Worried how this will look on my MSPE

[datpremedgirl]

---

Members don't see this ad.

Hi all,

Current M4 here applying for internal medicine. I believe I am a pretty strong applicant (Step 1 248, AOA) and have so far received a good amount of interviews. However, I am really concerned about my MSPE. At my school, they provide a graph of our cumulative average clinical evaluation grades relative to the class in the categories of Clinical Knowledge, Interpersonal Skills, and Professionalism. Of course, we all know that clinical grades tend to be heavily inflated, making the average for each category about a 4.5/5. I am at about average for the clinical knowledge and interpersonal categories, but 2 SD’s below the mean for professionalism (pretty much bottom of the class) . My average however is still a 4.1/5 and I have never had any issues with professionalism. I just had some pretty tough attendings that weren’t the ones to give straight 5’s. I’m really worried about how this will impact my application overall. My MSPE adjective is “outstanding” and I am in the first quartile of the class. How much will these low clinical grades affect me? Would programs not give me an interview despite the rest of my application being strong? Thanks for any input.

 

[thumbz]

I don't think it'll be a kiss of death but it would absolutely raise eyebrows at my program as professionalism is taken very seriously.

You can't undo what's done, but what you can do is make sure you are the epitome of professional on interview day and in ALL interactions with the program. The program coordinator (the one you email with) is often the right hand person of the PD so make sure you're always above reproach with everyone, especially them. We have had a handful of candidates moved to the do not rank list after their interactions with our coordinator.

Edit: I'd also do a little introspection about whether you come off in a different way than you intend to. The reason I say that is it's unlikely you drew all the attendings who are hard graders while the rest of your class got the "easy ones". My suspicion is you may be doing something to rub your attendings the wrong way.

 

[datpremedgirl]

I don't think it'll be a kiss of death but it would absolutely raise eyebrows at my program as professionalism is taken very seriously.

You can't undo what's done, but what you can do is make sure you are the epitome of professional on interview day and in ALL interactions with the program. The program coordinator (the one you email with) is often the right hand person of the PD so make sure you're always above reproach with everyone, especially them. We have had a handful of candidates moved to the do not rank list after their interactions with our coordinator.

Edit: I'd also do a little introspection about whether you come off in a different way than you intend to. The reason I say that is it's unlikely you drew all the attendings who are hard graders while the rest of your class got the "easy ones". My suspicion is you may be doing something to rub your attendings the wrong way.

Thank you for the great feedback. I really appreciate it. I am just worried that I may not even get interviews with that red flag on my application. And does it matter that even though I may be below average within my class, my average is still a 4.1/5 (where 3 = meets expectations). If you were to just go off the scale, my 4.1 is technically above expectations. Would you say the absolute number or my ranking within the class matters more?

 

[datpremedgirl]

I don't think it'll be a kiss of death but it would absolutely raise eyebrows at my program as professionalism is taken very seriously.

You can't undo what's done, but what you can do is make sure you are the epitome of professional on interview day and in ALL interactions with the program. The program coordinator (the one you email with) is often the right hand person of the PD so make sure you're always above reproach with everyone, especially them. We have had a handful of candidates moved to the do not rank list after their interactions with our coordinator.

Edit: I'd also do a little introspection about whether you come off in a different way than you intend to. The reason I say that is it's unlikely you drew all the attendings who are hard graders while the rest of your class got the "easy ones". My suspicion is you may be doing something to rub your attendings the wrong way.

I apologize for all the questions, but do you think it would be worth noting to programs (if they ask) that the only three things listed under professionalism for our evaluations are:
1. Shows initiative in identifying deficits in own knowledge
2. Follows through on commitments and tasks
3. Demonstrates sensitivity and competence in working with others from diverse backgrounds

I feel that there is a lot more that goes into being professional (being respectful, showing up on time, etc.) Or would programs just feel like I'm trying to make excuses for my grade?

 

[thumbz]

One big reason we like the MSPE is it's a chance to see where you sit among the ranks of grade inflation, as we all know the actual number grade means nothing. So we pay attention to where you rank among you peers, and not what the number is (so a 4.1 won't look good when it's notated as being 2 SD below the mean).

That being said, professionalism is incredibly subjective. A question you should be prepared for is:

"I notice that your professionalism grade is well below your peers. Why do you think this is, and what is your plan to improve?"

As far as getting interviews, I wouldn't worry too much as it seems like you already have a good number. I think your stats will get you interviews, and this will be nothing more than a blip if you can explain it away if it were to come up in an interview.

 

[thumbz]

I apologize for all the questions, but do you think it would be worth noting to programs (if they ask) that the only three things listed under professionalism for our evaluations are:
1. Shows initiative in identifying deficits in own knowledge
2. Follows through on commitments and tasks
3. Demonstrates sensitivity and competence in working with others from diverse backgrounds

I feel that there is a lot more that goes into being professional (being respectful, showing up on time, etc.) Or would programs just feel like I'm trying to make excuses for my grade?

I missed this question in my last post, apologies. Others may have a different opinion on this, but I wouldn't bring it up. A secret I'll let you in on is when I have an eval in front of me, I don't read what they say under each domain. I know what I think contributes to medical knowledge, professionalism, evidence based practice, etc. I don't need some bullet points to tell me what I should be grading you on. The reason I say this is a lot of my colleagues are the same, and I promise you at least some (most) of your attendings graded you based on their ideals of what professionalism means and not on those 3 bullet points.

 

[Ludwig2000]

I apologize for all the questions, but do you think it would be worth noting to programs (if they ask) that the only three things listed under professionalism for our evaluations are:
1. Shows initiative in identifying deficits in own knowledge
2. Follows through on commitments and tasks
3. Demonstrates sensitivity and competence in working with others from diverse backgrounds

I feel that there is a lot more that goes into being professional (being respectful, showing up on time, etc.) Or would programs just feel like I'm trying to make excuses for my grade?

I DEFINITELY wouldn’t make a point to say it’s just those 3 things, because then it’s like you’re saying “so what, I just didn’t follow through on commitments and I was insensitive to people of diverse backgrounds. But hey I was always on time!”

I would instead note that you never had any professionalism concerns raised, and maybe just didn’t have opportunities to show that you excelled at these things, particularly in the context of some tough attendings

Edit: also I’m just an applicant too, so grain of salt here, but if essentially the whole distribution is between 4 and 5 on a 5-point scale, I just can’t see it being that big of a deal. It seems like instead of having a score at all, your school should just have a “professional concerns?” box where 99% of students, including you, would have a “no.”

 

[datpremedgirl]

Thanks for all the responses guys! They are all extremely helpful.

Would it also be worth mentioning that during my last two blocks of core year on internal medicine and pediatrics, my school rolled out a new way to evaluate on professionalism just for these two clerkships? We went from the numerical 1-5 on the three things listed above to just simple Yes/No questions under the professionalism component. This new grading system was much more comprehensive and had around 10 components listed for professionalism, and I did receive a "Yes" from all of my evaluations. However, since these were not numerical, they did not factor in to the cumulative numerical average that is reported on my MSPE. I just find this a bit unfair since a quarter of my class had this new system, while 3/4 of those who did not do IM and Peds last were graded on the old scheme and had their numerical averages factored in to their MSPE average. (I have heard that typically, the more evaluations you have, the more your average tends to go up)

In all honesty, I felt that if I were asked about this, a truthful answer for me would be that I feel that since I am the more introverted type, I have a difficult time standing out from my peers. What I have seen from rotations is that evaluations seem to be graded more on how much an attending/resident really likes you, rather than how "Professional" you truly are. I don't think I can say this though, because it just sounds like I am trying to make up excuses for myself...

 

[thumbz]

I don’t want to put words in your mouth, but people who are introverted tend to come across as shy. And as backwards and awful as this is, as a female you can get labeled as a “female dog” and have resting “female dog” face. Sadly as you’re more attractive and introverted this perception gets worse. I obviously have no idea who you are, but again some introspection may help you elucidate if that could be contributing.

From my perspective, I think you could use being introverted and shy to help explain the poor grades - because you don’t speak out you may inadvertently come across as disinterested, therefore you get marked down in professionalism. I see it happen with my shy students.

Hopefully this helps!

 

[datpremedgirl]

I don’t want to put words in your mouth, but people who are introverted tend to come across as shy. And as backwards and awful as this is, as a female you can get labeled as a “female dog” and have resting “female dog” face. Sadly as you’re more attractive and introverted this perception gets worse. I obviously have no idea who you are, but again some introspection may help you elucidate if that could be contributing.

From my perspective, I think you could use being introverted and shy to help explain the poor grades - because you don’t speak out you may inadvertently come across as disinterested, therefore you get marked down in professionalism. I see it happen with my shy students.

Hopefully this helps!

Yes, that is very helpful! I really appreciate you taking the time to answer all my neurotic concerns haha. I think I definitely did improve in taking more initiative towards the end of my rotations (which is reflected as in my uptrend in clinical grades overall). I'm glad to hear that this could be used as a valid explanation.