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Third year grades?

rach4214

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    How important are third year grades in applying for residency in internal medicine (barring specialty interest at this point)? I'm talking actual numbers here, like if you wanted to match at a top tier program (Brigham, MGH, Mayo, Stanford, etc.), what kind of honors/high pass/fail ratio are we talking about here?
     

    Tootsies

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    Nov 5, 2009
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      I have a question regarding this topic as well. You see, at my school, you have to honors 4 different criteria (shelf exam, OSCE, rotation, and rotation week). Only 3-4% of the class ever gets and Honors in a rotation - so as you can see, it's not easy. I'm not a big fan of this grading system as it plays against the students, and doesn't allow for any differentiation. Not only that, but odds are, I'll just get a Pass in IM, along with 95% of my classmates, but will be competing against students from other schools who have Honors.

      How will program directors view this? Any thoughts on how this will affect my application?
       

      Scaredshizzles

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        I have a question regarding this topic as well. You see, at my school, you have to honors 4 different criteria (shelf exam, OSCE, rotation, and rotation week). Only 3-4% of the class ever gets and Honors in a rotation - so as you can see, it's not easy. I'm not a big fan of this grading system as it plays against the students, and doesn't allow for any differentiation. Not only that, but odds are, I'll just get a Pass in IM, along with 95% of my classmates, but will be competing against students from other schools who have Honors.

        How will program directors view this? Any thoughts on how this will affect my application?

        The dean's letter usually gives the percentage of people who get honors at your school.


        In any case, for the original question, to get into those top programs, you generally have to have honors unless you're from one of those handful of top med schools or if you're extraordinary in some other strange way...I.e. 10 first author papers, won a miss universe contest, etc. People think that IM might be less competitive because on the whole there are more spots than US applicants, whereas fields like anesthesia have mainly US grads...But for the top programs in IM, it is just as competitive as any other field with the exception of surgical subspecialities. Don't think because you would have trouble matching into a good place for rads that you can "settle" for IM and go to UCSF or Hopkins. It doesn't work that way...There are a ton of spots, but there are also a ton of applicants. 40 people from Harvard med school went into im last year, compared to 6 going into anesthesia. Getting a spot somewhere is easier in medicine, but getting to a top program in im is just as tough as getting a top place in radiology and probably tougher than getting to a top place in anesthesia.
         
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        obiwan

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          People think that IM might be less competitive because on the whole there are more spots than US applicants, whereas fields like anesthesia have mainly US grads...But for the top programs in IM, it is just as competitive as any other field with the exception of surgical subspecialities. Don't think because you would have trouble matching into a good place for rads that you can "settle" for IM and go to UCSF or Hopkins. It doesn't work that way...

          couldn't agree more...

          for top "ivory tower" programs, honoring your IM clerkship would be pretty much seem like a requirement but i think you can get away without honoring at still upper tier programs like UColorado and UTSW... honoring your SubI can go a long way to helping you if you didn't do as well the clerkship
           

          ResidentMD

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            How important are third year grades in applying for residency in internal medicine (barring specialty interest at this point)? I'm talking actual numbers here, like if you wanted to match at a top tier program (Brigham, MGH, Mayo, Stanford, etc.), what kind of honors/high pass/fail ratio are we talking about here?

            I know someone from a Boston program (not HMS), who honored all their sub-Is but did not honor their Core Medicine rotation. Scores 230+ on both step 1 and CK. Rejects from BWH and MGH.
             

            dragonfly99

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              I don't agree that it's just as hard to get into one of the top IM programs as it would be to get into a top radiology program. There are just a lot more spots in IM, and not as many applicants with great grades and great numbers. It's still definitely hard to get into one of those top 10 type IM programs. However, if you broaden your list to some very solid but not as "famous" programs like Southwestern, Mayo, Emory, Vanderbilt, even probably U of Washington, U of Chicago, Washington U in St Louis then you'll get in somewhere good. People always use Harvard as an example, but it's always going to be super hard to get into Harvard for most things, just because it's got such a famous name that people are always shooting for it...also, a lot of people like Boston.
               

              Scaredshizzles

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                I don't agree that it's just as hard to get into one of the top IM programs as it would be to get into a top radiology program. There are just a lot more spots in IM, and not as many applicants with great grades and great numbers. It's still definitely hard to get into one of those top 10 type IM programs. However, if you broaden your list to some very solid but not as "famous" programs like Southwestern, Mayo, Emory, Vanderbilt, even probably U of Washington, U of Chicago, Washington U in St Louis then you'll get in somewhere good. People always use Harvard as an example, but it's always going to be super hard to get into Harvard for most things, just because it's got such a famous name that people are always shooting for it...also, a lot of people like Boston.

                Well radiology top programs might be a little more competitive...ie. an extra 5-10 points on your steps...The AOA percentage is probably similar at the top programs, although overall considering all programs there are more % AOAs in radiology. But one of the big factors in that is that there is a higher percentage of people from NIH top 40 programs in medicine than radiology...meaning that it is pretty hard to earn AOA status in the top med schools..some of which don't even decide on AOA until after ERAS. But medicine tends to draw in more well rounded candidates with very interesting life stories, so when you consider everything together, I think the top 6-7 programs in medicine are about as competitive as the top 6-7 in rads...especially if you don't go to one of those top 10 med schools...Seems name of med school might carry you further in medicine than it will in rads.
                 

                unimaginative

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                Nov 13, 2009
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                  I know a guy, Me.

                  This board is always so full of opinions and like cable t.v. the loudest most obnoxious ones seem to dominate.

                  My actual experience and to answer the OPs question:

                  I did not honor my medicine clerkship and with an otherwise very strong application I got dissed by some of the big boys, i.e. some the OP mentioned. My adviser told me straight up that while I was a great applicant the bloated fish would possibly screen me right out without honors in the medicine clerkship. I was skeptical but it happened. I did get interviews at plenty of other excellent programs, including some the OP mentioned.

                  And contrary to the nonsense posted constantly on SDN you can still have a stellar career and life without going to the "top IM program". From my limited experience the most successful academicians are successful not because of their pedigrees but because of their personal work ethic and genuine passion about their areas of interest.

                  Me.
                   

                  ResidentMD

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                    I know a guy, Me.

                    This board is always so full of opinions and like cable t.v. the loudest most obnoxious ones seem to dominate.

                    My actual experience and to answer the OPs question:

                    I did not honor my medicine clerkship and with an otherwise very strong application I got dissed by some of the big boys, i.e. some the OP mentioned. My adviser told me straight up that while I was a great applicant the bloated fish would possibly screen me right out without honors in the medicine clerkship. I was skeptical but it happened. I did get interviews at plenty of other excellent programs, including some the OP mentioned.

                    And contrary to the nonsense posted constantly on SDN you can still have a stellar career and life without going to the "top IM program". From my limited experience the most successful academicians are successful not because of their pedigrees but because of their personal work ethic and genuine passion about their areas of interest.

                    Me.

                    Agreed. To the OP - as the above poster said, some programs will screen you out. But the beauty of it is that there are plentiful programs that will invite you as long as you work hard - many of these programs will be among the ones respected in the country - and you can still get whatever you want from life and your career there. You may not go to Brighams and Hopkins, but you can still do whatever you want, as long as you work hard.
                     

                    rach4214

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                      Thank you. Your replies are very helpful. I do realize that the "Top Tier" programs are not necessarily producing physicians that are really any better than other (dare I say it) "Lower Tier" programs, I was just trying to get a feel for how third year grades factor into the decision to interview or not.

                      To add to my OP, It seems as though an Honors in Medicine is (obviously) pretty important. But what about the other rotations (Say, Psych or OB)?
                       
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