to bet you could give me all the ERAS apps with LORs, transcripts, etc -- the exact stuff that residency programs get -- from any school that doesn't stratify, and I could probably arrange them in order of true class rank with very few errors. I could certainly place people in quintiles, and would only probably make some minor errors with people on the borders.

I actually did this a bit when we had AOA elections this year. We were sent the CVs over the top 25% of the junior and senior class for review (everyone had consented to this), but were not given info on grades/rank until the actual meeting. Purely on the basis of CV and board score (was on most CVs and available to all residency programs), I made my list of top people for junior and senior election and my personal lists were almost 100% aligned with the grades/rank list (in order, no less!!!) and ultimately the list of those elected. It's incredibly easy to stratify people -- even within a narrow percentile -- without code words or percentiles or even grades.

Yes, the name factor from top schools will especially benefit those in the middle, but not because their MSPE was super encoded.

When you said you were able to stratify class ranks based on CV and board score, are you talking about CV being research and extracurricular activities only?!? I can't see how you could be accurate without grades - unless you're saying the smarter people were more involved in outside things.

 

[charmiedermie]

People don't feel the MSPE is that useful for two reasons:

1. It is just the sum of its parts. They already get your grades via your transcripts. They already get your USMLE scores. They already get 3-4 letters of recommendation. While the MSPE is nice in that it compiles all that information into one place and provides some comparative statistics, it really doesn't add that much to the other stuff we already have to evaluate applicants.

2. It used to come out in November. Some fields would specifically wait for this to send out interview invites, but for most fields they had already evaluated the applicants and sent out the vast majority of their interview slots before the MSPE was ever even released. So historically most program directors learned to get by without it. It's only in the last couple of years that it has come out earlier.

Now, I do think it has some uses. For one it is really the only place that red flags (professionalism issues, history of substance issues, suspensions, withdrawals, time off, e.g.) comes out and they usually provide some explanation of that. I also find it helpful to read the subjective comments from the clerkship grades (although some schools selectively edit these).

And simply it puts everything in one place which is nice. However, our program and I suspect many others go even a step further. Our PD's admin staff creates a one page summary for all
of the applicants with board scores, clerkship scores (with % cutoffs and NBME scores when available), class rank/MSPE adjective (with definition), # of pubs, etc.

Thank you.

So then what more information would faculty want in an MSPE on an applicant, that isn't already there, that would better help them in selecting applicants for their field to interview? I don't know what else they could add really that would make a real difference.

 

[operaman]

When you said you were able to stratify class ranks based on CV and board score, are you talking about CV being research and extracurricular activities only?!? I can't see how you could be accurate without grades - unless you're saying the smarter people were more involved in outside things.

Yeah, CV as in the usual stuff you see on a CV.

I didn't think I was going to be that accurate. My guess is that the traits which push someone up the class rank are the same ones that make them productive scientists, leaders, humanitarians, and generally productive members of the school and community. There are probably a handful of outliers who defy the trend in one way or another.