Preclinical Grades?!?

[ijn]

As far as what's important/not, you're right, that's a tough call to make. My approach has been that whatever I will be exposed to on the wards and in residency is what is important. This attitude was built on many discussions that I've had with MS3s/MS4s, residents, and even some attendings and their responses on hearing what we were studying (90% of the time it was, "wow, I don't remember any of that" - at least for the M1 material).

There's as much minutiae and useless crap that you're expected to learn on the wards as there is in MS2 because you're going to specialize in one area of medicine, not everything. Do you think you're really going to need to know stages of labor, dilation rates, and management of ectopic pregnancies when you're going into internal medicine? **** no. MS3 isn't some magical year where everything is relevant. You chug and burn information for the clerkships NBMEs and Step 2 CK just as you're going to have to do for block exams and Step 1.

Definitely prioritize learning board relevant material, but using attendings or residents as a filter for important information is a poor gauge. Your MS3s are probably the best source. The problem is a lot of 1st and 2nd years aren't able to discern board importance without a lot of perspective on the year. Also very few people have the work ethic to learn all this information outside of a structured lecture/PBL environment that forces you to take small bites at a time. That's the great thing about class. A huge chunk of it is pointlessly learned, but it forces you to work.

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[Planes2Doc]

You know what blows my mind? The transition from the typical SDN pre-med gunner that will kill themselves over an A- to the SDN medical student that is okay with passing. Crazy stuff!

 

[zherussianbear]

Imagine you're a residency director with 200 applications. One's pre-clinical grades say "P," another has a P and a standard deviation, another a little picture to explain what's going on, another has As and Bs and Cs, one's got Hs, and another has numbers. Hieroglyphics.

Then you get to the USMLEs; everyone's got a number, and it works the same way!! Goodness, look at those shelf-exams! A dean's letter to explain everything, and a set of recs?!

Point is, a lot of the Ps are Cs and some are A-s, but none of it really matters because it don't compare. With hundreds of apps, you develop a machine approach and work through the pieces like gears and levers; if some don't fit, you throw them out. Another analogy: who cares how you do at rehearsal (i.e. pre-clinicals) if we can just watch the performance (of course, you ought to be practicing, but some people just need that last-minute pressure)?

That said, an F always shines as bright as the north star. Verdict: Pre-clinical grades to the pooper!

 

[235009]

background: my preclinical grades were mediocre (5/50 Ps and HPs at a H/HP/P/LP/F school)

class rank matters a lot. definitely the third most important thing on your app along with AOA which typically goes hand in hand. preclinical grades are a significant component of class rank (at my school it's 50/50 between preclinical and 3rd year grades). therefore preclinical grades matter.

also don't give me all this premed crap about neurosurg, plastics and derm. the % of people who choose to go into those specialties is negligible. a quarter to a half of any med school class will go into peds and IM. the top and upper mid tier academic programs in those fields for instance are extremely competitive and unless you are at a top 10 or 20 med school you're not going to match into a solid program in those fields if you are at the bottom of your class.

 

[JABWS]

I attend a "top 20" medical school that is graded and ranked, for the primary purpose of "allowing students to match competitively," per our dean and several administrative higher ups. So either they are completely ignorant and it is in fact the medical students on sdn who know best, or the whole "pre-clinical grades don't matter" mantra is misinformation, at least in the vast majority of cases where there is not a pure P/F system in place.

 

[username456789]

background: my preclinical grades were mediocre (5/50 Ps and HPs at a H/HP/P/LP/F school)

class rank matters a lot. definitely the third most important thing on your app along with AOA which typically goes hand in hand. preclinical grades are a significant component of class rank (at my school it's 50/50 between preclinical and 3rd year grades). therefore preclinical grades matter.

also don't give me all this premed crap about neurosurg, plastics and derm. the % of people who choose to go into those specialties is negligible. a quarter to a half of any med school class will go into peds and IM. the top and upper mid tier academic programs in those fields for instance are extremely competitive and unless you are at a top 10 or 20 med school you're not going to match into a solid program in those fields if you are at the bottom of your class.

Preclinical grades do often matter (and depending on your school, may have a very strong correlation with Step I scores), but since the vast majority of students (even on SDN) by definition cannot Honor classes, the defense mechanisms spring up and you end up with the "preclinical grades are useless!" mantra.

FWIW, my school reports a correlation of 0.8 with preclinical grades and eventual Step I score.

 

[FIREitUP]

background: my preclinical grades were mediocre (5/50 Ps and HPs at a H/HP/P/LP/F school)

class rank matters a lot. definitely the third most important thing on your app along with AOA which typically goes hand in hand. preclinical grades are a significant component of class rank (at my school it's 50/50 between preclinical and 3rd year grades). therefore preclinical grades matter.

also don't give me all this premed crap about neurosurg, plastics and derm. the % of people who choose to go into those specialties is negligible. a quarter to a half of any med school class will go into peds and IM. the top and upper mid tier academic programs in those fields for instance are extremely competitive and unless you are at a top 10 or 20 med school you're not going to match into a solid program in those fields if you are at the bottom of your class.

I have to respond to this because after just checking the charting the outcomes, it turns out class rank is 9th on the list, not 3rd. Furthermore, not all schools are like yours; mine counts clinical grades more heavily than preclinical grades. I have no idea where you got the 3rd number but I implore you to check the new charting the outcomes, page 3.

Also, no one here is saying preclinical grades have no importance, and "don't matter", we're saying that the importance is low on the list, which is corroborated by the charting the outcomes.

Anyways, I hope you matched well and wish you the best of luck!

@GuyWhoDoes stuff: everyone's school is different. I actually have honored classes and the amount of time I spent on random facts detracted from my actually learning the material. Everyone is different, and I find that my new study habits are better for me. To each his own.

 

[survivordo]

Depending on the grading system preclinical grades certainly do matter. The less "specific" the grading system (ie A/B/C/D/E vs P/F) the less they matter on your transcript. However, I think we would all agree Step I is a very important aspect of the competitiveness of your residency app.

Some schools teach more to the steps than others but regardless the bulk of the material covered in your preclinical classes is going to be very pertinent to Step I. Of course you aren't going to initially remember all the minutia involved in the Steps when you start studying but I can tell you from experience it comes back to you a LOT faster if you have learned it once already during your first 2 years. It comes down to whether you actually learned the material the first time or just crammed it in to pass a test.

Survivor DO

 

[235009]

I have to respond to this because after just checking the charting the outcomes, it turns out class rank is 9th on the list, not 3rd. Furthermore, not all schools are like yours; mine counts clinical grades more heavily than preclinical grades. I have no idea where you got the 3rd number but I implore you to check the new charting the outcomes, page 3.

Also, no one here is saying preclinical grades have no importance, and "don't matter", we're saying that the importance is low on the list, which is corroborated by the charting the outcomes.

Anyways, I hope you matched well and wish you the best of luck!

when you average things the way you do in the charting outcomes you come up with useless information. the low-tier academic and community programs far outnumber the strong academic programs in IM and peds therefore their responses distill the responses of the programs we are typically talking about. so basically you are attributing data that strongly represents noncompetitive community programs to strong/top academic programs. this is the ecological fallacy at it's best....making a conclusion about an individual based on data compiled on a group level.

btw i'm getting my info from my experience and the experience of those around me IRL and on SDN.

anyway, thanks for the nice wishes. i'm thrilled with where i ended up. the IM match this year was quite brutal though. it's getting extremely competitive at the top.

 

[FIREitUP]

when you average things the way you do in the charting outcomes you come up with useless information. the low-tier academic and community programs far outnumber the strong academic programs in IM and peds therefore their responses distill the responses of the programs we are typically talking about. so basically you are attributing data that strongly represents noncompetitive community programs to strong/top academic programs. this is the ecological fallacy at it's best....making a conclusion about an individual based on data compiled on a group level.

btw i'm getting my info from my experience and the experience of those around me IRL and on SDN.

anyway, thanks for the nice wishes. i'm thrilled with where i ended up. the IM match this year was quite brutal though. it's getting extremely competitive at the top.

fair enough. I think both anecdotal and experiment data each have validity in their own right. I'm glad everything worked out for you, but I'm surprised; I thought you were going to go into surgery?

 

[235009]

fair enough. I think both anecdotal and experiment data each have validity in their own right. I'm glad everything worked out for you, but I'm surprised; I thought you were going to go into surgery?

no clue where u got that. i absolutely hated surgery and it was the first thing i eliminated during 3rd year.

 

[FIREitUP]

no clue where u got that. i absolutely hated surgery and it was the first thing i eliminated during 3rd year.

haha i guess you said you were the favorite of the surgeon or something so i naturally assumed that you were into surgery.

 

[FutureDO2016]

This thread cheered me up completely! Because as a first year, my grades this year have been horrible. I have mostly gotten C's and the transition from getting all A's as a premed to becoming average has been very stressful/embarrassing.

The thing is the amount of material and getting used to studying differently takes long for some people to adjust and then again my school does block exams so we have 5 exams on 1 day every 6 weeks...

My class rank is going to suck but hopefully I can do better on board exams...

Any constructive advice anyone?

 

[NickNaylor]

This thread cheered me up completely! Because as a first year, my grades this year have been horrible. I have mostly gotten C's and the transition from getting all A's as a premed to becoming average has been very stressful/embarrassing.

The thing is the amount of material and getting used to studying differently takes long for some people to adjust and then again my school does block exams so we have 5 exams on 1 day every 6 weeks...

My class rank is going to suck but hopefully I can do better on board exams...

Any constructive advice anyone?

For what it's worth, I was in your exact position last year. My grades at first sucked because I just didn't know how to study, and they continued to suck because I focused my studying on boards rather than class notes. This isn't "advice" per se - more like encouragement for down the road - but I have been pleasantly surprised at my boards performance thus far despite what has been said on this thread - I took a NBME exam two weeks into my studying (one pass through First Aid, 20% UWorld questions done, and five weeks left to go until my test date) and got an above average score. You are by no means screwed on step 1 just because you do poorly in class.

As far as actual advice, I would say to not be afraid to keep experimenting with what works best for your studying. I never quite got it figured out until M2, but after that studying became WAY easier (and more efficient). Keep revising your methods until you find a way that works best with your brain. Once you do that, it's (relatively) smooth sailing.

 

[FutureDO2016]

Thanks for the great advice!

Yeah the problem with experimenting various study styles is that one technique may work for neuro but you may need to revise that for physio.

Keep calm and study on

 

[FutureDO2016]

How much does class rank affect residency decision? I didn't do well my first year but I did pass all my classes. I know I have 2 years to improve my rank but with a low class rank, are my residency options limited to family med, psychiatry and not as competitive IM programs?

I was interested in neurology and anesthesiology but I'm only a second year student so I'm still exploring.

I know class rank isn't the most important factor and board exam scores, 3rd year clerkship grades and letters of rec are more important, but do pre-clinical grades/class rank still play a role?