SLOE Rankings

[emletters]

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I know the importance of SLOE's has been discussed ad nauseum, and that's not my question. But rather if they are broken down by top 10%, top third, middle third, etc., by definition an average student doing a couple of EM rotations is going to end up in the middle third of the rankings. With all the discussion on these forums about how important it is for people to be top of the pack all the time, does that just mean people in the middle have a significantly more difficult experience in matching? Taking it a step further, do the people in the bottom third just not match? I would think that's not the case considering the match rate for EM is greater than 90%. What am I missing here?

 

[DO3]

I know the importance of SLOE's has been discussed ad nauseum, and that's not my question. But rather if they are broken down by top 10%, top third, middle third, etc., by definition an average student doing a couple of EM rotations is going to end up in the middle third of the rankings. With all the discussion on these forums about how important it is for people to be top of the pack all the time, does that just mean people in the middle have a significantly more difficult experience in matching? Taking it a step further, do the people in the bottom third just not match? I would think that's not the case considering the match rate for EM is greater than 90%. What am I missing here?

It’s all relative. A lot of it depends on experience and PDs/APDs knowing how to view each SLOE. Not all SLOEs are created equal.

Example: The committee knows that an applicants home program always ranks their own folks top 10%. In this case, you being ranked middle third in this scenario is bad.

2: the committee knows that program Y ranks most rotators in the middle 1/3 category and they rarely see someone from that program ranked in the top 1/3 or top 10%. A middle 1/3 won’t hurt you. A top 10% or 1/3 would really help you.

What really can help differentiate things is the actual grade you received because programs are required to put how many of each grade they gave the previous year.

Example: You get an honors grade but 90% of people that rotated at that program got an honors grade. That’s just viewed as average.

2: You get a high pass but the program says 75% of rotators last year received an honors grade. That’s can be a red flag.

So in essence, average is not bad, unless average is relatively bad compared to everyone else who rotated at that program.

 

[RPedigo]

I know the importance of SLOE's has been discussed ad nauseum, and that's not my question. But rather if they are broken down by top 10%, top third, middle third, etc., by definition an average student doing a couple of EM rotations is going to end up in the middle third of the rankings. With all the discussion on these forums about how important it is for people to be top of the pack all the time, does that just mean people in the middle have a significantly more difficult experience in matching? Taking it a step further, do the people in the bottom third just not match? I would think that's not the case considering the match rate for EM is greater than 90%. What am I missing here?

It completely depends on the institution for how the SLOE rankings are distributed. Although CORD wants each institution to strictly adhere to the top 10%, top 1/3, middle 1/3, and bottom 1/3 designations in appropriate amounts, most places under-utilize the bottom 1/3 and middle 1/3 and have a pretty significant leniency bias. This is accounted for in the SLOE section, because we submit on each SLOE a distribution of grades for the last academic year (e.g., a clerkship director may report that last year they put 20% in the top 10%, 40% in the top 1/3, 30% in the middle 1/3, and 10% in the bottom 1/3).

In institutions that strictly adhere to the recommendations, yes 1/3 of people will be in the lower 1/3 and no, it will not "tank" an applicant but will be a negative on their application. In that case it would really depend on the comments - why are they lower 1/3? Is it fund of knowledge (relatively easy/fun to fix) or because they are a very difficult person to work with (difficult/not fun to fix)? It also depends on the caliber of the institution to some extent - it's harder to be the top at the "top" places (which would be a totally different argument on which constitutes those places and has been repeated ad nauseum on this forum, so I won't even give an example...).

For institutions that very rarely use the lower 1/3 designation, yes it can "tank" an application. If only one student out of 50 in the last year got a "lower 1/3" designation, that student would have a tough time matching. Again it would also depend on the comments, but it would be more negative the less frequently that place uses a lower 1/3 designation, if that makes sense.

Source: I have written many hundreds of SLOEs. Also read many more than that every year!

 

[gamerEMdoc]

Exactly. It's all relative to the distribution of sloe ranks of the authoring program. Low 1/3's hurt, but as others have mentioned, they aren't the kiss of death if its from a program where 1/3 of it's sloes are "low 1/3". The true kiss of death for an application is the "do not rank" option below low 1/3 which states the program will not be ranking that student. These usually get explained away in the comments by a student having some personality issue or something went horribly wrong on rotation. Sometimes, its for unfair reasons out of the students hands (comments like, "they did well, but we don't rank IMGs").

 

[TheComebacKid]

There are a lot of nuances to the SLOE. Honestly, from the standpoint of the applicant, none of it matters. It seems like it does now, but it doesn't.

The only thing you have control over is going in there and doing your best. If program A does SLOEs a certain way and program B does it a different way, and you go in and try your hardest at both places, you may end up with two completely different SLOEs. There's absolutely no sense in trying to sort out how to get that top SLOE at a respective program.

One thing that is universal across all SLOEs is identifying tools. If you act like a tool, program A will know it and it will reflect on your SLOE. Program B will know it too and it will reflect on your SLOE. Just don't be a tool. This is super generic advice that everyone gave me (and yet I focused more on how to get top 10%) but now as a resident who goes to the rank meetings every year, there is much less time spent on who we should rank the highest, and more time spent on who we don't want to rank because, you guessed it, they are acting like a tool.

 

[gamerEMdoc]

There are a lot of nuances to the SLOE. Honestly, from the standpoint of the applicant, none of it matters. It seems like it does now, but it doesn't.

The only thing you have control over is going in there and doing your best. If program A does SLOEs a certain way and program B does it a different way, and you go in and try your hardest at both places, you may end up with two completely different SLOEs. There's absolutely no sense in trying to sort out how to get that top SLOE at a respective program.

One thing that is universal across all SLOEs is identifying tools. If you act like a tool, program A will know it and it will reflect on your SLOE. Program B will know it too and it will reflect on your SLOE. Just don't be a tool. This is super generic advice that everyone gave me (and yet I focused more on how to get top 10%) but now as a resident who goes to the rank meetings every year, there is much less time spent on who we should rank the highest, and more time spent on who we don't want to rank because, you guessed it, they are acting like a tool.

So so true