Alot of what goes into clinical rotation grades is pretty subjective, believe me, it depends entirely on learning how to integrate yourself seamlessly into the hospital environment. I have been at hospitals doing rotations where my role was never defined, and although I tried hard to do the right thing there are often hidden "extra" task that I didn't know I was allowed to do or should be doing. With time you understand your medical student role better. I don't believe that an honors student has mastered anything either, the differences are in many cases not there, but based on someone who is good smoozer who can smooth talk their way through a rotation. I knew student who said that he should have been failed some rotations, but becase he was a "nice guy" they professors couldn't do it to him, even when he failed a shelf exam like two times. . . Attendings are doing no favor to the future of medicine by making disparaging comments to some students, and giving other students excellent evaluations when near the same level of work is done. What happens? The honors student feel that they have worked so much harder on the rotation and somehow deserve their grade, whereas the students who get bashed for personal reasons are often working extra-hard (like double the honors students) just to overcome the negative consequences that an attending who does not like them will have on their evaluation.
I am very quiet too, and this can be misinterpreted as a lack of interest etc . . . on rotations. The rotations that I have honored I always felt very comfortable with what I was supposed to be doing, and was made to felt comfortable by the team and the end result was there was less stress and I was able to do my job and get excellent evaluations. On rotations where there is alot of social talk and loud people it can be easy for the residents and attendings to not like the quiet student, and subconciously or often conciously treat them differently which WILL have a negative effect on you because their non-verbal cues drag you down.
Sometimes even if they tell you what to do better (on the rare occassion you can understand their code words like "one level above", sounds more subjective to me), even if you improve, they can find ways to give you the same evaluation if their personal impression of you hasn't changed.
The socially popular students are not harassed or looked down on by attendings and hence respond favorably to this positive feedback. I had a medicine professor my first two years who gave me dirty looks each time in clinic and made me look bad even when I knew the answer, the result, I learned by association to dislike the ambulatory setting, which negatively impacted future work. You have to learn to put bad evaluations behind you or they will haunt you forever, just head into the next rotation with a positive attitude and everything will fall into place, trust me. Don't listen to unconstructive, vague criticism about not functioning on this or that level, it is just how academic types tell a student they don't like them. If there is something real to work on then do so, but again, this is rare.
