Question about rotation grades

[fldoctorgirl]

If you're a PD, or if you've gone through the application process and have some insight....

If a school reports clinical class rank (separately from pre-clinical rank), do you put more weight on that vs. individual clerkship grades? I'm kind of irritated as I just got my first clerkship grade back and missed honors by 1 point (school grades 100% based on shelf score). There is no high pass at my school, which means I will get a pass. It is frustrating to think that my grade will appear the same as someone who just passed the exam, which is basically like a 4th percentile score vs. an 86th percentile one. It is also frustrating knowing that at other schools, the numerical score for honors is lower and I would have gotten it had I been a student there. I have also heard rumors swirling that there has been less than ethical behavior on these exams since they're self-proctored due to COVID, but that's another issue.

I know my school has a clinical class rank that is reported only if you're in a certain top %; I don't remember what % it was. But, for arguments sake, as a PD, would you give more attention to this number vs. individual rotation grades? Also, assuming you're not gunning for a competitive specialty and/or top-tier programs, how much does it matter, especially if you have high Step scores? I know it's just one rotation, but I'm worried about what happens if I end up with straight P's....always one point off or something like that. Finally starting to understand why everyone is so irritated with the third year grading process haha

---

Members don't see this ad.

 

[Frogger27]

Sorry to hear OP and wish I had better better advice. As sad as it is, I advise people to learn how to play the game as soon as possible (eg, finding out who the easy graders are, going to chill community sites vs academic where they grade easier with less hours = more shelf study time, etc).

IMO third year should only consist of evaluations and your shelf score reported on the MSPE. Grading in third year is an absolute joke

 

[Lawpy]

What's with schools having bizarre clinical grading systems that only punishes their own students for no reason? Makes no sense. I get playing the game of finding the 5 givers and avoiding 3 bombers is the way to go but come on. It's a stupid way to do it in med school.

 

[theonlytycrane]

I'm always impressed by those who Honor everything- They played the game well.

to OP- sorry to hear... 3rd yr is trash. Try to get Honors in your intended specialty + Honors in your 4th your sub-i. And then as many Honors on top of that as possible.

 

[fldoctorgirl]

Sorry to hear OP and wish I had better better advice. As sad as it is, I advise people to learn how to play the game as soon as possible (eg, finding out who the easy graders are, going to chill community sites vs academic where they grade easier with less hours = more shelf study time, etc).

IMO third year should only consist of evaluations and your shelf score reported on the MSPE. Grading in third year is an absolute joke

That's the thing, though: my evals don't mean anything. The only thing that counts toward our grade is the shelf. And I was 1 point away from honors, but since we don't have high pass I'll have the same grade as someone who just passed the shelf by one point for example. I just don't get that system.

 

[Neopolymath]

That's the thing, though: my evals don't mean anything. The only thing that counts toward our grade is the shelf. And I was 1 point away from honors, but since we don't have high pass I'll have the same grade as someone who just passed the shelf by one point for example. I just don't get that system.

He is saying that your MSPE should have your written evaluations and your shelf grades (optimally compared to your classmates on a distribution), not your school's totally arbitrary "overall grade."

 

[fldoctorgirl]

He is saying that your MSPE should have your written evaluations and your shelf grades (optimally compared to your classmates on a distribution), not your school's totally arbitrary "overall grade."

Oh! I didn't realize they report our exact shelf grade.

 

[Neopolymath]

Oh! I didn't realize they report our exact shelf grade.

Let me clarify. I believe Frogger is saying that *ideally* that is what schools would do NOT what your school actually does. We do not know what your school does. Only you can contact your school/upperclassmen to know what is on your specific school's MSPE. They are not all the same, unfortunately.

The most important lesson of the overarching thread is this: 3rd year is amazing in some ways and also terrifyingly helpless/frustrating/stupid at the same time. The mission is to stay sane and kind throughout the year without much burnout. Work hard and keep chugging along to improve overall throughout the year. Always move forward! You missed the mark this time but you will improve. You will be fine! It just seems like every tiny little thing matters so much but it really doesn't. You will get over this feeling as time goes on.

 

[fldoctorgirl]

Let me clarify. I believe Frogger is saying that *ideally* that is what schools would do NOT what your school actually does. We do not know what your school does. Only you can contact your school/upperclassmen to know what is on your specific school's MSPE. They are not all the same, unfortunately.

The most important lesson of the overarching thread is this: 3rd year is amazing in some ways and also terrifyingly helpless/frustrating/stupid at the same time. The mission is to stay sane and kind throughout the year without much burnout. Work hard and keep chugging along to improve overall throughout the year. Always move forward! You missed the mark this time but you will improve. You will be fine! It just seems like every tiny little thing matters so much but it really doesn't. You will get over this feeling as time goes on.

Gotcha! Thanks for explaining.

 

[ciestar]

Oh! I didn't realize they report our exact shelf grade.

My school didnt report shelf grades on MSPE. Someone else made a good point of clinical grades are a bad way to assess your performance. If a PD is familiar with your school, they know how your grading system works. For example, another med school i rotated with had inflated grades. PDs in the area knew that. My MSPE also had the grade distribution for my class on each clerkship.

Basically, your money is the MSPE comments. M3 grades are so arbitrary.

 

[Miles Gloriosus]

If you're a PD, or if you've gone through the application process and have some insight....

If a school reports clinical class rank (separately from pre-clinical rank), do you put more weight on that vs. individual clerkship grades? I'm kind of irritated as I just got my first clerkship grade back and missed honors by 1 point (school grades 100% based on shelf score). There is no high pass at my school, which means I will get a pass. It is frustrating to think that my grade will appear the same as someone who just passed the exam, which is basically like a 4th percentile score vs. an 86th percentile one. It is also frustrating knowing that at other schools, the numerical score for honors is lower and I would have gotten it had I been a student there. I have also heard rumors swirling that there has been less than ethical behavior on these exams since they're self-proctored due to COVID, but that's another issue.

I know my school has a clinical class rank that is reported only if you're in a certain top %; I don't remember what % it was. But, for arguments sake, as a PD, would you give more attention to this number vs. individual rotation grades? Also, assuming you're not gunning for a competitive specialty and/or top-tier programs, how much does it matter, especially if you have high Step scores? I know it's just one rotation, but I'm worried about what happens if I end up with straight P's....always one point off or something like that. Finally starting to understand why everyone is so irritated with the third year grading process haha

Unfortunate situation. Now you know what to prioritize for your rotations. Staying late to follow up on a patient or to help resident/intern is not valued at your school. Get nice comments from attending during morning rounds and leave as soon as possible when attending is gone to study for shelf.

 

[Frogger27]

Unfortunate situation. Now you know what to prioritize for your rotations. Staying late to follow up on a patient or to help resident/intern not valued at your school. Get nice comments from attending during morning rounds and leave as soon as possible when attending is gone to study for shelf.

Such a shame for medical education that this is a thing, but 100% advise OP to do this.

 

[libertyyne]

Try your best in the situation you are in. Just by the luck of the draw some people will get easier graders, some schools will have a higher percent of their class honoring rotations.
Its not like you can change anything. Focus on your next rotation, and how you can get that one extra point to get your honors on that grade.

 

[Neopolymath]

Such a shame for medical education that this is a thing, but 100% advise OP to do this.

I'm definitely going to be a much worse clinician/intern by a significant margin due to this environment compared to the ideal world but ultimately I don't really care because I know I had to do it to play the game to maximize my chances of getting into a good program. Literally none of the things you learn clinically matters if you do not match into your goal program. (That and I was deciding between two specialties that don't use traditional skills)

 

[libertyyne]

I'm definitely going to be a much worse clinician/intern by a significant margin due to this environment compared to the ideal world but ultimately I don't really care because I know I had to do it to play the game to maximize my chances of getting into a good program. Literally none of the things you learn clinically matters if you do not match into your goal program. (That and I was deciding between two specialties that don't use traditional skills)

I felt like I will be a better clinician due to the way my school does things. I had to work well with a team to get good evals, and I had to do well on my shelf to get 50% of the grade.

 

[Neopolymath]

I felt like I will be a better clinician due to the way my school does things. I had to work well with a team to get good evals, and I had to do well on my shelf to get 50% of the grade.

My grades were 50% evals and 50% shelf as well. I still think that I would have spent more time learning "real medicine" instead of getting extra time in to study for the rotation exams to absolutely ensure crushing them.

 

[libertyyne]

My grades were 50% evals and 50% shelf as well. I still think that I would have spent more time learning "real medicine" instead of getting extra time in to study for the rotation exams to absolutely ensure crushing them.

IDK, i felt the shelves were fairly good at covering important clinical information. Obviously I dont have attending level skills or knowledge yet, but there are at minimum three years of residency to pick up that information. Plus there is already a lot of knowledge we have that is good for building nuance upon in our decided specialties. The real nitty gritty of medicine is not in that uptodate article, but rather when you are faced with unique situations and have to use clinical judgement. Those are only accessible realistically if you have skin in the game and are actually taking care of patients.

I view that studying as learning the important basics, the better you have that down the quicker you can move on to the next nuanced thing. If you dont have it down its almost impossible to build good evidence based clinical skills/management skills without that foundation.

 

[fldoctorgirl]

My grades were 50% evals and 50% shelf as well. I still think that I would have spent more time learning "real medicine" instead of getting extra time in to study for the rotation exams to absolutely ensure crushing them.

Can I ask how you studied? You can PM me if you don't want to go into it here.

 

[ciestar]

My new take as an intern: it irks me to my core to see med students just sitting there doing nothing.

Damn clinical education is so messed up

 

[deleted697308]

My new take as an intern: it irks me to my core to see med students just sitting there doing nothing.

Damn clinical education is so messed up

clinical education is so messed up...i hate the grading. i did honor all my clinicals third year (except my first rotation) but the first rotation taught me how to study and do better...

i'm an M4 on my elective surgery rotation. and i try to be active in what i'm doing. it's super frustrating as this is my elective and i will be going into surgery but for some reason nothing i do is good enough.

me: offers to put in orders for the NEXT day
residents put it in saying "oh too bad"
me makes the list the next day
residents we made it even after you made it and made print outs and then say wow it looks detailed but we aren't using yours
resident the prior week asked me to make the list a certain way - me makes it that way...me gets yelled at for making it that way

residents complain about me not doing enough
me: there are no cases thanks to covid, we round for 20 minutes??? and i sit????
me: offers to put foley in during a case
resident: don't do it
me: offers again 3 more times in other cases
resident: No
the next week i don't offer
nurse WHY DID U MAKE THE RESIDENT PUT IN THE FOLEY
me: i asked the resident 4 times? lol

me: can i help in any way?
resident: you should be anticipating what help we need!
me: lol we're all just sitting here cause we only have 4 patients -_-....

surgeon...gets mad i asked if it was the blue button i use when being passed the bovie.... -____- i've never used one before because no one lets me do anything

fellow - present an abbreviated plan focused presentation. me *does that* ... third year presents like that to attending. me gets asked 3000 questions on other irrelevant things, gets told not to say person with PMHx of xyz is currently POD# and gets told to just say POD #.


i hate being a student sometimes. nothing i do is good enough. i don't get the grading and live in constant anxiety OVER my grades.

 

[Miles Gloriosus]

clinical education is so messed up...i hate the grading. i did honor all my clinicals third year (except my first rotation) but the first rotation taught me how to study and do better...

i'm an M4 on my elective surgery rotation. and i try to be active in what i'm doing. it's super frustrating as this is my elective and i will be going into surgery but for some reason nothing i do is good enough.

me: offers to put in orders for the NEXT day
residents put it in saying "oh too bad"
me makes the list the next day
residents we made it even after you made it and made print outs and then say wow it looks detailed but we aren't using yours
resident the prior week asked me to make the list a certain way - me makes it that way...me gets yelled at for making it that way

residents complain about me not doing enough
me: there are no cases thanks to covid, we round for 20 minutes??? and i sit????
me: offers to put foley in during a case
resident: don't do it
me: offers again 3 more times in other cases
resident: No
the next week i don't offer
nurse WHY DID U MAKE THE RESIDENT PUT IN THE FOLEY
me: i asked the resident 4 times? lol

me: can i help in any way?
resident: you should be anticipating what help we need!
me: lol we're all just sitting here cause we only have 4 patients -_-....

surgeon...gets mad i asked if it was the blue button i use when being passed the bovie.... -____- i've never used one before because no one lets me do anything

fellow - present an abbreviated plan focused presentation. me *does that* ... third year presents like that to attending. me gets asked 3000 questions on other irrelevant things, gets told not to say person with PMHx of xyz is currently POD# and gets told to just say POD #.


i hate being a student sometimes. nothing i do is good enough. i don't get the grading and live in constant anxiety OVER my grades.

Never forget how it felt as a med student. Your residents and attending seem to have forgotten. Burn this in your memory so that in a few years you don’t do the same thing to the med student you supervise.

 

[Dr. Rafiki]

OP I have no advice to offer you other than to point out how stupid 3rd year is. At the top state MD school where I am, they grade 85% eval, 10% shelf score, 5% rotation specific busy work. In that system I feel as though most, if not all, will honor all their rotations.

 

[libertyyne]

clinical education is so messed up...i hate the grading. i did honor all my clinicals third year (except my first rotation) but the first rotation taught me how to study and do better...

i'm an M4 on my elective surgery rotation. and i try to be active in what i'm doing. it's super frustrating as this is my elective and i will be going into surgery but for some reason nothing i do is good enough.

me: offers to put in orders for the NEXT day
residents put it in saying "oh too bad"
me makes the list the next day
residents we made it even after you made it and made print outs and then say wow it looks detailed but we aren't using yours
resident the prior week asked me to make the list a certain way - me makes it that way...me gets yelled at for making it that way

residents complain about me not doing enough
me: there are no cases thanks to covid, we round for 20 minutes??? and i sit????
me: offers to put foley in during a case
resident: don't do it
me: offers again 3 more times in other cases
resident: No
the next week i don't offer
nurse WHY DID U MAKE THE RESIDENT PUT IN THE FOLEY
me: i asked the resident 4 times? lol

me: can i help in any way?
resident: you should be anticipating what help we need!
me: lol we're all just sitting here cause we only have 4 patients -_-....

surgeon...gets mad i asked if it was the blue button i use when being passed the bovie.... -____- i've never used one before because no one lets me do anything

fellow - present an abbreviated plan focused presentation. me *does that* ... third year presents like that to attending. me gets asked 3000 questions on other irrelevant things, gets told not to say person with PMHx of xyz is currently POD# and gets told to just say POD #.


i hate being a student sometimes. nothing i do is good enough. i don't get the grading and live in constant anxiety OVER my grades.

I’ve had similar experience during fourth year. The only thing that has helped is to remember that all this nonsense is intentional. They don’t value you as a team member because they were never valued in your position. Then there are hospital rules and other things that prevent you from being utilized.so you are essentially useless. Just embrace the suck, laugh at the absurdity and move on. I try to be helpful, take initiative , work hard and be kind to everyone around me. I worked hard had essentially pan honors third year and great board scores . If they can’t see my value then it’s their loss other services would be happy to have me . Some residents will treat you like adults and give you responsibilities and chances to shine , others will ignore you. It’s fine . It’s interesting to see how quickly residents forget that they were in your shoes not too long ago.

 

[ciestar]

clinical education is so messed up...i hate the grading. i did honor all my clinicals third year (except my first rotation) but the first rotation taught me how to study and do better...

i'm an M4 on my elective surgery rotation. and i try to be active in what i'm doing. it's super frustrating as this is my elective and i will be going into surgery but for some reason nothing i do is good enough.

me: offers to put in orders for the NEXT day
residents put it in saying "oh too bad"
me makes the list the next day
residents we made it even after you made it and made print outs and then say wow it looks detailed but we aren't using yours
resident the prior week asked me to make the list a certain way - me makes it that way...me gets yelled at for making it that way

residents complain about me not doing enough
me: there are no cases thanks to covid, we round for 20 minutes??? and i sit????
me: offers to put foley in during a case
resident: don't do it
me: offers again 3 more times in other cases
resident: No
the next week i don't offer
nurse WHY DID U MAKE THE RESIDENT PUT IN THE FOLEY
me: i asked the resident 4 times? lol

me: can i help in any way?
resident: you should be anticipating what help we need!
me: lol we're all just sitting here cause we only have 4 patients -_-....

surgeon...gets mad i asked if it was the blue button i use when being passed the bovie.... -____- i've never used one before because no one lets me do anything

fellow - present an abbreviated plan focused presentation. me *does that* ... third year presents like that to attending. me gets asked 3000 questions on other irrelevant things, gets told not to say person with PMHx of xyz is currently POD# and gets told to just say POD #.


i hate being a student sometimes. nothing i do is good enough. i don't get the grading and live in constant anxiety OVER my grades.

The rotation im on the student basically has nothing to do at all. Cant chart or anything either. Idk why the senior made them stay past noon (we attend all deliveries until noon, so the student does get involved in that)

 

[NicMouse64]

COVID makes it all worse. On my surgery rotations and not very many surgeries. Told not to PM round. Fearful that the attendings are just gonna fail me on the rotations because we are told to leave at noon. It's a double-edged sword, especially during these times. I personally don't mind going home at 12 or having less work, but feel like I'm not learning jack sh**.

 

[Lawpy]

Never forget how it felt as a med student. Your residents and attending seem to have forgotten. Burn this in your memory so that in a few years you don’t do the same thing to the med student you supervise.

I agree but isn't this just basic decency?

 

[ciestar]

I agree but isn't this just basic decency?

You’d think.

My third year IM rotation the M3 followed the intern in terms of call/schedule and basically made me stick around because he had to be there.

 

[Miles Gloriosus]

I agree but isn't this just basic decency?

Unfortunately decency goes by the wayside early on in residency. Revisionist history is strong with most. Surgery residents will often claim that they were faster, stronger, smarter as med students when compared to “kids these days.”

 

[fldoctorgirl]

I'm on surgery right now. Doc had 1 procedure for today. Then we're told to just look at the OR board and join cases if we want. We can't access EMR, doesn't seem like anyone wants us around. My grade is fully shelf-based so I'm not concerned, but I don't feel like I'm learning anything lol

 

[ciestar]

I'm on surgery right now. Doc had 1 procedure for today. Then we're told to just look at the OR board and join cases if we want. We can't access EMR, doesn't seem like anyone wants us around. My grade is fully shelf-based so I'm not concerned, but I don't feel like I'm learning anything lol

My surgery rotation was similar. I definitely didnt join any cases if that was the case and would hide out to study until they told me to leave lol

 

[deleted697308]

Unfortunately decency goes by the wayside early on in residency. Revisionist history is strong with most. Surgery residents will often claim that they were faster, stronger, smarter as med students when compared to “kids these days.”

100% told this all the time and the residents i'm with all went to the same school as me lol. i'm like ok lol. i went through the same thing???

 

[ciestar]

100% told this all the time and the residents i'm with all went to the same school as me lol. i'm like ok lol. i went through the same thing???

I legit keep this stuff in mind and when im a senior im just not gonna make students sit on their hands

 

[Matthew9Thirtyfive]

take the supplies i get in during the morning out of my POCKETS.

Uh WHAT.

Not letting that happen is not being aggressive. It’s called not being a door mat. You need to stop being a door mat and call them the **** out on that, because if they see they can do that to you, it won’t stop there.

That is ****ing ridiculous.

 

[Dr.Bruh]

Oh! I didn't realize they report our exact shelf grade.

At your school (we go to the same school) they don’t report comat score but your clinical ranking will reflect your score. If you get all Ps but all 86%ile (at our school you need 90%ile shelf to honor) your clinical ranking will be very high especially compared to someone who got all Ps and like <50%ile. But your clinical ranking will be in your mspe if your top 25%. For instance I am top 25% clinical ranking and only honored 2 shelfs. But most of mine were P but just short of honors.

also you can tell your mspe writer to include a specific shelf percentile in the written portion of you want.

 

[MLNS]

As a resident let me say: residents blow. So many pencil pushing suck-ups. I literally tell my students they can leave whenever they want. Or they can stay: they can study, or if they want to help me out I can give them “resident” **** to do. But I despised when lazy af residents made me do their work for them when I was a MS so I make sure to tell them to only do it if they want and it won’t affect their grade one iota.

I’m so swamped though it’s hard to “teach.” I also didn’t go to teacher school so on my end its literally impossible to teach to each persons specificity. So I ask them what helps them learn best.

Regardless, I think med students just don’t get that life long learning is a self-driving affair. Too many expect to just be spoon fed. With nurses/ fellows/ attendings/ nutrition/ rts/ etc breathing down my neck and annoying the **** out of me quite frankly I just don’t have the time to spoon feed ya.

 

[fldoctorgirl]

At your school (we go to the same school) they don’t report comat score but your clinical ranking will reflect your score. If you get all Ps but all 86%ile (at our school you need 90%ile shelf to honor) your clinical ranking will be very high especially compared to someone who got all Ps and like <50%ile. But your clinical ranking will be in your mspe if your top 25%. For instance I am top 25% clinical ranking and only honored 2 shelfs. But most of mine were P but just short of honors.

also you can tell your mspe writer to include a specific shelf percentile in the written portion of you want.

Yeah that was actually my original question when I posted the thread haha, whether PDs would may more attention to this rank or just see a bunch of Ps.

 

[ohmanwaddup]

Yeah that was actually my original question when I posted the thread haha, whether PDs would may more attention to this rank or just see a bunch of Ps.

I think our school does something similar if you are in the top 100.