Step 1 VS Preclinical Grades

[abcdior]

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Which one in your opinion makes for a stronger application?

bottom 1/3 of class and 250 step 1

or

top 1/4 of class and 235 step 1?

 

[gutonc]

Which one in your opinion makes for a stronger application?

bottom 1/3 of class and 250 step 1

or

top 1/4 of class and 235 step 1?

Will depend on specialty and clinical grades. But honestly, once you get over a certain (unknown) screening threshold for Step 1, the absolute value of the score isn't that important. I would say that most specialties will look more kindly on the 2nd applicant, assuming they see the app at all.

 

[BoardingDoc]

EDIT: I just realized that you're just starting MS and said PRE-clinical grades.

The higher step 1 score wins. Preclinical grades are meaningless unless they help you get AOA. Otherwise, noone cares. They care about your step 1 score, your clinical grades, your clinical grades in your desired specialty, step 2, and letters of rec (not necessarily in that order).

The entire point of studying and doing well as an MS1/MS2 is so that you rock Step 1.

 

[Law2Doc]

One of my med school mentors used to say the "dirty little secret" about med school is the preclinical grades dont even matter -- You just have to pass everything. Grades in med school are more about giving you a gauge and keeping some level of incentive to study hard. That advice was borne out when I saw the residency selection process from the other side. Yes there's some cache in bing AOA etc, but passing everything and having a high step score was markedly more important than being in the top of the class but with a lackluster step. Not even a Close call.

 

[Law2Doc]

... I would say that most specialties will look more kindly on the 2nd applicant, assuming they see the app at all.

I'd actually say few (not most) residencies would agree with this. A 235 is not the score above which a higher step is within the law of diminishing returns these days. Most competitive places will favor the guy with the 250 who passed everything, and largely ignore the class rank from the first two years -- they will however read with interest the LORs and evaluations from the clinical years. less competitive places will probably interview them both. So in the end, ace your step, get good clinical evaluation, and pass everything the first two years should be an adequate formula for most residencies. You can be the worst passing student in the first two years but if you ace the step and they like you in your rotations, everything is forgiven.

 

[mercaptovizadeh]

Step 1 is way more important than pre-clinical grades

That said, studying hard in MS1/2 is essential to both doing well on step 1 and helps you perform better in MS3/4 and on step 2.

 

[smq123]

Moving to allopathic.

 

[DermViser]

Which one in your opinion makes for a stronger application?

bottom 1/3 of class and 250 step 1

or

top 1/4 of class and 235 step 1?

Depends on the specialty in question. That being said being in the bottom 1/3 of the class does limit your specialty options somewhat (but you probably knew that).

 

[DermViser]

EDIT: I just realized that you're just starting MS and said PRE-clinical grades.

The higher step 1 score wins. Preclinical grades are meaningless unless they help you get AOA. Otherwise, noone cares. They care about your step 1 score, your clinical grades, your clinical grades in your desired specialty, step 2, and letters of rec (not necessarily in that order).

The entire point of studying and doing well as an MS1/MS2 is so that you rock Step 1.

Unless you go to a "true" P/F school in the first 2 years - which are usually only the very elite schools, preclinical grades will contribute to your class rank and thus AOA.

 

[DermViser]

I'd actually say few (not most) residencies would agree with this. A 235 is not the score above which a higher step is within the law of diminishing returns these days. Most competitive places will favor the guy with the 250 who passed everything, and largely ignore the class rank from the first two years -- they will however read with interest the LORs and evaluations from the clinical years. less competitive places will probably interview them both. So in the end, ace your step, get good clinical evaluation, and pass everything the first two years should be an adequate formula for most residencies. You can be the worst passing student in the first two years but if you ace the step and they like you in your rotations, everything is forgiven.

Except the average now is 227, and your class rank is after about 3 years of work, and residencies can't tell how much of it is comprised by the first 2 years.

 

[Spikebd]

Depends on the specialty in question. That being said being in the bottom 1/3 of the class does limit your specialty options somewhat (but you probably knew that).

In general, does being top half but not top quartile hurt you that much assuming you do well on Step I and II?

 

[DermViser]

In general, does being top half but not top quartile hurt you that much assuming you do well on Step I and II?

It depends on how you are stratified in your Dean's letter, and how far the school goes to cut the class up. For example at Wash U - students are cut up into top 1/3, middle 1/3 and bottom 1/3. University of Chicago uses code words like: Exceptional, Outstanding, Excellent, Very Good, Good, and Acceptable with an explanation of what that means with respect to class standing.

That being said, being in the top half is usually fine for most specialties.

 

[ChEMD]

I don't know why people seem to always think the two are mutually exclusive. Plenty of people will do well in their classes AND on step I.

 

[DermViser]

I don't know why people seem to always think the two are mutually exclusive. Plenty of people will do well in their classes AND on step I.

Depends on the grading system.

 

[ChEMD]

Depends on the grading system.

What do you mean?

 

[DermViser]

What do you mean?

If you're graded P/F, you can fully concentrate on board studying if you want to. Harder to do if you have a tiered system and are aiming for high class rank or AOA.

 

[BoardingDoc]

Unless you go to a "true" P/F school in the first 2 years - which are usually only the very elite schools, preclinical grades will contribute to your class rank and thus AOA.

Yes, this is exactly why I said what I said.

 

[DermViser]

Yes, this is exactly why I said what I said.

Even w/o AOA, they still matter as they contribute to overall rank.

 

[Dave89]

...University of Chicago uses code words like: Exceptional, Outstanding, Excellent, Very Good, Good, and Acceptable with an explanation of what that means with respect to class standing...

That is ridiculous.

 

[DermViser]

That is ridiculous.

How is that ridiculous?

 

[VisionaryTics]

That is ridiculous.

Every med school does this.

 

[Dave89]

How is that ridiculous?

All three convey the same basic idea. "Excellent" might sound a tad less gushing than the other two, but not to any meaningful extent.

EDIT: In case this isn't clear, I'm referring specifically to the bolded.

 

[Dave89]

Every med school does this.

Every med school has code words for three types of terrific students?

 

[VisionaryTics]

Every med school has code words for three types of terrific students?

Yep. We "oustanding" "excellent" "strong" "good". I think those were for quartiles 1-4.

 

[Dave89]

Yep. We "oustanding" "excellent" "strong" "good". I think those were for quartiles 1-4.

I see.

Well, I still think that it's odd, but it is what it is. I mean, definitely better than using negative labels, right?

 

[DermViser]

All three convey the same basic idea. "Excellent" might sound a tad less gushing than the other two, but not to any meaningful extent.

EDIT: In case this isn't clear, I'm referring specifically to the bolded.

I would say what's more ridiculous is their grade distribution.

And that all of the class falls into the first 3 code words:

 

[DermViser]

Every med school has code words for three types of terrific students?

Northwestern has Distinguished, Outstanding, Excellent, Very Good, and Good. The words by themselves don't mean anything, as they are "code" for where you fall in the class which is defined at the end of the MSPE. It's a roundabout way of getting at the same thing.

 

[Dave89]

Northwestern has Distinguished, Outstanding, Excellent, Very Good, and Good. The words by themselves don't mean anything, as they are "code" for where you fall in the class which is defined at the end of the MSPE.

I guess that I just don't see the point in beating around the bush. Just say that John Smith was an excellent student who scored in the XXth percentile.

 

[BoardingDoc]

I would say what's more ridiculous is their grade distribution.
View attachment 184740

And that all of the class falls into the first 3 code words:
View attachment 184741

That grade distribution is absurd. It is also precisely why the emergency medicine SLOR/SLOE requires the program not only to state what grade the person got, but also what the grade distribution was for that EM rotation by percentage.

I don't know if every school does this, but the grade breakdown information was also included in my Dean's letter for every course including the preclinical ones.

 

[BoardingDoc]

I guess that I just don't see the point in beating around the bush. Just say that John Smith was an excellent student who scored in the XXth percentile.

Agreed. That's what my medical school did.

 

[DermViser]

I guess that I just don't see the point in beating around the bush. Just say that John Smith was an excellent student who scored in the XXth percentile.

Bc it makes students feel bad and probably hypercompetitive. That being said there are some schools that do rank you: http://130.108.128.32/careers/evaluation.html
Throughout her third (clerkship) year, ________ maintained her academic performance over the first two years and after the third year, had a cumulative course average of 88.15, placing her 26th in a class of 87.

 

[DermViser]

That grade distribution is absurd. It is also precisely why the emergency medicine SLOR/SLOE requires the program not only to state what grade the person got, but also what the grade distribution was for that EM rotation by percentage.

I don't know if every school does that, but that information was also included in my Dean's letter for every course including the preclinical ones.

You also have to understand that it's University of Chicago-Pritzker, a top 10 elite medical school, where every student is very intelligent and accomplished.

 

[Dave89]

Bc it makes students feel bad and probably hypercompetitive. That being said there are some schools that do rank you: http://130.108.128.32/careers/evaluation.html
Throughout her third (clerkship) year, ________ maintained her academic performance over the first two years and after the third year, had a cumulative course average of 88.15, placing her 26th in a class of 87.

Oh, I'm not advocating ranking. I'm saying that if they're putting rank on the letter anyway, there's no really good reason to use codewords.

The only thing a student should see (if anything) is his or her cumulative course grade - e.g. 92% in Surgery, 75% in EM, etc.

 

[SouthernSurgeon]

I guess that I just don't see the point in beating around the bush. Just say that John Smith was an excellent student who scored in the XXth percentile.

Because when they started using the secret code word thing, it was actually a secret. So Johnny got to look at his deans letter and saw that the dean called him a very good student and felt happy about himself, ignorant to the fact that "very good" was code to the PDs that he was in the bottom 10%

 

[BoardingDoc]

You also have to understand that it's University of Chicago-Pritzker, a top 10 elite medical school, where every student is very intelligent and accomplished.

I'm sure that's the argument they use to justify their grade inflation but that's all it is. To use a city I'm familiar with as an example, Boston: Harvard students generally have an incredibly high GPA. Down the street at MIT, the average GPA is, well, average. Are the Harvard kids all smarter than the MIT ones? I suspect most people would argue the opposite.

 

[Dave89]

I'm sure that's the argument they use to justify their grade inflation but that's all it is. To use a city I'm familiar with as an example, Boston: Harvard students generally have an incredibly high GPA. Down the street at MIT, the average GPA is, well, average. Are the Harvard kids all smarter than the MIT ones? I suspect most people would argue the opposite.

👍

 

[SouthernSurgeon]

I'm sure that's the argument they use to justify their grade inflation but that's all it is. To use a city I'm familiar with as an example, Boston: Harvard students generally have an incredibly high GPA. Down the street at MIT, the average GPA is, well, average. Are the Harvard kids all smarter than the MIT ones? I suspect most people would argue the opposite.

I'm pretty sure DV was being facetious

 

[DermViser]

Oh, I'm not advocating ranking. I'm saying that if they're putting rank on the letter anyway, there's no really good reason to use codewords.

The only thing a student should see (if anything) is his or her cumulative course grade - e.g. 92% in Surgery, 75% in EM, etc.

Well technically they don't "rank" meaning there is no actual ordinal rank: Dave89 ranks 5th out of 175 students in his class. It's semantics, but it's how med schools can tell you they don't rank. The percentage grade doesn't really mean anything by itself. It's more important how that grade stands out amongst your class - hence the histograms in the MSPE.

 

[DermViser]

I'm pretty sure DV was being facetious

Actually, no I wasn't. University of Chicago-Pritzker is a top tier (sorry not top 10, actually it's ranked #11), very well respected medical school and recruit top notch applicants.

 

[DermViser]

Because when they started using the secret code word thing, it was actually a secret. So Johnny got to look at his deans letter and saw that the dean called him a very good student and felt happy about himself, ignorant to the fact that "very good" was code to the PDs that he was in the bottom 10%

You mean they didn't let Johnny see the legend on his MSPE to decode the code words?!? Sneaky!

 

[Psai]

I don't know why people seem to always think the two are mutually exclusive. Plenty of people will do well in their classes AND on step I.

No, everyone knows that people who do well on step 1 have to suck clinically

 

[DermViser]

No, everyone knows that people who do well on step 1 have to suck clinically

If it makes people feel better inside, who are you to take that away from them? That being said there are people like that in med school and I'm sure you know some.

 

[TooMuchResearch]

Which one in your opinion makes for a stronger application?

bottom 1/3 of class and 250 step 1

or

top 1/4 of class and 235 step 1?

You know what the MSPE sent out by your school to residency programs will say? "Abcdior completed the preclinical curriculum." That's how important your MS1-2 years are for your residency app. One sentence.

Clinical grades and Step 1 matter.

 

[ChEMD]

You know what the MSPE sent out by your school to residency programs will say? "Abcdior completed the preclinical curriculum." That's how important your MS1-2 years are for your residency app. One sentence.

Clinical grades and Step 1 matter.

Honestly, everything matters. Period. Now a PD isn't going to dismiss your application due to subpar preclinical grades, but getting good grades shows a track record of success, proving you can perform at a high level for an extended period of time. What low preclinical grades and a high step I score tells me is that the person blew off their school work because they thought it wasn't as important. Do you really think that a PD wants someone who is going to dismiss the work that they are given just because they think something else is more important? I wouldn't.

 

[DermViser]

Honestly, everything matters. Period. Now a PD isn't going to dismiss your application due to subpar preclinical grades, but getting good grades shows a track record of success, proving you can perform at a high level for an extended period of time. What low preclinical grades and a high step I score tells me is that the person blew off their school work because they thought it wasn't as important. Do you really think that a PD wants someone who is going to dismiss the work that they are given just because they think something else is more important? I wouldn't.

👍👍👍

 

[Law2Doc]

You know what the MSPE sent out by your school to residency programs will say? "Abcdior completed the preclinical curriculum." That's how important your MS1-2 years are for your residency app. One sentence.

Clinical grades and Step 1 matter.

This. The preclinical grades really matter very little to residencies. Yes they factor into class rank which matters a little and does merit a different wording in your deans letter. And they factor into AOA which is basically nice to have but won't make or break you (perhaps for derm, where every tiny thing helps, but not so much for the remainder of road). People get into competitive residencies all the time from the middle of their class and without AOA if they have great step scores and good evals/letters. And that's why my mentor used to say the preclinical grades were the dirty little secret and overplayed. You can ace them and get a 240 and not end up in as competitive a Spot as the guy who lived at the mean but breaks 250.

 

[operaman]

All of this said, lets not forget that students in the bottom 10% of their class are fairly unlikely to score above the 90th %tile nationally.

The talk about someone barely passing their classes but magically busting out 250+ on Step 1 sounds an awful lot like the pre-med forum where people with a 3.1 sGPA think they can make up for it with a 40+ MCAT.

Hypotheticals are interesting, but don't let them distract you too much from reality.

 

[username456789]

Depends on the grading system.

I had an A/B/C/D/F system in medical school and was still able to Honor all my classes (in a system rather stingy with Honors, not one of those "1/4 or 1/2 the class gets Honors" farces) and perform very well on Step I. It doesn't have to be an either/or situation, even in non-P/F curricula.

 

[DermViser]

I had an A/B/C/D/F system in medical school and was still able to Honor all my classes (in a system rather stingy with Honors, not one of those "1/4 or 1/2 the class gets Honors" farces) and perform very well on Step I. It doesn't have to be an either/or situation, even in non-P/F curricula.

 

[cbrons]

So... Back to *pre*clinical grades. Do they matter? Idk... doesn't really seem so. Seems like step I and clerkship evals are the only thing anyone looks at. After all what peeps really care about is whether or not you're minimally competent for one, and that you wont be a PITA to work with. Seems like step i and clerkship evals answer those questions just fine. Dont think how well you did in Embryology or anatomy or how many blood drives your specialty interest group/racial medical pressure group organized is relevant, but I will happily take correction on this if i am wrong.


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