Subjective grades in third year

[Paws]

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I am wondering how people deal with really subjective - and even really unfair - grades in third year. I have had a tase of that so far but my official clinical rotations start soon and I am frankly worried.

For the most part, I feel I have come through these experiences ok but I have definitely had some experiences where a preceptor gave me, like 40% for a standardized patient interview when everyone else got over 90%. Was I really that bad? Not according to the person who just observed me the day before or the day before that. They said I was excellent! But for some reason the test examiner decided that I stank. Did I mention that I knew the preceptor from other experiences and that they were negative? Did this guy fail me because he didn't like me?

So I have definitely seen some bullying, and some unfair behavior. What do you do as a student? just be quiet and take all the sh&t that comes at you? get a failing grade because someone decides they don't like you? I struggle with wanting to say something but knowing I need to keep my mouth shut so I can get through and get my degree. My sense is that I would be punished for speaking up. 🙁

Like I said, for the most part I have done ok and no problems. I know medicine is full of this stuff, and I will have more to come. But where do you draw the line? do you draw the line or just take everything with a smile? I am not very good at kissing up, mostly I try and just be professional and friendly. I am not good at being fake and insincere.

 

[footcramp]

suck it up and improve, that is all you can do.

 

[Zuwie]

Do well on written exams. If someone decides to flunk you because they didn't like you and you do well on the exam (or even just pass it), this will show that their evaluation is full of s&*t.

 

[Medical123]

Unfortunately, subjective evals are a big part of third year. Sometimes, they are unfair. At my school, we are allowed to challenge any evaluation that we receive within ten days.

I had a situation on surgery where I felt that two of my teammates and I were graded unfairly. I got a Pass (with lots of negative comments about lack of organization), one guy got a Low Pass, and the third guy failed the rotation (challenged it for a Low Pass). The 4th person Honored the rotation, though she called in sick once a week, whined all of the time about how she hated surgery, and always had an excuse about why she couldn't go into the OR. That person has since almost been kicked out of medical school for her poor attitude and lack of attendance on the wards.

She and the attending were of similar backgrounds and would often chit chat about their upbringing and religious faith. He definitely liked her much better than he liked the rest of us. When she would call in sick, we would have to cover her patients at the last minute. Of course, she didn't ever tell the rest of us what was going on with her patients, so we all looked stupid when the attending would pimp us on them or worse yet, didn't have time to even see her patients. Basically, we were yelled at , berated, and treated like dirt on the days that we were scrambling to cover her patients. For some reason, nothing was ever said to her for not showing up.

I didn't challenge the grade and now I regret that I didn't do so since it is the only negative eval that I received all year---at least to this point. A lot of people, however, had similar issues with this attending as the year progressed and did challenge their grade. Most of them who challenged were able to bump their grade up somewhat.

I was discussing this situation with one the Deans (the one who writes our letters for residency) when I had to meet with them to get my schedule approved for next year. The Dean told me that since this was the only negative evaluation that she had in my file, that it would not even be mentioned in my Dean's letter--especially since I did very well in my surgical subspeciaties, receiving comments that contradicted every negative thing that he had said about me. However, she told me that if I had received negative comments in all of my rotations, she would have been obligated to put those in my letter.

Apparently, the Deans are very aware of which attendings tend to give poor evaluations and tend to take those with a grain of salt as long as everything else is okay.

I know it hurts, but just try to hang in there and do the best job you can on all of your rotations!

 

[Law2Doc]

This thread is duplicated on the allo board -- perhaps a moderator should combine them.

 

[Paws]

Thanks guys for your replies. I appreciate the feedback, and maybe other people reading can benefit too. Hey Law2, it's not the same thread, just similar. This thread is about the whole process of subjective grades and how do we deal with them overall.

The allo thread was about challenging one particular grade. I decided to ask the specific question on the allo thread as it seemed more appropriate there. But for the rotations, yep I was definitely wandering how people deal with it through the whole year.

I am nervous about third year, and so are some of my friends. We are afraid of getting creamed with negative or strange evals and not knowing how to deal with all that. I would imagine alot of people wonder how to deal with this. It's not like bubble sheets anymore.

I get along with most people pretty well so I am hoping for the best. But still, that doesn't stop you from worrying and wondering about the future.

 

[footcramp]

for the most part people will get similar comments throughout the year. there are always unfairly bad evaluations but those are balanced out by the unfairly good ones too. if you look at the entire year you will get a good idea of what type of performance you achieved, and that's the important thing. don't worry, most comments aren't too off the wall. always challenge grossly unfair comments (unless it is in your favor), but if you can't change it then just take your lumps and move on.

 

[bigfrank]

So much of LIFE is subjective. The 3rd year is a metaphor for life and will prepare you for the match process and its inherent subjectivity.

 

[PainDr]

There's no way around it. Just be flexible, easy going and hard working. A little sucking up is ok, but most people will see straight through that and won't like it. The main goal is to present yourself as a likable, hard working team player. Physicians are just like any other particular segment of society, some are highly ethical and brilliant, others are amoral idiots and most are somewhere inbetween. You can't get along with everyone all the time, but if you can get along with most of the people, most of the time you'll be fine. 😀

 

[Dr.Bevo]

One of the biggest keys I've found for avoiding the shock of a bad eval is too seek feedback from your attending early and often. Many times you'll get comments in passing like "good job" or whatever and you'll think you are doing great. Then you get an eval later and it turns out that you don't get your A or B.

You need to get a moment of your attending's time for feedback. Make sure you get specific feedback on what you are doing well, what you can improve on, and especially, what grade does the attending think you'll be getting right now. You'll get better feedback by asking the attending for a time to come by their office and getting 5 good minutes or so rather than just stopping them in the hall when they're busy with something else.

After you get the feedback, be sure to improve on the things they comment on in a visible way.

This won't necessarily always get you the perfect eval, but it does:
1) help you avoid surprises
2) shows the attending that you care about the rotation, the grade you make, and makes it obvious that you are trying hard to improve (a lot of times your hard work/extra efforts don't come across in their limited interaction with you.)
3) not to sound cheesy, but you also learn more by getting critiqued and you eventually pick up good habits that serve you well on other rotations.

Finally, just from the attending's standpoint. You know it has to be hard to give a bad grade to someone who you know has really tried hard and was always trying to improve.

As many have said, some attendings are dicks and give bad evals reguardless; that's life. But as long as you aren't annoying about it, feedback usually helps a lot.

 

[Telemachus]

You have to ask yourself how important this particular thing is and whether or not it really makes a difference. If it is not that important, maybe you should just step back and take a deep breath, and review the whole picture.

One suboptimal, subjective eval is unlikely to do you harm. It may not be worth getting worked up over. But only you can decide.

 

[Paws]

Thanks everybody for the comments, I like to hear what sort of stuff other people are dealing with too. Makes me feel much better knowing I am not the only one ... 🙂

I have talked to alot of different people and really thought about the sdn comments I have read and I - bravely - decided to suck it up and start kissing up to the powers that be. I know, it totally sucks and I don't like myself for it. But I have about $100,000 in debt already and what am I going to do if I win some tiny stupid battle but end up working the welcome door at Costco. Not so good, I don't think. As a friend said, does the system ever lose and some minor player ever win? no, the system always wins. Students, employees, whatever. Do they ever 'win'? no usually they just get fired or whatever.

So, I am setting myself the goal of learning how to teflon-ize myself and reprocess my brain to not get upset when/if someone decides to try and screw me out of a decent grade or whatever. It's like what Telemachus says, decide how important is it. Then let it go and move on. It sucks but what can I do. Have to learn how to do what everyone else is doing. Paws is a little depressed right now tho ...

But! I will take the advice given here and pro-actively ask more directly this year about how'm I doing to the attending, resident or whoever. I will also take their feedback to heart and actively try and improve as they suggest. I will work hard, be on time, be helpful and reasonably cheerful, and a generally decent professional person on the team, not take things personally, etc. I will definitely use all of this as a good learning experience. 😉