Winter is Coming

[failedatlife]

Apps are in!

For some the next four months will be glorious celebration of the hard work they have put in and the high Step scores they have achieved. It will be an exciting journey from city to city as esteemed faculty try to sway them into their ivory hospital doors.

...And then there are people like myself.

Fourth year can be a great time if your first three years went EXACTLY as you planned (i.e.: you nailed the three pillars of a successful application). However, that doesn't happen for everyone and interview season can be stressful, especially if you are sitting on the wrong edge of numerical curve.

May this thread serve as a place for those feeling the anxiety of the process to vent and for others to provide support when needed.

Best of luck to all!

Sincerely;

Pennywise

---

Members don't see this ad.

 

[Jabbed]

Are you still going for ENT?

 

[raiderette]

Yes, what did you do? Any plan B?

 

[Gorne]

What are these supposed 3 pillars?

 

[Brorthopedic]

What are these supposed 3 pillars?

step score, height, and self-confidence

 

[Stagg737]

step score, height, and self-confidence

Nah, it's step score, AOA, and height. If you're going for ortho replace height with bench max. If you're going for derm, replace AOA with skin quality (since everyone has AOA anyway).

 

[mehc012]

Nah, it's step score, AOA, and height. If you're going for ortho replace height with bench max. If you're going for derm, replace AOA with skin quality (since everyone has AOA anyway).

What if your school doesn't do AOA for match purposes?

 

[Stagg737]

What if your school doesn't do AOA for match purposes?

Then class rank. There's almost always internal class rank, even at the schools where they supposedly don't have it...

 

[mehc012]

Then class rank. There's almost always internal class rank, even at the schools where they supposedly don't have it...

Nope. Talked to the folks who write the letters and they said that they used to have the standard 'code words' but those have been eliminated entirely from the letters. If they did exist, they'd have to be purely clinical years, because there is no way to use the tests we have to rank everyone by more than vague tiers.

 

[libertyyne]

Then class rank. There's almost always internal class rank, even at the schools where they supposedly don't have it...

Some of the the higher tier schools have no rank and subsequently no AOA.

 

[Amba]

What if your school doesn't do AOA for match purposes?

Nope. Talked to the folks who write the letters and they said that they used to have the standard 'code words' but those have been eliminated entirely from the letters. If they did exist, they'd have to be purely clinical years, because there is no way to use the tests we have to rank everyone by more than vague tiers.

Some of the the higher tier schools have no rank and subsequently no AOA.

Y'all sure know how to kill a joke.

 

[failedatlife]

Are you still going for ENT?

Unfortunately

 

[Stagg737]

Nope. Talked to the folks who write the letters and they said that they used to have the standard 'code words' but those have been eliminated entirely from the letters. If they did exist, they'd have to be purely clinical years, because there is no way to use the tests we have to rank everyone by more than vague tiers.

Then congratulations for being at one of the (very) few schools that truly have no class rank. Just means your board scores are all the more important.

Some of the the higher tier schools have no rank and subsequently no AOA.

I'm aware. There's a document on this site somewhere that shows not only what code words are used in the MSPE for the internal rankings at every school in the country, it also shows what percentiles receive which code words. At the time there were literally 3 or 4 schools total that didn't use internal ranking. May have changed since then,

 

[mehc012]

Y'all sure know how to kill a joke.

Nah, the joke had already been run with by a few folks. I was legitimately curious and the responses taught me things. So now I know that my board scores and height are more important than they otherwise would be; I was only focusing on the board scores, but I guess I need to double down on that and learn to walk in higher heels. The heels will probably take longer to learn...

 

[kb1900]

Then congratulations for being at one of the (very) few schools that truly have no class rank. Just means your board scores are all the more important.



I'm aware. There's a document on this site somewhere that shows not only what code words are used in the MSPE for the internal rankings at every school in the country, it also shows what percentiles receive which code words. At the time there were literally 3 or 4 schools total that didn't use internal ranking. May have changed since then,

Link or lie

 

[Anti-PD1]

Link or lie

This is probably dated by now, but should be accurate for the most part.

 

[kb1900]

This is probably dated by now, but should be accurate for the most part.

Thank you

 

[zero0]

This is probably dated by now, but should be accurate for the most part.

Shady af if they say there's no ranking there should be no ranking

 

[Stagg737]

Link or lie

The document @Anti-PD1 linked is what I was referring to. As I said (but was apparently cut off), some school may have changed, but most schools that "don't rank their students" still have internal rankings.

 

[kb1900]

The document @Anti-PD1 linked is what I was referring to. As I said (but was apparently cut off), some school may have changed, but most schools that "don't rank their students" still have internal rankings.

So my school and I’d imagine most “true p/f preclinical” schools just use clinical year grades and/or step score for those “key words”.

At least for the sample mspe we are given it dilineates exactly what the keyword percentile is based on

 

[Stagg737]

So my school and I’d imagine most “true p/f preclinical” schools just use clinical year grades and/or step score for those “key words”.

At least for the sample mspe we are given it dilineates exactly what the keyword percentile is based on

I'm at a DO school and we do it a little differently. Our pre-clinical GPA is given and we have the choice to include our clinical class rank if we want to. However, from what I understand the "P/F" schools with internal grading typically use pre-clinical years to create that rank because they can stratify people better. It's a lot harder to create a ranking system when there are only 6 grades and there subjective components like attending evals are included. Maybe some do just use clinical year grades, but from the couple of friends I know at "pass/fail" schools they were told their pre-clinical performance actually did matter. Again, I'm sure PDs have a more comprehensive understanding, but the reality is that many schools that claim to not rank their students actually do.

 

[ortnakas]

Unfortunately

If you had a realistic backup plan, you would be a happier and healthier person.

I have the same Step 1 score and am at a DO school, and I'm sitting on multiple interview offers. Not in ivory towers, but places I can learn to be a capable doctor. Your "the world is ending" trope is getting old because if you would consider anything "less" than academic ENT you'd do just fine.

 

[sliceofbread136]

If you had a realistic backup plan, you would be a happier and healthier person.

I have the same Step 1 score and am at a DO school, and I'm sitting on multiple interview offers. Not in ivory towers, but places I can learn to be a capable doctor. Your "the world is ending" trope is getting old because if you would consider anything "less" than academic ENT you'd do just fine.

Ya but how tall are you. Critical piece of info

 

[mehc012]

I'm at a DO school and we do it a little differently. Our pre-clinical GPA is given and we have the choice to include our clinical class rank if we want to. However, from what I understand the "P/F" schools with internal grading typically use pre-clinical years to create that rank because they can stratify people better. It's a lot harder to create a ranking system when there are only 6 grades and there subjective components like attending evals are included. Maybe some do just use clinical year grades, but from the couple of friends I know at "pass/fail" schools they were told their pre-clinical performance actually did matter. Again, I'm sure PDs have a more comprehensive understanding, but the reality is that many schools that claim to not rank their students actually do.

Depends on the curriculum. We only have 6 pre-clinical grades, and none of them are percentages or letter grades, so there's nothing to stratify on. Our exams are literally not grade-able by a percentage scale, so you can't really sort a class based on them. There are actually more 'grades' available in our clinicals than in all of pre-clinical.

 

[ortnakas]

Ya but how tall are you. Critical piece of info

I'm considerably shorter than average. Good thing I'm applying IM and not a surgical subspecialty, I suppose.

 

[Stagg737]

Depends on the curriculum. We only have 6 pre-clinical grades, and none of them are percentages or letter grades, so there's nothing to stratify on. Our exams are literally not grade-able by a percentage scale, so you can't really sort a class based on them. There are actually more 'grades' available in our clinicals than in all of pre-clinical.

How on Earth do you only have 6 pre-clinical grades? I've never heard of a school that does that other than Lerner, and their assessment system sounds like it's own special kind of hell imo. For real, I legitimately had more pre-clinical grades than that in most semesters...

 

[kb1900]

How on Earth do you only have 6 pre-clinical grades? I've never heard of a school that does that other than Lerner, and their assessment system sounds like it's own special kind of hell imo. For real, I legitimately had more pre-clinical grades than that in most semesters...

Probably pbl based curriculum

 

[Mad Jack]

Depends on the curriculum. We only have 6 pre-clinical grades, and none of them are percentages or letter grades, so there's nothing to stratify on. Our exams are literally not grade-able by a percentage scale, so you can't really sort a class based on them. There are actually more 'grades' available in our clinicals than in all of pre-clinical.

Found out all my talk of UNECOM no longer reporting class rank is true, in a way. All code words have been replaced by graphs showing what percentage of the class got what score in a given rotation/class, so they can see exactly where we stood rather than one big overarching metric.

 

[spiker268]

Unfortunately

Nice man, good luck. I know people who matched with what I assume are worse scores than you; just grind through the cycle and you'll be good dude. I personally rotated at a top program this year that told me they don't care what your step score is at all and that they've had people with 200 on their step1 come through the program. So you can definitely match.

 

[mehc012]

How on Earth do you only have 6 pre-clinical grades? I've never heard of a school that does that other than Lerner, and their assessment system sounds like it's own special kind of hell imo. For real, I legitimately had more pre-clinical grades than that in most semesters...

lol no, I'm not at Lerner and have no desire to be. Don't they have zero exams?
But we only have exams once per block, and each block is a few months long, so...5 or 6 sets of exams in all preclinical years. Each exam covers all of the physiology, pathophys, pharm, and ethics related to the organ systems or topics covered in those months. These exams are not graded numerically, either. They are literally only assigned a pass or fail grade, with no percentage recorded or used at any point in the process. The only exception is Anatomy, which is tested and scored separately and uses more standard grading, but if our entire class rank were to be based solely upon Anatomy scores, that'd be pretty...odd...to say the least. You could probably force some kind of comparison out of our exams, there is some level of grading in order to set the P/F threshold, but trust me, it would not be particularly high-resolution, so it'd suck for stratification of an entire class. You'd end up with tons of overlap.

Probably pbl based curriculum

Yup. Exactly.

 

[mehc012]

Found out all my talk of UNECOM no longer reporting class rank is true, in a way. All code words have been replaced by graphs showing what percentage of the class got what score in a given rotation/class, so they can see exactly where we stood rather than one big overarching metric.

Jesus, that sounds terrible.

 

[Mad Jack]

Jesus, that sounds terrible.

Eh, we'll see how it goes. I think it is fine.

 

[Stagg737]

lol no, I'm not at Lerner and have no desire to be. Don't they have zero exams?
But we only have exams once per block, and each block is a few months long, so...5 or 6 sets of exams in all preclinical years. Each exam covers all of the physiology, pathophys, pharm, and ethics related to the organ systems or topics covered in those months. These exams are not graded numerically, either. They are literally only assigned a pass or fail grade, with no percentage recorded or used at any point in the process. The only exception is Anatomy, which is tested and scored separately and uses more standard grading, but if our entire class rank were to be based solely upon Anatomy scores, that'd be pretty...odd...to say the least. You could probably force some kind of comparison out of our exams, there is some level of grading in order to set the P/F threshold, but trust me, it would not be particularly high-resolution, so it'd suck for stratification of an entire class. You'd end up with tons of overlap.

Yup. Exactly.

So you only have 5 or 6 blocks total? How does that work? As in what were the actual blocks? We were also a systems based curriculum and had at least 7 different systems each year (we did 2 passes on each system). Plus the extra courses that are typically required at most med schools (bioethics, random "how to be a doctor" course, etc).

 

[mehc012]

So you only have 5 or 6 blocks total? How does that work? As in what were the actual blocks? We were also a systems based curriculum and had at least 7 different systems each year (we did 2 passes on each system). Plus the extra courses that are typically required at most med schools (bioethics, random "how to be a doctor" course, etc).

A lot of systems are very interrelated, so it's hard to study complex disorders without integrating multiple systems. So a block may cover multiple individual systems, and then towards the end focus on pathologies that integrate multiple of those systems...for example, a block may contain, among other things, both pulmonary and renal systems. Early in the block, you focus on those systems in isolation and pathologies that primarily impact one of those (say, emphysema), but by the end you'll have cases that require an understanding of both, as well as their interactions, such as acid-base disorders, which would be hard to study without involving both.

Basically, we do multiple passes, but we do that by including multiple systems in each block and circling through the isolated systems and then back around through more complex, multi-system subjects.
Bioethics is lumped into each block. 'How to be a doctor' stuff is graded 100% pass fail as a completely separate longitudinal component...no grades at all, not involved in your Block evaluations.

 

[Turkishking]

Nah, it's step score, AOA, and height. If you're going for ortho replace height with bench max. If you're going for derm, replace AOA with skin quality (since everyone has AOA anyway).

I got the height

 

[Stagg737]

A lot of systems are very interrelated, so it's hard to study complex disorders without integrating multiple systems. So a block may cover multiple individual systems, and then towards the end focus on pathologies that integrate multiple of those systems...for example, a block may contain, among other things, both pulmonary and renal systems. Early in the block, you focus on those systems in isolation and pathologies that primarily impact one of those (say, emphysema), but by the end you'll have cases that require an understanding of both, as well as their interactions, such as acid-base disorders, which would be hard to study without involving both.

Basically, we do multiple passes, but we do that by including multiple systems in each block and circling through the isolated systems and then back around through more complex, multi-system subjects.
Bioethics is lumped into each block. 'How to be a doctor' stuff is graded 100% pass fail as a completely separate longitudinal component...no grades at all, not involved in your Block evaluations.

Interesting, same idea behind our 2 pass curriculum, just not in such large blocks (ours were all 3-5 weeks)

 

[failedatlife]

If you had a realistic backup plan, you would be a happier and healthier person.

You should know by now that I am not in tune reality.

All my life I've been trying to be something I'm not. It's sad but I'm used to failing at this point in my life.

I know there will be many invite-less days like today moving forward. Will anyone actually read my application? Guess a little more time will tell.

 

[68PGunner]

You should know by now that I am not in tune reality.

All my life I've been trying to be something I'm not. It's sad but I'm used to failing at this point in my life.

I know there will be many invite-less days like today moving forward. Will anyone actually read my application? Guess a little more time will tell.

As long as you keep your cool, I think you will match ENT bc you sound like a pretty funny person to be working with.

 

[mehc012]

Mopey self-pity is more amusing with the entire internet between you. A few 12hr shifts in a row and I'll bet you guys the novelty would wear off.

 

[spiker268]

You should know by now that I am not in tune reality.

All my life I've been trying to be something I'm not. It's sad but I'm used to failing at this point in my life.

I know there will be many invite-less days like today moving forward. Will anyone actually read my application? Guess a little more time will tell.

Well I mean ENT doesn't offer interviews until the middle to end of October, so you're right there will be many interview less days for all of us applying regardless of our 400 step score or 100 step score until then.

 

[ortnakas]

You should know by now that I am not in tune reality.

All my life I've been trying to be something I'm not. It's sad but I'm used to failing at this point in my life.

You're the one CHOOSING to be not in tune with reality and set goals that aren't flexible or realistic. You're choosing to fail-- choosing to pursue a less competitive specialty and to be happy (or at least content) about it is totally an option, and I don't know why you refuse to consider it. I also don't know why I continue to bother giving advice to a brick wall, but there you go.

 

[failedatlife]

10/6/2017:
Dear Journal. Today I went home. I slept in my bed. It's a familiar place with a familiar feeling. It was where I cried my eyes out every night for two weeks after I got waitlisted at Yale and rejected by Harvard and Princeton for undergrad. It was where I cried for days on end and prayed that God give me strength as the pain of getting rejected by almost every top 30 medical school made me severely depressed. There were days after I got my SAT and MCAT scores back that I just didn't want to get out of bed.

I lay down and look at the ceiling as I think about how few interviews I have 3 weeks after submitting my application to residency. I don't feel good about this. I know this feeling. I put myself through this. Winter is coming. There will be many tearful days coming.

 

[CyrusHabs7695]

10/6/2017:
Dear Journal. Today I went home. I slept in my bed. It's a familiar place with a familiar feeling. It was where I cried my eyes out every night for two weeks after I got waitlisted at Yale and rejected by Harvard and Princeton for undergrad. It was where I cried for days on end and prayed that God give me strength as the pain of getting rejected by almost every top 30 medical school made me severely depressed. There were days after I got my SAT and MCAT scores back that I just didn't want to get out of bed.

I lay down and look at the ceiling as I think about how few interviews I have 3 weeks after submitting my application to residency. I don't feel good about this. I know this feeling. I put myself through this. Winter is coming. There will be many tearful days coming.

You mocking/trolling these type of things on an online anonymous forum is pretty insulting to people who actually have serious problems theyre going through. This stuff was kind of funny to watch at first but now its getting a little old

 

[AnatomyGrey12]

10/6/2017:
Dear Journal. Today I went home. I slept in my bed. It's a familiar place with a familiar feeling. It was where I cried my eyes out every night for two weeks after I got waitlisted at Yale and rejected by Harvard and Princeton for undergrad. It was where I cried for days on end and prayed that God give me strength as the pain of getting rejected by almost every top 30 medical school made me severely depressed. There were days after I got my SAT and MCAT scores back that I just didn't want to get out of bed.

I lay down and look at the ceiling as I think about how few interviews I have 3 weeks after submitting my application to residency. I don't feel good about this. I know this feeling. I put myself through this. Winter is coming. There will be many tearful days coming.

You're my hero

 

[spiker268]

Well only 2 ENT programs have even gotten back to anyone; so the fact that you have any interviews means that you actually are doing better than most people lol. I don’t have any, and I’m okay with it.

10/6/2017:
Dear Journal. Today I went home. I slept in my bed. It's a familiar place with a familiar feeling. It was where I cried my eyes out every night for two weeks after I got waitlisted at Yale and rejected by Harvard and Princeton for undergrad. It was where I cried for days on end and prayed that God give me strength as the pain of getting rejected by almost every top 30 medical school made me severely depressed. There were days after I got my SAT and MCAT scores back that I just didn't want to get out of bed.

I lay down and look at the ceiling as I think about how few interviews I have 3 weeks after submitting my application to residency. I don't feel good about this. I know this feeling. I put myself through this. Winter is coming. There will be many tearful days coming.

 

[Frogger27]

Well only 2 ENT programs have even gotten back to anyone; so the fact that you have any interviews means that you actually are doing better than most people lol. I don’t have any, and I’m okay with it.

Did he say he had any interviews? He said "how few interviews I have after 3 weeks." This could mean zero.

Anyways, @failedatlife you are by far my favorite person on this forum. I know people give you crap, but I actually find what you say somewhat helpful. Hoping to hear you land some interviews and end up matching in ENT.

 

[failedatlife]

Did he say he had any interviews? He said "how few interviews I have after 3 weeks." This could mean zero.

Anyways, @failedatlife you are by far my favorite person on this forum. I know people give you crap, but I actually find what you say somewhat helpful. Hoping to hear you land some interviews and end up matching in ENT.

Yeah guys, I was trying to say that I have exactly 0 interviews from non home/sub I programs. A number I suspect will remain constant...

 

[Frogger27]

Yeah guys, I was trying to say that I have exactly 0 interviews from non home/sub I programs. A number I suspect will remain constant...

I am just curious, how different do you think your prospects would be if you scored say a 235 (still substantially below avg for what you're applying for) instead of your low 220's?

 

[AnatomyGrey12]

, I was trying to say that I have exactly 0 interviews from non home/sub I programs

Lol, so you do actually have interviews.....

 

[libertyyne]

Lol, so you do actually have interviews.....

It is customary to grant interviews to people who do away rotations and home program applicants.