IamNikolas Registered User Posts: 9 (4/21/01 5:35:24 pm) Reply Clerkship Grades Can anyone help me out here? I'm wondering how important 3rd year grades really are. I have really good grades from my preclinical years, and good board scores (240's)...but I've been struggling 3rd year...it seems like you need to kiss some rear end to do well 3rd year, and that's just not my cup of tea. 3rd year grades are so subjective (at least where I go to school), and a lot depends on who you work with, as some attendings/residents are more generous with dishing out honors grades. I haven't done horribly...good comments, but nothing stellar (even a pass in OB/gyn -- ouch!) Do ortho residencies place as much weight on clerkship grades as board scores/preclinicals/ortho electives? Do they at least recognize the fact that clerkship grades are largely subjective, and may not be a good representation of the applicant?...or should I forget about Ortho? I would appreciate some perspective on all of this. Scott Silverstein Registered User Posts: 9 (4/22/01 12:48:23 am) Reply Re: Clerkship Grades Third year grades are much more important than preclinical ones. If you are struggling with these rotations you need to look carefully at the comments people are making about you and be willing to accept criticism. Of course you should not forget about ortho unless you are not serious about it to begin with. Just figure out how to do better!! bonepain Registered User Posts: 10 (4/22/01 8:26:48 pm) Reply 3rd yr. I am in a similar boat as you. I was real strong after my first 2 years, and did real well on step 1 (250s). However, 3rd year has been a whole different animal. I am getting good evals, but I usually end up around the average and get the token "high pass" grade. I even got a "pass" in general surgery.... bastards. It really has a lot to do with how much @#%$ you are willing to swallow and how much ass you are willing to kiss... and that is not mu cup of tea either. I talked to my program director about this, and he pretty much didn't give a @#%$ about anything after I told him by step 1 score and junior AOA status. Go figure. I am starting to understand that ortho is much more a numbers game than other specialties. It seems like the intangibles (except big time research) matter little to most (not all) programs. They are looking for AOA and high Step 1... plain and simple. Legacy doesn't hurt either (I don't have any of that). Having said that, a lousy Deans letter won't help you... but I don't think it is hard to get decent evals on rotations, while I do think it is hard as @#%$ to get a lot of "honors". I could be wrong... I will have to get out there and find out. I am interested in other opinions on this matter. But, my PD was pretty much offering me a spot if I wanted to stay based only on my numbers a a little research I did in the department. My advice to other med studs out there is to kick as much ass your first 2 yrs and on step 1, and 3rd year pretty much becomes damage control. I think this is a better method than the other way around. Who wants to suffer 3rd year anyway? late, bp IamNikolas Registered User Posts: 11 (4/22/01 9:30:08 pm) Reply 3rd year Thanks for the responses. Dr. Silverstein: the only "negative" comment I've gotten so far has been that I am hesitant to participate in conferences...and that I communicate more effectively in written form than orally. But otherwise, my comments have been great, stressing that I work real hard, cooperative, etc. etc. I don't disagree with their assessment, but I'm generally a quiet guy...I don't say all that much...But I work my ass off. It's hard to just change one's personality and become a different person. If that's reason to lower my grade, then that leads me to believe that 3rd year evaluations are bogus, because that has nothing to do with how good a doctor or surgeon I will be. bonepain...No doubt about it...3rd year sucks. I think 3rd year is easy for people with the right personality for it....you pretty much have to be an outgoing ass-kisser...For some it's easier than for others I guess. There's this one guy in my class who brings in doughnuts and coffee for the residents once a week...and they love this guy. I guess I'd love him too if I were his resident. Bonebuster Registered User Posts: 4 (4/23/01 9:32:06 am) Reply Re: 3rd year BP and IamNikolas... everyone out there has gone through third year and everyone out there knows that it is subjective and you might not have gotten the grades you deserve. That being said, your performance third year is much more important than the first two years. Performance one Step I and your third year grades are mentioned at many interviews. Yes, junior AOA is awesome and will help you get many interviews but third year grades are equally important... I am not saying that you have to honor a bunch of clerkships to get a spot... I personally know quite a few people you have matched at good programs with one or no honors, but the more honors you get the more competitive an applicant you will be... About comments in clerkships... I know at my school they only wrote good comments on the dean's letter... your performance in each clerkship was described in one paragraph... the most important line in the Dean's letter is the last line where they describe you as an outstanding, excellent, or good candidate. Many times it seems as though that's the only line interviewers read... Bonebuster bonepain Registered User Posts: 11 (4/23/01 12:59:18 pm) Reply i agree I agree witht the importance of 3rd yr grades.... but talking with residents etc has made me realize that if you are a strong candidate after step 1, doing super good in 3rd yr is not all that critical (getting honors in everything is not really necessary). Most everyone has told me that if you are AOA and have a high step 1, you can just plain pass 3rd yr and still match well. I don't know how true this stuff is, since I haven't gone through it yet. I think 3rd year grades can make a weak app strong... but if you are strong already, you would have to really mess up to make yourself weaker. Who knows, though. I have found that a large % of programs put an inordinate value on step 1 scores. Thoughts? BP dbonz Registered User Posts: 4 (4/23/01 6:13:17 pm) Reply clerkship grades Having just gone through this... Third year grades are absolutely important. While it may feel great to have 250 on step I and be AOA, I can assure you that the MAJORITY of applicants with whom you interview will have those exact stats. It is the nature of orthopaedics; the applicant pool is rich with superstars because ortho has the reputation for being a tough match, and many with "lesser" scores are scared off. That is not to say that applicants without such credentials do not match, but they are in the minority of ortho applicants. While the above stats (board scores >240 and AOA) WILL procure you plenty of interviews, it would be unwise in my opinion to rely on these alone to match. 3rd year grades (honors) and research (meaningful) are important pieces of the puzzle. At my home program, applicants are screened by the program director based on may criteria, and selected to interview. After interviews, applicants are given a numeric score based on step I scores, AOA, 3rd year honors (with extra points given for honors in Medicine and Surgery clerkships), research, etc. The applicants are then ranked, and special consideration may or may not be given based on whether or not you did a rotation there, or other intangibles. The result is the rank list. The point: stellar scores and AOA may get you on the list, but do not necessarily place you at the top. bonepain Registered User Posts: 12 (4/23/01 7:14:22 pm) Reply i disagree I find it hard to believe that the majority of applicants to orthopedics have 250+ on Step 1 and Junior AOA status. In fact, my program director mentioned that in the last 3 years, only 4 applicants in the entire state (and it is a big state) had above a 250 on Step 1. I am not trying to float my own boat or anything, but such a score is rare. Also, pehaps unethically, the ortho secretary who I befriended allowed me to flip through the applicant packets for the people invited to interviews at my school one afternoon. Although there were plenty of high scores, many applicants were not even AOA, and the average board score was around the 230-235 range.... keep in mind, these are interviewed folks. In fact, the average board score of the 4 accepted interns this year was around 235, and this program is no slouch. Of course, I don't think you can rely just on Step 1 and AOA, but I also don't think you can devalue it either. I am also saying that having a rough ride in 3rd year is not all that uncommon.... our No. 1 guy, who got a 260 on Step 1 and is jAOA has only honored a couple meaningless rotations. Point is, kicking butt in 3rd year is tough, and people realize this, so there is no reason to give up on things just because of a tough couple rotations. Best of luck, BP OrthoStud Registered User Posts: 1 (4/23/01 7:42:45 pm) Reply Re: i disagree also It's hard for me to believe majority of applicants are 250+ and junior AOA as well-- if anything, these applicants are in the minority. As others have noted above, 3rd year evals are largely subjective and unfair. Nikolas -- stay true to yourself and don't be a sell-out...your board scores and hard work will drown the 3rd year ass kissers. Personally, I'm more impressed by someone who kills first 2 years and the boards than someone who's mediocre in these 2 areas and "shines" 3rd year. Such an applicant has obviously manipulated a number of residents and attendings in getting these grades. Bonebuster Registered User Posts: 5 (4/23/01 10:25:12 pm) Reply Third year I don't want to beat a dead horse but... eventhough Step I scores in the 250's are an incredible score don't think you have it made. I don't know what state you come from but in my medical school in new york, we had 5 people in our class score above 250. A high score on step I will get you plenty of interviews... but remember that it just gets you in the door, no program is gonna take you just because you did well on the boards and know your krebs cycle... just coming out of the interview season and match i realized that my third year performance was really important. I went through third year too, and once felt the same as you, disgruntled and disheartened cuz lots of people were getting honors just by kissing ass... but don't let those feeling obscure the truth... third year is critical UCCOM Registered User Posts: 2 (4/24/01 6:54:37 am) Reply Re: Clerkship Grades I am just curious, but Bone Pain, how did you get junior AOA if your 3rd year Clerkship grades have only been mediocre (sp?). I too am a third year and have been nominated for AOA but no decisions have been made yet and the MOST important factor is the third year grades because the count as much as the first two years combined at my school. If you did great the first two years and did not do great your third year you have no hope of junior AOA. Supposedly the only people that get junior AOA (at my school anyways) are people who have all or almost all honors, especially third year. Just curious about how your school works that bonepain Registered User Posts: 13 (4/25/01 9:11:35 am) Reply ok We had a number of 250+ on Step 1 (8 last year), but they all didn't apply to Ortho. A lot of those folks did ENT, Derm, Rays. Only 1 applied to ortho. I am not saying that I have it made.... not even close. I just think that if I can get interviews, I have other interesting things I can talk about, like research etc. The screening is there.... you can't deny that, and it is done by AOA and Step 1. I know 3rd year is critical, but getting a lot of honors is pretty much impossible here... and a lot of good students end up with high passes and passes. I also feel like Step 1 is important because of the standardized system.... class rank and grades are very dependent on each school.... and as more schools go to a pure pass/fail system, the boards become more important. Although honors is great at any school, it is a very subjective grade. I am sure I would have an easier time with 3rd year at another school.... after all, our administration came out and told us that they thought our school had "grade inflation" and that thus 3rd year grading would be a lot tougher. Scott Silverstein Registered User Posts: 10 (4/27/01 11:21:30 am) Reply Re: Clerkship Grades - my last comment on them I know there is some controversy on this but.... Yes they are subjective... Ass kissing does not usually get you honors... We know the people who kiss ass and we dont like them either!! You dont need to honor everything your 3rd / 4th years although some candidates do. Step 1 scores and AOA will open doors for interviews but I can tell you there were people like this that we didnt rank. The reason is fit. We try to find people who are smart, hard workers, well liked on their rotations and CAN COMMUNICATE with coworkers and patients and do well on tests. Just do your best and take criticism well and be a team player and all will work out fine. Good luck! orthohopeful Registered User Posts: 5 (5/7/01 4:42:44 pm) Reply yet another death blow to a completely dead horse My thoughts on this very interesting debate that rages about grades vs. AOA vs. step 1 I think (and have been told by program directors) that MS3 is by far the most important year because this is when you do CLINICAL work (ya know, the kind you do as a resident...). Last I checked residents don't sit around studying Biochem, they interact with patients and coworkers and do surgery. This is why most medical schools weight the third year grades about double the first two. My school doesn't even give AOA until the MS3 grades are in, because they are so important. While killer step 1 and preclinical grades clearly show you are 1. smart 2. dedicated to doing well by studying and working hard, they do not show that you will necessarily make a good house officer. I completely disagree that kissing ass will get you honors in MS3 clerkships. If that's how your school works, then that really sucks. At mine we have to get an A on a boards-type shelf exam to get honors in a clerkship, regardless of what the evals say. So the idiots who don't know anything but get the residents to like them don't walk off with all the good grades, but by the same token if you can memorize books but can't work well on a team or interact effectively with patients then you don't get honors either. That being said, I don't really know what the point of this argument is. Do you guys want someone to tell you you're in just because you kicked ass for two years? That's not how it works. Med school is 4 years, so keep working and improve your weaknesses, be yourself and you'll be fine. Good luck to all you other hopeful applicants. Two Fingers Registered User Posts: 1 (5/9/01 4:41:19 am) Reply Clerkship Grades While your 3rd year grades may or may not be a huge factor in applying to ortho, I think your 3rd year is a very important one. All the students out there should remember that you're in medical school to become a doctor, not just to get into an ortho residency. From personal experience, I strongly believe the variety of clinic training you get in your 3rd year will be valuable to you when you're out on your own no matter what specialty you are in. So even if your boards are 250+ (which is meaningless outside of residency applications) and are Junior AOA (again pretty meaningless), don't dismiss your 3rd year. If your attitude is to learn to be a good doctor no matter where you are, people will recognize that and you'll be rewarded for it. Just trying to keep perspective, Two Fingers