Shelf scores affecting chances at match?

[whatnext86]

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Hi All!

I tried searching to see if this had been addressed before, but could not really find anything that matched, so I'm sorry if this may have been on a previous thread...

Currently an MS3 who finished up Med, Surg, Peds. In our school, they claim that our evaluations make-up the majority of what determines our grade in the syllabus, but they always tell us that our grade is determined by our shelf exam scores. I got a B in internal, and a B+ in surgery both due to shelf scores. I was having a hard time accepting these two, and after studying my butt off for peds, I found out I did not pass the shelf exam for the rotation!! I was very sick on the rotation and had some family issues, but I'm sure thats not excuse. Our school lets us retake the exam and if you pass the second time, then you still pass the clerkship. I have no idea how to improve myself, but of course I am going to try even harder (not sure how yet ha!) But I will only just pass the clerkship.

I was wondering how this would affect my application to residency programs in IM. All of my evaluations from faculty are excellent, but my grades are low because I just can't take those exams!! My step one score is 230. I had two faculty who really liked me on my IM rotation (this was my first rotation of the year) and one who offered to write me a letter of rec. He is a rather well known faculty in the field and has numerous connections. I also have basic science research experience under my belt with some publications (not first author) and a bunch of volunteer hours. Before this shocker in peds, I had hoped to apply to programs in the northeast like Columbia, Cornell, NYU, UChicago, Drexel, etc. I was wondering if this misfortune in peds is going to completely ruin my chances at hopes for such programs.

Thanks in advance for all your responses!

 

[Phineus]

Hi All!

I tried searching to see if this had been addressed before, but could not really find anything that matched, so I'm sorry if this may have been on a previous thread...

Currently an MS3 who finished up Med, Surg, Peds. In our school, they claim that our evaluations make-up the majority of what determines our grade in the syllabus, but they always tell us that our grade is determined by our shelf exam scores. I got a B in internal, and a B+ in surgery both due to shelf scores. I was having a hard time accepting these two, and after studying my butt off for peds, I found out I did not pass the shelf exam for the rotation!! I was very sick on the rotation and had some family issues, but I'm sure thats not excuse. Our school lets us retake the exam and if you pass the second time, then you still pass the clerkship. I have no idea how to improve myself, but of course I am going to try even harder (not sure how yet ha!) But I will only just pass the clerkship.

I was wondering how this would affect my application to residency programs in IM. All of my evaluations from faculty are excellent, but my grades are low because I just can't take those exams!! My step one score is 230. I had two faculty who really liked me on my IM rotation (this was my first rotation of the year) and one who offered to write me a letter of rec. He is a rather well known faculty in the field and has numerous connections. I also have basic science research experience under my belt with some publications (not first author) and a bunch of volunteer hours. Before this shocker in peds, I had hoped to apply to programs in the northeast like Columbia, Cornell, NYU, UChicago, Drexel, etc. I was wondering if this misfortune in peds is going to completely ruin my chances at hopes for such programs.

Thanks in advance for all your responses!

Read Pre-Test (not Blue Prints) twice and you should do well- I got this advice from many people and it panned out very well for me. As for it affecting match- I have no idea. Your peds hx might affect the number of interviews you get, but you seem to have an already strong application for those NE schools. Also, think of taking the Step II early to allay any doubt that you are good at taking standardized exams.

 

[yankeescard]

You should be fine for most of the competitive IM programs except the top tier (MGH, SF, Columbia etc...) who want the complete package (good scores, grades and research). But with that being said, I think you should match well at a great program with your CV/scores!

 

[Frugal Traveler]

You need to find out why the exams are hard for you (easier said than done). For instance, is the factor taking the test (timing, concentration, understanding questions) or knowledge base deficit. Many schools do not teach to the exam, so when you see a potential question on the medicine shelf about a D-xylose test, you have no idea what the answer is. You may want to utilize the SDN shelf exam threads for guidance in studying. Different things work for each person.

Great clinical evaluations are hard to interpret because many students may have great evaluations secondary to attendings not wanting to get into trouble for providing an accurate and critical assessment of students... it's a "kinder, gentler" America these days. The final result the program sees is the grade... and they are not going to take the time to figure out the shelf exam got you. In your Dean's letter, there is usually a histogram of grades (how many people got H, HP, P, F)... so programs will examine that to see how you compare to your classmates. If you are doing above average, then you have a good chance in the medicine match. If you are below average, you may fare ok. Even mediocre programs in great locations are competitive. Case in point: UChicago is a second tier program that receives 5000 applications and interviews about 300-400... they have impressive residents from Hopkins to other great schools. Cornell also a second tier program can be fairly selective because outstanding applicants apply there... maybe not for the program... but living in Manhattan with subsidized housing is a huge impetus. These statements are of course stereotyped given that SDN is so USWNR-centric at times (both UChicago and Cornell are great programs). The bottom line is that location does not make programs more or less competitive.

There is a debate about shelf scores and resultant Step 2CK scores with seemingly discordant point of views. Scoring high on Step 2CK can catch some attention... so try your best on that exam.

Overall, use this unpleasant experience as a learning opportunity and don't let it get you down.

 

[chitown82]

You need to find out why the exams are hard for you (easier said than done). For instance, is the factor taking the test (timing, concentration, understanding questions) or knowledge base deficit. Many schools do not teach to the exam, so when you see a potential question on the medicine shelf about a D-xylose test, you have no idea what the answer is. You may want to utilize the SDN shelf exam threads for guidance in studying. Different things work for each person.

Great clinical evaluations are hard to interpret because many students may have great evaluations secondary to attendings not wanting to get into trouble for providing an accurate and critical assessment of students... it's a "kinder, gentler" America these days. The final result the program sees is the grade... and they are not going to take the time to figure out the shelf exam got you. In your Dean's letter, there is usually a histogram of grades (how many people got H, HP, P, F)... so programs will examine that to see how you compare to your classmates. If you are doing above average, then you have a good chance in the medicine match. If you are below average, you may fare ok. Even mediocre programs in great locations are competitive. Case in point: UChicago is a second tier program that receives 5000 applications and interviews about 300-400... they have impressive residents from Hopkins to other great schools. Cornell also a second tier program can be fairly selective because outstanding applicants apply there... maybe not for the program... but living in Manhattan with subsidized housing is a huge impetus. These statements are of course stereotyped given that SDN is so USWNR-centric at times (both UChicago and Cornell are great programs). The bottom line is that location does not make programs more or less competitive.

There is a debate about shelf scores and resultant Step 2CK scores with seemingly discordant point of views. Scoring high on Step 2CK can catch some attention... so try your best on that exam.

Overall, use this unpleasant experience as a learning opportunity and don't let it get you down.

I hardly think Cornell and Chicago are second tier programs. They are both Top 25 in most people's books.

 

[Phineus]

I hardly think Cornell and Chicago are second tier programs. They are both Top 25 in most people's books.

I think he was implying that they are not in the tier of UCSF, MGH, BWH, Duke and JHU. However, according to Cornell's website they have sent grads to MGH, Duke and UPenn as hospitalists- pretty impressive to get a job at such institutes.

 

[chitown82]

I think he was implying that they are not in the tier of UCSF, MGH, BWH, Duke and JHU. However, according to Cornell's website they have sent grads to MGH, Duke and UPenn as hospitalists- pretty impressive to get a job at such institutes.

Agreed.

 

[Frugal Traveler]

I hardly think Cornell and Chicago are second tier programs. They are both Top 25 in most people's books.

Read the part where I say: "These statements are of course stereotyped given that SDN is so USWNR-centric at times (both UChicago and Cornell are great programs). The bottom line is that location does not make programs more or less competitive. "

Second tier refers to the magical, ill-defined USWNR rankings. I don't want to start an argument about rankings and such... I'm an advocate of "if it doesn't fit, you must acquit." Go to the place where you felt right.

And the last sentence should read "location does make programs more/less competitive."

Hopefully, this does not start another thread about ranking programs since we already have 6 going.

 

[JoyfulMD]

I think he was implying that they are not in the tier of UCSF, MGH, BWH, Duke and JHU. However, according to Cornell's website they have sent grads to MGH, Duke and UPenn as hospitalists- pretty impressive to get a job at such institutes.

Not really. When I interviewed at a couple of the preparation H programs in Boston last year, they had new hospitalists who had just finished their residency at state schools like Utah.

 

[Phineus]

Not really. When I interviewed at a couple of the preparation H programs in Boston last year, they had new hospitalists who had just finished their residency at state schools like Utah.

I stand corrected.

 

[futureres]

Hi All!

I tried searching to see if this had been addressed before, but could not really find anything that matched, so I'm sorry if this may have been on a previous thread...

Currently an MS3 who finished up Med, Surg, Peds. In our school, they claim that our evaluations make-up the majority of what determines our grade in the syllabus, but they always tell us that our grade is determined by our shelf exam scores. I got a B in internal, and a B+ in surgery both due to shelf scores. I was having a hard time accepting these two, and after studying my butt off for peds, I found out I did not pass the shelf exam for the rotation!! I was very sick on the rotation and had some family issues, but I'm sure thats not excuse. Our school lets us retake the exam and if you pass the second time, then you still pass the clerkship. I have no idea how to improve myself, but of course I am going to try even harder (not sure how yet ha!) But I will only just pass the clerkship.

I was wondering how this would affect my application to residency programs in IM. All of my evaluations from faculty are excellent, but my grades are low because I just can't take those exams!! My step one score is 230. I had two faculty who really liked me on my IM rotation (this was my first rotation of the year) and one who offered to write me a letter of rec. He is a rather well known faculty in the field and has numerous connections. I also have basic science research experience under my belt with some publications (not first author) and a bunch of volunteer hours. Before this shocker in peds, I had hoped to apply to programs in the northeast like Columbia, Cornell, NYU, UChicago, Drexel, etc. I was wondering if this misfortune in peds is going to completely ruin my chances at hopes for such programs.

Thanks in advance for all your responses!

Back to the topic: I think if you can rebound on the shelf (do very well) that would be great. Your CV sounds good and your step 1 score is great. However, your dean's letter may reflect your lower scores/shelf problems so be prepared for that. i.e. at my medical school they show the distribution of grades for each rotation along with your detailed letter (which will comment on passing/not passing the shelf, at least at my home institution). Peds ended up being my best shelf because I used Pre-test (blueprints sucks!!) and First Aid for Peds (some folks preferred case files to first aid b/c it is more high yield). I didn't get through all of first aid but I did get through pre-test. Also, a useful tool is Pediatrics in Review, which is a peds journal with great review articles + CME questions at the end of each. I'd only pull a few articles for some of the high yield topics (CF, asthma, bronchiolitis, congenital heart disease, gastroenteritis, etc), but it was helpful. Review some peds derm too. It's a tough shelf, but pretest is probably your best high-yield source.

Honestly, your application may be affected for some of the top programs. Getting a pass in a basic rotation is not ideal. However, apply broadly and see what happens. It sounds like other aspects of your application are in order, and as long as step 2 goes well programs won't question your ability to take standardized tests (step 2>shelf exams imo). Also, some top programs prioritize your performance in advanced electives/sub-internship rotations more than basics. Since there is no final exam for these (at least not at my school), you should focus on being a stellar IM AI/sub-intern, rotate on some subspecialty services and get a letter or 2 and great evals from these. Getting a letter from your AI/sub-I is standard for most top programs. You may even want to do a visiting rotation at one of your top choices to get an inside track to their program. If you do well, it will help. The goal is to demonstrate that you'll be a great house officer, not just a good test taker. Good luck!🙂

 

[whatnext86]

thanks for all the advice and encouragement! Very much appreciated. I'm going to try and study as hard as I can for this shelf to make sure I at least pass again. Hope for the best from there!