Clerkship Grades: How important are they?

Clerkship grades are huge. I had the same problem. Try to find out which site hand out honors and go there. The only things more important are research and stepI.

I agree, clerkship grades are very important. And not just your ortho sub I or your gen surg grade. I had several interviewers comment on the honors i got in internal medicine. It shows you are serious about academics in general, not just the stuff you like.

I too almost felt the pain of subjective grading. I destroyed the shelf exam and one half of my clinical eval's in GSurg but almost got screwed out of an honors by some asshole chief resident who did not like me b/c, no joke, her ex fiance was a ortho resident and dumped her. I had to talk to the chairmen and he agreed that all the other reviews of me were great and that hers stuck out.
The other thing I think is subjective, but unfortunately is also heavily looked at is if you are AOA. Each school goes about awarding this differently, with some being more of a popularity contest (my school), and others being based on strict academic criteria.

Basically, some damage has already been done. My school has the Honors, Advanced, Proficient system of grades. I have put up a steady string of Advanced grades despite busting my ass. The comments section of my evals would make you think I was a saint, but the grade says ADVANCED for Surgery, OB/Gyn, Psych. I expect Family med to be Honors and Medicine (I have the perfect site). I have good Board score (238) and three Ortho research projects (one soon to be published, First author). My schools AOA is a very strict meritocracy so that is not gonna happen. If grades really mean that much, I'll do general surgery
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I agree with everyone above. Clerkship grades are important, but your grades, as well as being AOA, isn't the end all be all to getting into Ortho. Obviously, having lots of Honors, being AOA, having a high Step1 score, and doing research will help you, and increase your chances of getting in. However, I wasn't AOA, only had one Honors during 3rd year (in OB/GYN no less), and stilll matched at a great Ortho program. My opinion is that if you want to do Ortho, you should go all out and try to match into Ortho, you can always try get a gen surg prelim year if you don't match and are also interested in gen surg....there's no such thing as an ortho prelim year.

cacahuete,
don't worry so much. yeah, clinical grades are important but it is only one piece in your application. look at the Matched Cridentils posts of years past and you will see the vast majority of people who matched did not honor all their 3rd year clerkships and many didn't even honor half. work your ass off on the remaining 3rd year rotations and hope for the best.

with research and a decent step 1 score, i'm sure someone could match with no to few 3rd year honors. however, matching at a top program would be very difficult, but as long as you match at any program you'll get to live the dream.

also, away rotations are very important and they can definitely make up for average grades at many places.

Most schools' transcripts will include a breakdown of the grades given for all of the 3rd year. So residency programs will know if everyone gets honors or if nobody gets honors. That helps to even out differences between grading scales at different schools.

Your application package will include your board scores, summaries of your clerkship evaluations, as well as your grades. Programs have a lot to work with to paint a picture of your academic ability, even if you don't have honors across the board.

At least at my program, it's this overall impression of academic ability that's important, rather than just the grades themselves.

The original post I think was referring to differential grading at different sites within the same medical school in which case, it doesn't matter if everyone else's grade from that school is taken into consideration--not everyone is with the prick chief medicine resident who hates orthopaedics.

Furthermore, having participated heavily in the screening of applicants, I can tell you that with the sheer volume of applications, neither I nor my fellow screeners had time to see what the evaluation gradients were for a particular school. The USMLE, letters, AOA status were looked as well as the clinical grades which, for the most part, are taken at face value.

Having been personally somewhat screwed by subjective clinical grading, I can tell you that it's just the beginning of the uneven playing field you'll encounter throughout your medical career. Unfortunately for our profession, often those who know how to play the game or "work the system" are often very successful. On the bright side, despite the subjective grading, I matched at my second choice program.

Unfortunately The Biceps comments are tough but true at some programs. The good news is that a fair number of other programs (several that quickly come to mind) actually take more time and care to look into the whole application into consideration who to offer interviews to. On a couple of my interviews, I was told that they read closely our deans letters (which include your evals) because they can really provide a lot of valuable information about our whole medical experience. So you can still interview at some of the best programs in the country based on more than just the # of honors on your transcript. I can personally attest to that.

Joints

I think this type of subjective grading is equalized by step 1 scores. I am the kind of guy that works hard and reads a lot. I do not kiss ass or try to manipulate my grades. I just show up and take care of my patients and read about them.

On rounds, I usually know more about the diseases the other students patients have then they do. I just keep my mouth shut and let rounds progress.

I think step 1 is the equalizer-- its very objective and proves who knows their stuff and who dosent. So I take solice in high shelf and step grades beause ultimately you have control over these.

I killed some people in my class on the IM shelf, but they got honors because they had an ambulatory evluation that some joker gave them all 5/5 and the person even told me that they were never even allowed to see a patient by themselves.

You must learn to become a better doctor so you can treat your patients better. If you turn this into a purely grades/numbers game you will loose sight of why we all wanted to become doctors in the first place.

As long as the clerkship grades are half decent, I don't think they matter too much as far as getting interviews.

Sometimes med students are just not in the right hospital/medschool. ie, someone could be working in a hospital where everyone is just miserable and will give you a low grade if you aren't miserable like them.

Personally, and not to be obnoxious or anything, but when I rotated with residents who were from higher tier schools, I tend to get better evals than from my own mid-tier school- somehow we felt like we understood each other better.

Sometimes med-students are just not in the right place and don't fit in like they should, despite busting their ass during rotations. This should be a major consideration when someone selects which med-school to go to, but many people don't know about this.

At least make sure you are in the right ortho program when you apply and interview. Some will love you, others may hate you. Be aware which is which.

As long as you can show that you are smart, work hard, and are able to score well, I wouldn't worry too much about the details of your evals. A lot of it is just plain BS.

If there is one recommendation I should give to get better evals- don't make yourself look smarter than the residents. Many don't remember exactly what some obscure disease is that you've studied for the boards and are being pimped on. Many residents don't remember and will shred you if you show that you know. The key is to just help them out during rotations, that's all- don't show that you are smarter than them. Just help them.

I absolutely agree with Cain that "FIT" should be a major consideration when choosing med-schools to go to.

I was one of those individuals who chose a great medical school but knew a month into it that this was not the place for me. For example, I was told repeatedly on multiple rotations that my demeanor and personality is too much like a surgeon and I actually got dinged for this in my evals (under the guise of "bed side manners"). Interestingly, on my Medicine, Pediatrics and Neurology rotations, patients told my attendings and residents that I had great bed side manners which they included in the comments section but still dinged me in the rating section.

Before choosing to go to a state school, you NEED to find out what their objectives are. For instance, is the school getting funds to churn out primary care docs? If you want to go into ortho, this might not be the best place for you.

My school will always claim that they match well in surg-sub (and yes they do) BUT the road getting there is NOT pretty. And I believe the numbers are too low for that calibar of med-school. If you decide on a surg-sub, you are essentially on your own as opposed to getting the red carpet laid out for you when you decide to go into medicine.

When I was deciding on medschools, I had a conversation with a neurosurgeon at the school I am going to. This guy told me that his son goes to another school with a "slighty" greater emphasis on specialties but you can go into specialties here as well... blah, blah, blah. Why would his son, who also wanted to be a neurosurgeon, go to a lower-ranked private school and pay tuition there as opposed to get free tuition at a "better" school? This was probably the biggest hint anyone could have given me but as a dumb pre-med, I didnt know how to process this.