When you're a resident, how will you grade your students?

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I can guarantee that I won't make students do any outside work. That just sucks, regardless of whether they learn from it or not. I might suggest they read stuff, but I'll never mandate it unless they're just stuck there looking for something to do and can't go home, for whatever reason.

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I know I have a rather controversial view on this, but when I'm a resident and attending, as long as it is obvious a student is trying their hardest and is passionate, then I will give them a perfect score every time. This is partially because I believe grades are meaningless and also because I understand how subjective clerkship evaluations are.

In terms of having students do presentations, readings, etc... I would absolutely never do that. By that time in their medical education, they are in charge of their own learning. If they want to learn something, they can easily do so without me telling them they have to. If they want my suggestions for learning I will gladly give it to them but I would never force it. Same goes for pimping. I still feel that pimping is for ego purposes of the pimper only. If someone really wanted students to know something, they should tell them the day before that they want them to know it for the next day. Students would then be able to go home, learn it, and then be proud that they know it the next day. It would cut out useless aspects such as humiliation and they'd actually remember the material instead of how humiliated they were for not knowing it on the spot. But again, I personally would never do this. I may suggest that students learn something but I would never ask for a report. After all, that is not how learning occurs in "real life".
 
I know I have a rather controversial view on this, but when I'm a resident and attending, as long as it is obvious a student is trying their hardest and is passionate, then I will give them a perfect score every time. This is partially because I believe grades are meaningless and also because I understand how subjective clerkship evaluations are.
".

Then all of your students would get a Pass for a few semesters, and ultimately you'd be disciplined by your department. I've seen it happen at my school: the eval's are curved to the doc's historical average, so when someone decides to be the cool guy and honor everyone then no one can honor. Generally if the doc refuses to give in they stop sending him students or, if he's from a less lucrative department like Psych of Peds, they might even fire him. This was an issue with one specific doctor on my Psych rotation.

I really don't think it's unreasonable to recognize the fact that some medical students are better at this than others. It didn't take the world's brightest surgery attendings to figure out that I have neither the talent or the personality for Surgery, no matter how hard I tried at it. Now it was sort of a moot point since I also hated Surgery, but what if I had decided I wanted to be Ortho? If my school sent me out into the world with their stamp of approval and got me accepted they'd be complicit every time I killed another patient. Or I would fail out of residency in which case they would have killed my career with kindness. It would also be terribly unfair to all the people who got honors and worked their asses off on the rotation. My honors would devalue theirs.
 
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Then all of your students would get a Pass for a few semesters, and ultimately you'd be disciplined by your department. I've seen it happen at my school: the eval's are curved to the doc's historical average, so when someone decides to be the cool guy and honor everyone then no one can honor. Generally if the doc refuses to give in they stop sending him students or, if he's from a less lucrative department like Psych of Peds, they might even fire him. This was an issue with one specific doctor on my Psych rotation.

I really don't think it's unreasonable to recognize the fact that some medical students are better at this than others. It didn't take the world's brightest surgery attendings to figure out that I have neither the talent or the personality for Surgery, no matter how hard I tried at it. Now it was sort of a moot point since I also hated Surgery, but what if I had decided I wanted to be Ortho? If my school sent me out into the world with their stamp of approval and got me accepted they'd be complicit every time I killed another patient. Or I would fail out of residency in which case they would have killed my career with kindness. It would also be terribly unfair to all the people who got honors and worked their asses off on the rotation. My honors would devalue theirs.

I didn't say "every" student, I said students who worked really hard and showed true effort. And I believe that's what "honors" is about. Medicine isn't rocket science. If you were willing to work hard enough, you could also become a great surgeon. Maybe not the best surgeon on the planet, but you could be great. That's what I believe medical clerkship grades are about. I know you disagree. On the other hand, I do have a different opinion about narrative comments/LORs, etc. That is exactly where I would point out a good student from an exceptional student who is gifted. For instance for one student I may say, "Jimmy is an excellent student and with hard work, I know he will become a great surgeon." vs. "Jimmy is a truly exceptional student. He has a gift for surgery that goes beyond words. He will likely be the best surgeon in America, one that I will consider a teacher."

By the way, I have seen Drs who actually do give every student a Honors pass, or 100, or whatever the grade scale is. They were chastised, but kept doing it because they didn't care. The school couldn't do anything about it because he's a great teacher and they need the clinical spots. If the school wants to stop sending students, it's the school's loss. I would feel exactly the same way as the attending.

I guarantee you will always be able to find schools to send you students if you are an excellent teacher. Not every school in America (MD, DO, PA, NP, etc.) is going to turn you down just because you give everyone a good grade.
 
Nit-picky pimping questions are meant to stump you. They are meant to make you feel uncomfortable with your knowledge and encourage you to continue reading every day after 12 hours in the hospital.

In the same vein, if you can easily find the info in a review text and you couldn't answer the questions, then you are woefully under-prepared. There is a reason why residents still go to teaching and sit for exams. There is a reason why board certified doctors still read journals and go to conferences.

Plus, if you know your physiology cold, then you can use your logical reasoning to come to a plausible conclusion. But physiology is not going to tell you what APGAR stands for whilst rotating through OBGYN.
I don't mind pimp questions in general, but I hate the "guess what I'm thinking ones." An example: "So, tell me what we worry about most in a trauma patient?" Uhhh, I dunno, a lot of things like the patient dying?

Kind of like this:

http://www.youtube.com/watch?v=uyw7yYNvI5o
 
I didn't say "every" student, I said students who worked really hard and showed true effort. And I believe that's what "honors" is about. Medicine isn't rocket science. If you were willing to work hard enough, you could also become a great surgeon. Maybe not the best surgeon on the planet, but you could be great. .

Another way of saying 'this isn't rocket science' is 'this isn't brain surgery'. People say that because they know that medicine is, in fact, sorta hard and not everyone can do it. Furthermore not everyone who can get through medical school is qualified to do every type of residency. There are people out there that are smart enough to do a lot of good as general practicioners who are not smart enough to be nephrologists or orthos. Saying otherwise on their transcripts is dong a diservice to both them and their patients. For the record I have seen a hard working Intern fail out of a Surgery residency because he couldn't run the floors, and I have seen a hard working attending with a great attitude that was a disaster in the OR and on the floors and was in the process of getting fired.

For instance for one student I may say, "Jimmy is an excellent student and with hard work, I know he will become a great surgeon." vs. "Jimmy is a truly exceptional student. He has a gift for surgery that goes beyond words. He will likely be the best surgeon in America, one that I will consider a teacher."

So I guess my point is that I strongly believe that a student can try very hard and not have either one of these statements apply to him. I think it's even possible for a student to try very hard and not be able to manage a passing grade, though hopefully I'll never have to be the one to deliver the bad news. It sounds like you've had a lot of luck with your colleagues (any chance you go to a top 20 medical school?) and I hope you have a lot of luck with your students as well, but when you ultimately get someone who is earnestly incompetent I don't think it's fair to honor them just for making a good effort.

I don't mind pimp questions in general, but I hate the "guess what I'm thinking ones." An example: "So, tell me what we worry about most in a trauma patient?" Uhhh, I dunno, a lot of things like the patient dying?

Kind of like this:

http://www.youtube.com/watch?v=uyw7yYNvI5o

I definitely agree with this. The best pimp questions I've had were either rehashes of previous teaching or questions about my patient that I have been reading about. The random 'guess what I'm thinking' questions generated by tangents at chart rounds are just awful.
 
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Another way of saying 'this isn't rocket science' is 'this isn't brain surgery'. People say that because they know that medicine is, in fact, sorta hard and not everyone can do it. Furthermore not everyone who can get through medical school is qualified to do every type of residency. There are people out there that are smart enough to do a lot of good as general practicioners who are not smart enough to be nephrologists or orthos. Saying otherwise on their transcripts is dong a diservice to both them and their patients. For the record I have seen a hard working Intern fail out of a Surgery residency because he couldn't run the floors, and I have seen a hard working attending with a great attitude that was a disaster in the OR and on the floors and was in the process of getting fired.



So I guess my point is that I strongly believe that a student can try very hard and not have either one of these statements apply to him. I think it's even possible for a student to try very hard and not be able to manage a passing grade, though hopefully I'll never have to be the one to deliver the bad news. It sounds like you've had a lot of luck with your colleagues (any chance you go to a top 20 medical school?) and I hope you have a lot of luck with your students as well, but when you ultimately get someone who is earnestly incompetent I don't think it's fair to honor them just for making a good effort.

That is our fundamental disagreement. But, I must clarify that you have to work hard enough the RIGHT way. It's kind of like studying for the MCAT or for med school. There are lots of people that put in 18 hours a day and fail miserably at both. Then when they actually figure out how they were working hard the WRONG way, they work hard the RIGHT way and succeed. I believe the same goes for medicine. Anyone can be a doctor if they are willing to work hard enough (and willing to work hard enough to figure out how to work hard the right way). I believe that very strongly. If it wasn't true, I wouldn't be a 4th year medical student. I worked hard enough to figure out how to work hard the right way. The other fact is that some people do have to work harder than others- but they can still get there if they work hard enough.
 
The problem with your reasoning is that you cannot be the second kind of person without first knowing the information cold.

Your ability to 'think logically' falls flat if you do know have a mastery of the facts of medicine.

Medicine is such a broad field, that nobody - even the seasoned attending - ever attains "mastery of the facts of medicine". In addition to keeping up with changes in the field, that's the reason for renewal of speciality boards and CME.

For instance, I've long since given up on trying to memorize the doses of medication. ACLS and intubation drugs aside, most everything else will give me the 10 seconds I need to flip to a dose on epocrates. This will ensure that I'm correct 100% of the time and that a patient is never given an incorrect dose because of fatigue or an errant memory.

The memorizers in medicine would see this as a weakness - I see it as professionalism and advancing the standard of care.
 
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Facts of medicine are not doses and drug names.



Medicine is such a broad field, that nobody - even the seasoned attending - ever attains "mastery of the facts of medicine". In addition to keeping up with changes in the field, that's the reason for renewal of speciality boards and CME.

For instance, I've long since given up on trying to memorize the doses of medication. ACLS and intubation drugs aside, most everything else will give me the 10 seconds I need to flip to a dose on epocrates. This will ensure that I'm correct 100% of the time and that a patient is never given an incorrect dose because of fatigue or an errant memory.

The memorizers in medicine would see this as a weakness - I see it as professionalism and advancing the standard of care.
 
Medicine is such a broad field, that nobody - even the seasoned attending - ever attains "mastery of the facts of medicine". In addition to keeping up with changes in the field, that's the reason for renewal of speciality boards and CME.

For instance, I've long since given up on trying to memorize the doses of medication. ACLS and intubation drugs aside, most everything else will give me the 10 seconds I need to flip to a dose on epocrates. This will ensure that I'm correct 100% of the time and that a patient is never given an incorrect dose because of fatigue or an errant memory.

The memorizers in medicine would see this as a weakness - I see it as professionalism and advancing the standard of care.

+1:thumbup:

I would much rather have a Dr. that checked all my doses with the latest software than did it from memory. Checking is indeed part of providing the best care.
 
For me, my goal will be to set expectations for students at the beginning of every rotation. These will include:

1. Show up on time or early.
2. Know your patients cold and read on their pathology
3. Make an effort to be a useful member of the team.
4. Show respect for patients and teammates. Be professional.
5. If I tell you to leave, leave. Don't ask to leave early.

If you meet these expectations, you won't have a problem with your evaluation. If you don't, you might.
 
1. I will want to hear their differential and thought process for the primary diagnosis on each patient they present.

2. I will want them to see and examine their patients before they get vitals for the rest of the team. If they don't have time for vitals, I won't let it affect my perception of their performance as long as it's not a chronic issue.

3. I will want them to show evidence of having studied more than just a review book.

4. I will want them to ask to do ABGs, central lines, etc.

Among many other things.
 
1. Standard neckties spread infection. All male and female students must wear bowties.

2. I want to enjoy my workplace. Ugly students (male or female) will receive a high pass at best.

3. I will want them to have fresh coffee and a doughnut for me daily. But no sprinkles! For every sprinkle I find, I will fail them.

4 When I'm sleeping in the call room, I will want them to stand outside making soothing ocean sounds
 
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1. Standard neckties spread infection. All male and female students must wear bowties.

2. I want to enjoy my workplace. Ugly students (male or female) will receive a high pass at best.

3. I will want them to have fresh coffee and a doughnut for me daily. But no sprinkles! For every sprinkle I find, I will fail them.

4 When I'm sleeping in the call room, I will want them to stand outside making soothing ocean sounds
:thumbup::laugh::laugh::laugh:
 
1. Standard neckties spread infection. All male and female students must wear bowties.

2. I want to enjoy my workplace. Ugly students (male or female) will receive a high pass at best.

3. I will want them to have fresh coffee and a doughnut for me daily. But no sprinkles! For every sprinkle I find, I will fail them.

4 When I'm sleeping in the call room, I will want them to stand outside making soothing ocean sounds

:laugh: Winner.

My old thread from 3rd-year still thriving <3.
 
I don't believe in medical school grading. Everyone will get honors as long as they show up.

I'm more or less in the same boat. There's a lot of self-righteous bull**** in this thread. I'll give real criticism in person (harsh if need be) and very much to the point, making suggestions for improvement daily. You can try to objectify any grading system, but in the end, standardization is not validity. Clerkship grades are already ridiculously grade inflated as it is (less than 1 in 4 students at my school score less than high pass on any rotation), so if you try to fight the inflation yourself, you're just dicking someone over. If you've mastered the basic requirements of the rotation by the end of the 6 weeks, that's all that matters and the difference between a high pass and honors is really down to personal bias. (I've always thought it backwards that schools are PF in the preclinical years when grading is entirely objective, yet have a full scale when it comes down to ass kissing skills post-boards)

/though excessively extroverted and perky people annoy me. they lose points.
//fans of NY sports teams lose points too. :smuggrin:
 
I don't believe in medical school grading. Everyone will get honors as long as they show up.
Also agree. Most people at my school just give HP for evals unless you are a total screw up or a total superstar. Then, they let the shelf sort out who ultimately ends up with an A/B+/B/C.

It's the people who didn't get the memo and say stuff like, "A pass is what the average student at this school should get....and this is a great school, so that's not bad!" are the ones that piss me off.

In addition, although our eval forms are broken down into categories (notes, presentation, fund of knowledge, etc,) and then there is a final bottom-line grade, I've long suspected (until one course director flat-out said) that they just say, "Well, this is a HP student" and then go back and randomly fill in the grades for the individual sub-categories. It seems to me that a better way would be to evaluate the student in each of those categories and then put them together into a final grade.

So I agree that the current system is bulls**t, I will have no part in it in the future, and will probably just do what I said above.
 
Also agree. Most people at my school just give HP for evals unless you are a total screw up or a total superstar. Then, they let the shelf sort out who ultimately ends up with an A/B+/B/C.

It's the people who didn't get the memo and say stuff like, "A pass is what the average student at this school should get....and this is a great school, so that's not bad!" are the ones that piss me off.

In addition, although our eval forms are broken down into categories (notes, presentation, fund of knowledge, etc,) and then there is a final bottom-line grade, I've long suspected (until one course director flat-out said) that they just say, "Well, this is a HP student" and then go back and randomly fill in the grades for the individual sub-categories. It seems to me that a better way would be to evaluate the student in each of those categories and then put them together into a final grade.

So I agree that the current system is bulls**t, I will have no part in it in the future, and will probably just do what I said above.

ha! I have you beat for how evals are done. no idea on the other specialties but in IM, the clerkship director flat out told me that her committee throws out all of the numbers from the individual categories and simply places the student into P/HP/H based on a rubric of adjectives used in the descriptive comments.

so "WingedOx was an excellent student"

gets a higher grade than...

"WingedOx showed himself to be particularly effective in his interactions with patients, had an extensive amount of concern for the patient's dignity and respected his/her concern and conveyed to me their questions. Was great at facilitating end of life discussions and worked tirelessly on our patient who had major issues."

...because the adjective "excellent" has a higher value on the rubric than any individual word in the latter description.

...I sh-t you not.
 
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Dumb question, but how can a 3rd year med student be considered "useful" other than studying and presenting a patient?

Usually, the med student is considered the least important person in the team, which makes sense because this is the first exposure to things such as presenting patients or doing procedures. I know that if I was asked to do a procedure, I might screw up. Like putting in a line, I might cause a couple bleed outs, but I guess that's expected for med students since they'll be heavily supervised.
 
now I'm only a 2nd year and going into my clinicals (never quite) soon enough. But I know me, and I will grade students mercilessly and without remorse.

Actually prob not. But I would be the kind of person who would really pimp those under me hard, make them nervous and motivate them a bit by the fear of being graded harshly... and then in the second half of the month lighten up once I have them working hard enough and prob grade nicely overall. I wouldn't give out Honors for free, they'd be earned. But people who respond appropriately and 'up their game' would prob get high passes if they can keep up to my expectations.
 
So...why would you do that, again? It's that kind of "**** rolls downhill" attitude that makes med school notoriously terrible. Thanks for keeping the rep alive. :thumbup:
 
Having just finished my clerkships, I'm gonna go easy on students for sure. I know I always did best in the sort of environment where I could ask questions without feeling stupid.

And I think that if students do a good job they should get honors, period. I definitely don't believe in rationing the good grades. Plus, you have to balance out the jerks that never give honors!
 
Having just finished my clerkships, I'm gonna go easy on students for sure. I know I always did best in the sort of environment where I could ask questions without feeling stupid.

And I think that if students do a good job they should get honors, period. I definitely don't believe in rationing the good grades. Plus, you have to balance out the jerks that never give honors!

For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?
 
For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?

Almost never.

I asked for it abundantly during the first rotation of 3rd year...then realized it's basically useless and stopped...I've only had one attending since then actually sit down with me and give feedback without being asked first. Everyone is nice but people will write whatever they want on your actual eval so I'm finding feedback pretty useless. If there was a way to study evaluation marks and how good of a day someone's having while doing the evaluation, I would put my money that good marks are more highly correlated with how someone is doing during the moment of filling out the evaluation than the actual skill/knowledge/ability of the person being evaluated. Unless you're really good looking...then you just win all the time.
 
For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?

I'm lucky to have a very nurturing resident and attending body (well... attendings in some fields, residents in every field).

In every rotation I've been on (and ive been on all the cores now) residents have sat down with me, on their own time, and gone through what i can improve on and where they are impressed with. Also its my schools rule that you have to meet with an attending every 2 15 days to discuss your progress. Sometimes they know exactly how you're doing and are great, sometimes they know nothing and its just them nodding while the chief resident really evaluates you. The exception was OBGYN... but forget them. I didnt like OVGYN anyway so I was okay with no feedback from anyone. I just did the best I could to be an academic factoid wiz there and move on with my life.

To be fair though, while the attending eval is semi-required... a lot of the residents sit down with me and run through stuff because i make sure I ask them how I'm doing every monday or tuesday. Just in passing, but i hit up every high ranking resident on my service like that and inevitably a few take time out to not just go "very well" but to actually give full analysis.
 
For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?

Its funny you bumped this thread today. I was in the OR today doing a case with the surgeon who apparently was the medical student coordinator and his fellow. He asked the fellow what he thought of the medical student as he had to put together his eval. It was brutal.
No ortho for you pal.
Anesthesiologists are definitely nicer.;)
 
Clinical grades exist to serve as a comparison amongst students. The fact that this thread even exists demonstrates the problem inherent with such a system.
 
Clinical grades exist to serve as a comparison amongst students. The fact that this thread even exists demonstrates the problem inherent with such a system.

It's not like clinical grades are 100% reliant. There are rotations where people hand honors for everyone, you get honors without having to know very much, or get just a pass because people don't feel like giving out honors. Or getting a pass because the attending/resident has mood swings and this was the bad time of the month
 
For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?

Pretty much never. If you ask you can get a generic comment on how you're doing good, but nothing particular constructive. So I don't even bother asking anymore.
 
I will talk politics and religion with them. If they are right-wing or religious I will fail them. If I am an attending I will put on a pokerface and offer to write a LOR and make calls to their dream programs (secretly warning any future employer that this individual is bat-**** crazy and doesn't belong in medicine).


Um.....really hope this was a joke?
 
It's not like clinical grades are 100% reliant. There are rotations where people hand honors for everyone, you get honors without having to know very much, or get just a pass because people don't feel like giving out honors. Or getting a pass because the attending/resident has mood swings and this was the bad time of the month


Exactly the point. Poorly sensitive and specific. I love how schools harp on evidenced based medicine and believe such a system has any validity. It's almost comical.
 
Going to be a bit reductionist here, but a lot of the comments about the subjectivity of the second two years falls into this category.

Butthurt-Butthurt-everywhere.jpg


If i could name the single most hated part of medical school at my institution it was OSCE. Why? Because it turned physical exams into an absurdly tedious practice of accomplishing every objective checkmark so that we could have an "objective" way to "quantify" a performance art. Which is what medicine is. Highly scientific performance art. The way you perform matters only a smidgen less than the actual knowledge you have. Sure its subjective. I'll take subjective 100 times out of 100 over objective clinical experiences. loathsome.
 
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The thing that is most frustrating about this whole process is determination of potential residency spot/location because of seeming randomness (from the implications of the grade itself and determination of things such as AOA). Something that is way more random than it should plays a way too large part in the process...
 
For those of you currently in the 3rd or 4th year of med school, how often do your residents give you feedback, either positive or negative, regarding your performance?
Was told today to not say anything in the OR because the attending hates it when students talk. This includes asking questions of any sort. The OR is the only time we come in any significant contact with attendings...I mean...wtf
 
that is why all my students will get the highest evals possible with good comments assuming they simply show up, try their best, and don't complain. Evals are really dumb in my opinion as I think face to face feedback that doesn't count as a grade is far more effective and also some residents get power hungry. I think students should first and foremost learn as much as they can and second enjoy coming in to learn. Otherwise you end up being miserable, tired, vindictive, and do not actually learn a whole lot. I'll give students real time feedback if they ask but I plan on telling them day 1 when I meet them not to worry about an eval from me.

This is also part of the problem. You have this attitude and a handful of students rotate through your service and benefit with Honors. However, another batch of equally capable students rotate with Resident X who doesn't have the same attitude and suffer gradewise.

To PD at residency program Y, there is no discerning between these two strategies (despite the inclusion of a grade breakdown). This one grade could in fact be the difference between being eligible for AOA and not. You may say that the "luck" evens out over the year, that this batch of students will work with an equal number of people with your attitude vs. the other one over the year and actual "skill" wins out. In my experience, however, this is just not the case.
 
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I agree this is an issue. The problem however is that you have lazy program directors who will convert, say, a 4/5 into a percentile grade without even looking at the grading patterns of that resident (I understand it is difficult though but unfair to do otherwise). I think a student's grade should be largely based on the shelf or other stuff that the rotation requires. Evals should be there to make sure the student is competent and for comments for a dean's letter. I don't think it should contribute to a grade.

Seriously what should I do? Give a bunch of 3-4/5's. I don't think that's fair and all it does is make for a poor experience on the rotation. I can't change what other residents will do but I will not do that to a student who tries hard and wants to learn. I don't care if they know absolutely nothing. I likely won't pimp them anyway and if I ask a question I won't care if they get it wrong. I just think it's important that they try and enjoy the rotation. I've been through some crap 3rd year and I will not be apart of that in the future. A student would have to be pretty bad to not get a good eval from me.

I also think students put way too much emphasis on things like AOA, grades, etc. Very very few have the perfect app. My gpa is about 3.7 or so. I wish I had the 4.0 but crap grading and subjective evals on certain rotations prevented that. I also won't be AOA because my school wants these lovey dovey dogooders who volunteer at homeless shelters every weekend. They don't even care that much about grades because most people in my class are pretty close when it comes to that. So even things like AOA is subjective. The best way to differentiate yourself is board scores and research. Try your best to get good grades in core rotations but a HP won't kill you. And yeah I think it averages out in the end with respect to grades.

I agree with everything you say. Believe it or not, I was given a HP on a rotation because despite my evals giving me honors, my comments did not use enough of the "honors" adjectives. I agree the comments on evals can sometimes be worthwhile, but it is obvious how flawed assigning subjective grades can be.
 
I think a student's grade should be largely based on the shelf or other stuff that the rotation requires. Evals should be there to make sure the student is competent and for comments for a dean's letter. I don't think it should contribute to a grade.


The best way to differentiate yourself is board scores and research. Try your best to get good grades in core rotations but a HP won't kill you. And yeah I think it averages out in the end with respect to grades.

Do you think board scores and research are the primary determinants of a student's quality or clinical skills? Do you think students with high shelf and board scores will make the best doctors?

If clinical evaluations don't contribute to a grade, what motivation do students have to perform well? What's to stop them from running away from the wards and hiding in the library to study for the shelf? Don't you think this would lead to students doing the bare minimum to be considered competent?
 
How do clinicals equal competence?

I trust shelf and board scores WAY more than lame **** that is evals. Since it is very subjective and sometimes based on nothing useful. I got honors before only presenting two patients and never getting pimped.
 
I trust shelf and board scores WAY more than lame **** that is evals
I'd much rather work with someone with average-ish Step scores and amazing evals across the board than someone with amazing scores who gets poor or mediocre evals. I don't really think either measure tells you a whole lot about competence. I'd just rather be around the person who gets along with everyone and can still do the job well.
 
How do clinicals equal competence?

I trust shelf and board scores WAY more than lame **** that is evals. Since it is very subjective and sometimes based on nothing useful. I got honors before only presenting two patients and never getting pimped.

While there are bad apples in every specialty, most residents and attendings are reasonable people, just like you will be when you're in that position. I think clinical evaluations are subjective by definition, but I think they are equally or more useful than a step 1 score in determining clinical competence. I've dealt with hundreds of students as a surgery resident and fellow, and I've seen plenty of clinical all-stars with bad step 1 and/or shelf scores, as well as plenty of clinically incompetent students with great scores.

I think the objective test of knowledge is important, and the subjective grading of clinical skill is important as well...which is why the overall grade is a combination of the two. Honors students should be well-rounded.
 
How do clinicals equal competence?

I trust shelf and board scores WAY more than lame **** that is evals. Since it is very subjective and sometimes based on nothing useful. I got honors before only presenting two patients and never getting pimped.

I will have to disagree on this one. Shelf and board scores may measure medical knowledge, but that is only one component of competence. Being a good physician involves much more, including clinical performance (i.e. data gathering, interpreting lab data, sythesizing all of this info to formulate an assessment and plan,), professionalism (getting along well with residents, attendings, nurses, patients, etc...), and also work ethic (staying on top of your patients and working hard to make sure things get done for them in a timely manner). You cannot measure this stuff on the shelf exams. I've worked with residents who had great Step 1 and 2 scores, but who were also lazy, had poor judgement, and had no clue what was going on with their patients. Doesn't that strike you as incompetent? A hybrid of shelf exam scores and clinical evaluations is the only way we have to assess what kind of resident a medical student will turn out to be.
 
Come on. If you're even close to normal (perhaps less likely than I thought if a med student/physician), then it should go somewhere along these lines (loosely)

1. Start on Day 1 with Knute Rockne (or perhaps Jimmy V ESPY speech) "rah-rah" speech and your expectations (Note: if you had to google this you fall into the persons mentioned in sentence above in parentheses).
2. If give good effort, contribute to team (attempt at least), know patients and make attempts at actually Improving and leaving with more than that with which you began = Honors. No question
3. Frequently complain, skip out on stuff, or worst....intentionally try and outshine "outgun" or make other members of team look bad = Pass. No question.
4. Team game. You play hard and play to win, I'll send you home with plenty of time to see actual daylight and "get your life on" and phenomenal reviews to boot. Real simple isn't it?

IMHO
 
I will have to disagree on this one. Shelf and board scores may measure medical knowledge, but that is only one component of competence. Being a good physician involves much more, including clinical performance (i.e. data gathering, interpreting lab data, sythesizing all of this info to formulate an assessment and plan,), professionalism (getting along well with residents, attendings, nurses, patients, etc...), and also work ethic (staying on top of your patients and working hard to make sure things get done for them in a timely manner). You cannot measure this stuff on the shelf exams. I've worked with residents who had great Step 1 and 2 scores, but who were also lazy, had poor judgement, and had no clue what was going on with their patients. Doesn't that strike you as incompetent? A hybrid of shelf exam scores and clinical evaluations is the only way we have to assess what kind of resident a medical student will turn out to be.

I think the problem is that it is extremely difficult to summarize all of the things that you mention comprising the clinical grade in one phrase or number. Based on the fact that it is competitive fields/programs that are able to and can make these distinctions, why not just include comments? Let these programs read the evaluations and make their own conclusions, rather than relying on a single phrase/number that may or may not be accurate.
 
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