Preclinical Grades?!?

[Turtlez]

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Are preclinical grades important for semi-competitive specialties?

If out of 12 first year classes I get 4 H / 2HP / 6P , is that considered good/okay/bad?
Thanks for the help!

 

[JP2740]

Dude relax. Those are competitive for family medicine and psych. You'll be fine.

 

[survivordo]

You're fine. Just avoid any red flags such as a Fail and you will be competitive for anything. If you look at charting outcomes pre-clinical grades are typically far down on the list of factors.

Survivor DO

 

[NickNaylor]

Dude relax. Those are competitive for family medicine and psych. You'll be fine.

 

[armybound]

they're important to an extent, but much less important than clinical grades.

depends what your Hs were in, really. If you want to do a surgical specialty and got H in anatomy, that's good.

 

[oceanillusion42]

Dude relax. Those are competitive for family medicine and psych. You'll be fine.

We had a neuroradiologist come in and give an amazing lecture last year. He began by saying "the only people that care about your pre-clinical grades are you and your parents."

 

[yehhhboiii]

We had a neuroradiologist come in and give an amazing lecture last year. He began by saying "the only people that care about your pre-clinical grades are you and your parents."

Don't forget the gunners.

 

[girlonfire]

How many Fails? Those are the only grades that matter

 

[JABWS]

I have yet to understand this sentiment. If pre-clinical grades don't matter, then AOA status and class rank should not matter either. But somehow it always seems to be those who rank near the top of the class that get the stellar residencies.

I know AOA status is institution-dependent, and everyone has their own specific criteria, but I'll just use my school as an example. Our AOA is determined primarily by pre-clinical grades. Only the first half of third year is taken into account when deciding who is eligible for nomination.

Obviously you don't need AOA to match into a great program, but no one will argue that AOA doesn't bolster your status as an applicant. Also, I haven't heard anyone make the argument that, all else being equal, someone ranking in the bottom quartile of their class should be considered equal to a student in the top quartile. You don't need to ace everything in your pre-clinical years per se, but is it really the best advice to suggest grades don't matter. It's like saying your GPA and MCAT are the most important requirements for getting into medical school, therefore you should only focus on those two elements of your application and forget all the rest. Or better yet, even though your cumulative GPA is important, individual courses don't matter. It doesn't make any sense. Sure, your GPA and MCAT are arguably the most important factors with regard to getting into medical school, but would anyone feel comfortable applying without anything else?

Finally, I don't really see the problem with doing well during your pre-clinical years. No one is asking you to choose between having good pre-clinical vs. clinical grades. You can excel in both. This whole argument undermining the importance of pre-clinical grades just seems like a lazy excuse to not apply yourself as much as you should/could during the first two years. Also, those who are in the top quartile consistently do extremely well on Step 1. At least this is the case at my school. I understand prioritizing a bit if your school does not teach to the exam, but I would venture to say that isn't the case for the vast majority of students out there.

Despite what you read on SDN, there are differing opinions out there. For instance, the chair of the surgery department at my school recently gave a presentation and someone asked about the most important things first and second years can be doing to prepare for a surgery application. He replied, "Work hard and do well in your classes. Don't believe this crap about grades not being important. We want students who have worked hard and demonstrated dedication throughout their time in medical school." He is just one person, but I have an easier time taking advice from someone who evaluates applicants on a regular basis than a medical student who didn't do as well as they may have liked during the first two years and wants to feel better about themselves.

 

[NickNaylor]

I have yet to understand this sentiment. If pre-clinical grades don't matter, then AOA status and class rank should not matter either. But somehow it always seems to be those who rank near the top of the class that get the stellar residencies.

I know AOA status is institution-dependent, and everyone has their own specific criteria, but I'll just use my school as an example. Our AOA is determined primarily by pre-clinical grades. Only the first half of third year is taken into account when deciding who is eligible for nomination.

Obviously you don't need AOA to match into a great program, but no one will argue that AOA doesn't bolster your status as an applicant. Also, I haven't heard anyone make the argument that, all else being equal, someone ranking in the bottom quartile of their class should be considered equal to a student in the top quartile. You don't need to ace everything in your pre-clinical years per se, but is it really the best advice to suggest grades don't matter. It's like saying your GPA and MCAT are the most important requirements for getting into medical school, therefore you should only focus on those two elements of your application and forget all the rest. Or better yet, even though your cumulative GPA is important, individual courses don't matter. It doesn't make any sense. Sure, your GPA and MCAT are arguably the most important factors with regard to getting into medical school, but would anyone feel comfortable applying without anything else?

Finally, I don't really see the problem with doing well during your pre-clinical years. No one is asking you to choose between having good pre-clinical vs. clinical grades. You can excel in both. This whole argument undermining the importance of pre-clinical grades just seems like a lazy excuse to not apply yourself as much as you should/could during the first two years. Also, those who are in the top quartile consistently do extremely well on Step 1. At least this is the case at my school. I understand prioritizing a bit if your school does not teach to the exam, but I would venture to say that isn't the case for the vast majority of students out there.

Despite what you read on SDN, there are differing opinions out there. For instance, the chair of the surgery department at my school recently gave a presentation and someone asked about the most important things first and second years can be doing to prepare for a surgery application. He replied, "Work hard and do well in your classes. Don't believe this crap about grades not being important. We want students who have worked hard and demonstrated dedication throughout their time in medical school." He is just one person, but I have an easier time taking advice from someone who evaluates applicants on a regular basis than a medical student who didn't do as well as they may have liked during the first two years and wants to feel better about themselves.

I don't think anyone would disagree with the idea that doing well in classes is a positive for your app and generally. Where I think there is more controversy is the converse, ie, that doing poorly means you are doomed to failure.

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[airplanes]

Where I think there is more controversy is the converse, ie, that doing poorly means you are doomed to failure.

...who is making that argument.

 

[JABWS]

I don't think anyone would disagree with the idea that doing well in classes is a positive for your app and generally. Where I think there is more controversy is the converse, ie, that doing poorly means you are doomed to failure.

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You're not doomed if you do poorly, but doing well is certainly beneficial. Somehow this gets misconstrued into the notion that grades don't matter.

 

[NickNaylor]

...who is making that argument.

No one states it directly, but I get that implication when people talk about grades and scoff at the idea that you might not study as hard as you possibly can during the pre-clinical years with no real impact on anything. This is obviously not true in every situation and people should use common sense (slacking off while at a school that is graded and ranked, for example, is stupid), but it has certainly been true in my experience and in discussions with people from other similar schools.

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[JABWS]

No one states it directly, but I get that implication when people talk about grades and scoff at the idea that you might not study as hard as you possibly can during the pre-clinical years with no real impact on anything. This is obviously not true in every situation and people should use common sense (slacking off while at a school that is graded and ranked, for example, is stupid), but it has certainly been true in my experience and in discussions with people from other similar schools.

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The problem is that people don't use common sense. I attend a school that is graded and ranked, and I can't tell you how many times I've heard "pre-clinical grades don't matter." Have fun applying for residency with a transcript littered with Cs.

 

[oceanillusion42]

Grading/ranking at my school is, in and of itself, a very nebulous process. Its honors/pass/fail with honors being the top 10%. I'm above average, but certainly not the top 10%. That being said, I recently got a copy of a transcript in applying for clerkships. The transcript literally just reads "P" for every class. There is no rank, no numbers, no "GPA" to speak of. How they are going to evaluate me based on this transcript is beyond me... I guess they just want to see that you've passed everything and any "H's" on your transcript would be an asset. In addition I submitted a letter of intent and a CV so these are other criteria. But my point is that, at least in my case, grading is a very cryptic process that not many people fully grasp.

If my transcript is literally going to read P for everything, then why bust my butt for an 88, when someone with a 70 is going to get the same "P" as me. I'm not saying I subscribe to that logic, just playing the devils advocate really. If they were to say "hey you may only get a P, but the numeric grade will determine your class rank and thats important", then yea, I'm gonna bust my butt for that 88. But in the absence of that information I can see how some people would let their grades slide (especially with boards approaching lol).

 

[JP2740]

Idk, I've been honoring my classes, but you can justify the extra work you put in by at least hoping you learn it better for step 1. That's my main motivation for honoring- I know if I do well enough to honor, I probably learned that subject pretty well. Like someone said above, it's definitely beneficial, but if you're not destroying your 1st/2nd year classes, you will be fine (as long as you put in work to bolster yourself elsewhere and also perform well on step)

 

[NickNaylor]

The problem is that people don't use common sense. I attend a school that is graded and ranked, and I can't tell you how many times I've heard "pre-clinical grades don't matter." Have fun applying for residency with a transcript littered with Cs.

Yeah, totally agree. I might be in a somewhat unique situation in that we are true P/F, unranked, with no junior AOA so grades really don't matter for us. But obviously the people you refer to are misguided.

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[FIREitUP]

The problem is that people don't use common sense. I attend a school that is graded and ranked, and I can't tell you how many times I've heard "pre-clinical grades don't matter." Have fun applying for residency with a transcript littered with Cs.

i lol'd at this. i go to a school that has a ranked and has grades; i couldn't care less about my grades as long as I learn the material and understand it. if you think a program is going to inspect your preclinical grades for C's you're highly mistaken, and on the deans letter from my school preclinical grades encompass 1-2 sentences of a multiple page letter, so I think I'll be alright.

 

[JABWS]

i lol'd at this. i go to a school that has a ranked and has grades; i couldn't care less about my grades as long as I learn the material and understand it. if you think a program is going to inspect your preclinical grades for C's you're highly mistaken, and on the deans letter from my school preclinical grades encompass 1-2 sentences of a multiple page letter, so I think I'll be alright.

Perhaps our goals are different. I think most of us do "alright" by default. That's not exactly what I'm shooting for.

 

[FIREitUP]

Perhaps our goals are different. I think most of us do "alright" by default. That's not exactly what I'm shooting for.

my goal is to learn the material the best I can with a deep understanding leading to long to retention. the pedagogy at my school doesn't offer this, and subsequently the tests questions are reflective of minutiae rather than anything else. i prefer not to memorize minutiae and suffer by not doing as well on exams, which is something that doesn't bother me in the slightest. i think we probably have similar goals in that we both want to be good at what we do, and I just would like to contest that doing well on an exam does not necessarily have to equate with knowing the material well.

 

[notbobtrustme]

The problem is that people don't use common sense. I attend a school that is graded and ranked, and I can't tell you how many times I've heard "pre-clinical grades don't matter." Have fun applying for residency with a transcript littered with Cs.

You can easily make up that transcript with good clinicals + Step I score. Unless your goal is neurodermasurgery, that transcript won't hold you back all that much.

 

[JShephard]

Sdn pissing contests about who can pick a multiple choice answer correctly a few more times than average.

The measure of your manhood and your mark left on this world.

 

[airplanes]

i lol'd at this. i go to a school that has a ranked and has grades; i couldn't care less about my grades as long as I learn the material and understand it. if you think a program is going to inspect your preclinical grades for C's you're highly mistaken, and on the deans letter from my school preclinical grades encompass 1-2 sentences of a multiple page letter, so I think I'll be alright.

my goal is to learn the material the best I can with a deep understanding leading to long to retention. the pedagogy at my school doesn't offer this, and subsequently the tests questions are reflective of minutiae rather than anything else. i prefer not to memorize minutiae and suffer by not doing as well on exams, which is something that doesn't bother me in the slightest. i think we probably have similar goals in that we both want to be good at what we do, and I just would like to contest that doing well on an exam does not necessarily have to equate with knowing the material well.

Well guess what, it never stops. You think shelfs exams aren't full of minutiae? Are you just going to shoot for "learning and understanding" the material as well? Or are you going to flip a magic switch. It seems a bit amusing to me that you're so cavalier about grades simply because you don't agree with the curriculum.

If you're shooting for something competitive, AOA helps, and you're not going to get AOA by littering your pre-clinical grades with C's. Excluding NickNaylors outlier med school.

 

[FIREitUP]

Well guess what, it never stops. You think shelfs exams aren't full of minutiae? Are you just going to shoot for "learning and understanding" the material as well? Or are you going to flip a magic switch. It seems a bit amusing to me that you're so cavalier about grades simply because you don't agree with the curriculum.

If you're shooting for something competitive, AOA helps, and you're not going to get AOA by littering your pre-clinical grades with C's. Excluding NickNaylors outlier med school.

i'm glad i have the ability to amuse you. no doubt there's a ton of minutiae tested even on Step 1. my goal is to minimize the amount of information i need to memorize that i'll never see again in my entire life. i think if you went to my school you'd get a better idea of what i'm talking about. i've seen very good results so far with my method and people are constantly asking me how i study, so not only does my study style amuse you, but I've also found it to be very effective thusfar. thanks for your input, though.

 

[airplanes]

i'm glad i have the ability to amuse you. no doubt there's a ton of minutiae tested even on Step 1. my goal is to minimize the amount of information i need to memorize that i'll never see again in my entire life. i think if you went to my school you'd get a better idea of what i'm talking about. i've seen very good results so far with my method and people are constantly asking me how i study, so not only does my study style amuse you, but I've also found it to be very effective thusfar. thanks for your input, though.

How is than an effective strategy to do well on step 1? After step 1, all bets are off.

To be honest, you'd be surprised at how often some of the things you figured to be "minutiae" come up again. Although usually you're not expected to have it still memorized and at the ready.

 

[FIREitUP]

How is than an effective strategy to do well on step 1? After step 1, all bets are off.

To be honest, you'd be surprised at how often some of the things you figured to be "minutiae" come up again. Although usually you're not expected to have it still memorized and at the ready.

cool. i appreciate your concern for my knowledge-base.

 

[airplanes]

cool. i appreciate your concern for my knowledge-base.

...So you avoided the question? Great conversation. Would chat again. Two thumbs up.

 

[FIREitUP]

...So you avoided the question? Great conversation. Would chat again. Two thumbs up.

cool, let's set something up to make this a regular thing

 

[airplanes]

cool, let's set something up to make this a regular thing

Why don't you just fire me a PM when you wake up and realize that part of playing the game that is med school requires knowing the details for at least step 1. Continue being cavalier about it at your own risk. You're certainly entitled to do so. 👍

 

[JABWS]

You can easily make up that transcript with good clinicals + Step I score. Unless your goal is neurodermasurgery, that transcript won't hold you back all that much.

But wouldn't you rather have a transcript that helps you, rather than one that "won't hold you back all that much?"

I can't speak for everyone and their differing curriculums/exams/PhD nonsense etc.. But when I earn an A in a class, it's because I absolutely worked my tail off. It's not a pissing contest, it's a measure of the amount of effort I was willing to put in to master the material.

 

[FIREitUP]

Why don't you just fire me a PM when you wake up and realize that part of playing the game that is med school requires knowing the details for at least step 1. Continue being cavalier about it at your own risk. You're certainly entitled to do so. 👍

i'm happy to say that you've repaid me with a response I find equally amusing. cheers!

 

[JShephard]

But wouldn't you rather have a transcript that helps you, rather than one that "won't hold you back all that much?"

I can't speak for everyone and their differing curriculums/exams/PhD nonsense etc.. But when I earn an A in a class, it's because I absolutely worked my tail off. It's not a pissing contest, it's a measure of the amount of effort I was willing to put in to master the material.

I wasnt referring to your performance or your work ethic. I was referring to your conversation about it and telling others to enjoy applying with all C's. Your work ethic is to be commended that's not what you're voyaging about.

 

[airplanes]

i'm happy to say that you've repaid me with a response I find equally amusing. cheers!

God, I love med students. I'm sure I'll get the last laugh. But you can have the last word you clearly want it so badly.

 

[FIREitUP]

god, i love med students. I'm sure i'll get the last laugh. But you can have the last word since you want it so badly.

 

[JShephard]

Pre clinical grades are a means to an end. They only need to be high enough to achieve whatever your goals are. If you average 99% or 89%, it really doesn't matter as long as you match the specialty you want and where you want. People achieve this with great grades and good grades.

If you need to honor every course for your specialty or you get off by talking about grades on the Internet, well great.

I've never been around a group of people so obsessed with comparing themselves to others - grades, steps, hours studied, weeks to prepare, days I went out this week, etc.

 

[FIREitUP]

Pre clinical grades are a means to an end. They only need to be high enough to achieve whatever your goals are. If you average 99% or 89%, it really doesn't matter as long as you match the specialty you want and where you want. People achieve this with great grades and good grades.

If you need to honor every course for your specialty or you get off by talking about grades on the Internet, well great.

I've never been around a group of people so obsessed with comparing themselves to others - grades, steps, hours studied, weeks to prepare, days I went out this week, etc.

but then how will we know if you're cool or not?

 

[JABWS]

I wasnt referring to your performance or your work ethic. I was referring to your conversation about it and telling others to enjoy applying with all C's. Your work ethic is to be commended that's not what you're voyaging about.

It was a figure of speech to make the point that having a sub-par transcript will not be helpful when applying for residency. I wasn't trying to flaunt my success or sound superior to anyone else.

Seriously, are pre-clinical grades so stigmatized that you can't have a legitimate conversation about their importance without everyone getting overly defensive?

 

[FIREitUP]

It was a figure of speech to make the point that having a sub-par transcript will not be helpful when applying for residency. I wasn't trying to flaunt my success or sound superior to anyone else.

Seriously, are pre-clinical grades so stigmatized that you can't have a legitimate conversation about their importance without everyone getting overly defensive?

it just sounds like you're making implications that because certain individuals like myself don't aim for high preclinical grades, that we don't work hard. if doing well in class makes you feel accomplished and helps motivate you, then more power to you. there seems to be so much of a doom and gloom connotation to posts directed at people who don't find preclinical grades to be an accurate predictor of one's knowledge.

 

[NickNaylor]

God, I love med students. I'm sure I'll get the last laugh. But you can have the last word you clearly want it so badly.

I share a similar approach as Fire and I can say that it hasn't impacted my comfort level with the boards or anything else at all. I intend to follow up on these discussions with my step 1 score - great or not - so we'll see who gets the last laugh. You claim that people with this approach are simply trying to rationalize doing poorly. It's just as easy to flip the argument and say that the opposite position is nothing more than rationalizing wasting your time learning things that are irrelevant. It's a pointless discussion to have unless you know the entire situation any one person is in.

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[JP2740]

I share a similar approach as Fire and I can say that it hasn't impacted my comfort level with the boards or anything else at all. I intend to follow up on these discussions with my step 1 score - great or not - so we'll see who gets the last laugh. You claim that people with this approach are simply trying to rationalize doing poorly. It's just as easy to flip the argument and say that the opposite position is nothing more than rationalizing wasting your time learning things that are irrelevant. It's a pointless discussion to have unless you know the entire situation any one person is in.

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Listen man stop trying to rationalize your bad grades to us. I am a superior human being so bow down and take it. I'll make sure to follow up where I matched in this post.

 

[NickNaylor]

Listen man stop trying to rationalize your bad grades to us. I am a superior human being so bow down and take it. I'll make sure to follow up where I matched in this post.

Please do, because that way if you match derm, plastics, etc. I will know that you have achieved winning status in life and will follow your words blindly. 😍

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[notbobtrustme]

But wouldn't you rather have a transcript that helps you, rather than one that "won't hold you back all that much?"

I can't speak for everyone and their differing curriculums/exams/PhD nonsense etc.. But when I earn an A in a class, it's because I absolutely worked my tail off. It's not a pissing contest, it's a measure of the amount of effort I was willing to put in to master the material.

sure, it helps, but as long as you don't remediate, everyone is pretty much in the same boat with respect to pre-clinical grades. And every school is different with how tests are structured. For the most part, if you know the material, you'll end up with a C or B. If you know all the stupid minutia, you'll get an A. The question is do you want to spend that extra 4, 6 or 10 hours memorizing all those tiny details in order to get that A or would you rather enjoy your free time off and realize that the big money is in clinical and Step I.

 

[JABWS]

I share a similar approach as Fire and I can say that it hasn't impacted my comfort level with the boards or anything else at all. I intend to follow up on these discussions with my step 1 score - great or not - so we'll see who gets the last laugh. You claim that people with this approach are simply trying to rationalize doing poorly. It's just as easy to flip the argument and say that the opposite position is nothing more than rationalizing wasting your time learning things that are irrelevant. It's a pointless discussion to have unless you know the entire situation any one person is in.

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Nick, you attend a top 20 school that is purely P/F. You were set from day 1. Considering that Step material is much more general than what is covered in your pre-clinical courses, I'm sure you'll do just fine. But the practice of medicine isn't confined solely to what is tested on the USMLE, and how can anyone who is an MS1/2 have any perspective on what's truly important?

 

[NickNaylor]

Nick, you attend a top 20 school that is purely P/F. You were set from day 1. Considering that Step material is much more general than what is covered in your pre-clinical courses, I'm sure you'll do just fine. But the practice of medicine isn't confined solely to what is tested on the USMLE, and how can anyone who is an MS1/2 have any perspective on what's truly important?

Definitely true, and I will admit that the main flaw in this approach is that I am definitely missing out on material that, though perhaps not required for step 1 studying, would no doubt be helpful to have. That's part of the sacrifice I've made. However, based on discussions with older students I don't see this as having much of an effect; it will be learned on the wards anyway, though I might be a little clueless initially compared to those that did learn and memorize all this stuff.

It comes down to priorities and what's important. For me, it was important that I don't kill myself during the pre-clinical years with work and studying. I wanted to have a life, and I refused to let school define how I spend my time or really anything. Many people take the opposite approach - school is the ONLY thing they're focused on, and all else is secondary. And of course many/most folks lie somewhere in between. I found that 1) not attending class and 2) studying the "boards relevant" material gave me a happy mix of doing well enough on in-class exams, building a reasonable knowledge base for step 1 and the wards, and having lots of free time to do with whatever I want. No, I'm not going to be at the top or even near the top of my class, but that's something that I've had to come to accept because of what is more important than that (to me).

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).

I guess that's a good point to make, which is that this applies mostly to the classic M1 material - all of the basic sciences excluding path and pathophys and perhaps even physio. I 100% agree that all of the details, etc. are critical to the classic M2 material because those details are necessary to distinguish many different disease processes. However, I find it extremely hard to believe that knowing all of the intricacies of the PPP pathway or which cyclin/CDK complexes cause progression in the various points of the cell cycle are even remotely relevant to most practices of medicine.

As the saying goes, "everything is important, but some things are more important than others." I focus on the things that are more important than others, with the understanding that what is "more important" will constantly change as my role and responsibilities change with the level of my training.

 

[oceanillusion42]

People need to relaxxxx, damn.

 

[airplanes]

I share a similar approach as Fire and I can say that it hasn't impacted my comfort level with the boards or anything else at all. I intend to follow up on these discussions with my step 1 score - great or not - so we'll see who gets the last laugh. You claim that people with this approach are simply trying to rationalize doing poorly. It's just as easy to flip the argument and say that the opposite position is nothing more than rationalizing wasting your time learning things that are irrelevant. It's a pointless discussion to have unless you know the entire situation any one person is in.

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😕 You're putting words in my mouth. Show me where I said people are simply rationalizing. I said it amused me that the primary reason he states for being nonchalant is that he disagrees with the curriculum. He assumes he knows better. I beg to differ. And FWIW, I did not ace my preclinical grades. I matched into Ophtho at a great program but missed out on my dream residency, likely because my preclinical and clerkship grades were not outstanding, something most top programs in most specialties require.

Here's what he said:

my goal is to minimize the amount of information i need to memorize that i'll never see again in my entire life.

and here's what I asked him.

How is than an effective strategy to do well on step 1? After step 1, all bets are off.

He conveniently ignored it. There is plenty that comes up on step 1 that you don't see ever again. I'm find with the assertion that you never again see a solid portion of the preclinical curriculum. But the same is not true for step 1. If you plan on doing well on step 1, you are going to have to review a fair amount of minutiae.

 

[JP2740]

Honoring = a definite plus
Not honoring = not the end of the world

/end thread

 

[JABWS]

Definitely true, and I will admit that the main flaw in this approach is that I am definitely missing out on material that, though perhaps not required for step 1 studying, would no doubt be helpful to have. That's part of the sacrifice I've made. However, based on discussions with older students I don't see this as having much of an effect; it will be learned on the wards anyway, though I might be a little clueless initially compared to those that did learn and memorize all this stuff.

It comes down to priorities and what's important. For me, it was important that I don't kill myself during the pre-clinical years with work and studying. I wanted to have a life, and I refused to let school define how I spend my time or really anything. Many people take the opposite approach - school is the ONLY thing they're focused on, and all else is secondary. And of course many/most folks lie somewhere in between. I found that 1) not attending class and 2) studying the "boards relevant" material gave me a happy mix of doing well enough on in-class exams, building a reasonable knowledge base for step 1 and the wards, and having lots of free time to do with whatever I want. No, I'm not going to be at the top or even near the top of my class, but that's something that I've had to come to accept because of what is more important than that (to me).

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).

I guess that's a good point to make, which is that this applies mostly to the classic M1 material - all of the basic sciences excluding path and pathophys. I 100% agree that all of the details, etc. are critical to the classic M2 material because those details are necessary to distinguish many different disease processes. However, I find it extremely hard to believe that knowing all of the intricacies of the PPP pathway or which cyclin/CDK complexes cause progression in the various points of the cell cycle are even remotely relevant to most practices of medicine.

As the saying goes, "everything is important, but some things are more important than others." I focus on the things that are more important than others, with the understanding that what is "more important" will constantly change as my role and responsibilities change with the level of my training.

We definitely go about things differently, but I can't argue with the reasoning behind your approach, especially in light of the leeway afforded by your curriculum. If I were in your position, I'd probably follow along the same path. But I'm not. I receive grades and am ranked relative to my peers, and at the end of the day, no one cares that I "learned the most important stuff" if I have nothing to show for it on my transcript. I would venture to say that you'd be more concerned with your class performance if it was recorded in a manner similar to mine.

Having said that, I do hope all of my hard work pays off in areas other than just grades. Forgetting a lot of the "minutiae" is a given, but I've yet to subscribe to a completely nihilistic view when it comes to the pre-clinical material. I feel like I've already learned so much that can be applied to patient care, as was evident during a recent hospital visit, and I've found that even an awareness that certain information exists can be beneficial in a clinical setting.

Nevertheless, I completely understand the opposite side of the coin. I've been told by countless upperclassmen that the material that is truly important will be repeated over and over again. I've also come to appreciate the limitations of a physician (and medical student) due to the daunting amount of knowledge that medicine encompasses.

Ultimately, I don't know the right answer. Perhaps there is a better and more efficient way to get through medical school than to abide by the expectations of a traditional curriculum. My initial argument, which you agreed with but everyone else seems to object to, is that pre-clinical grades do matter, to an extent. AOA members at my school match derm at MGH, anesthesiology at Stanford etc.. and I just don't think that would be possible with less than stellar pre-clinical grades. So while pre-clinical grades certainly aren't the most important aspect of your residency application, and doing poorly or average won't necessarily sink your chances, I do believe strong scores help you more than most people on sdn are willing to acknowledge, at least coming from a school that is graded and ranked.

 

[JABWS]

Honoring = a definite plus
Not honoring = not the end of the world

/end thread

My point exactly.

 

[JShephard]

Honoring = a definite plus
Not honoring = not the end of the world

/end thread

Agreed.

Listen man stop trying to rationalize your bad grades to us. I am a superior human being so bow down and take it. I'll make sure to follow up where I matched in this post.

I liked this post better. It's my view of the typical sdn poster.