IamNikolas
Registered User
Posts: 9
(4/21/01 5:35:24 pm)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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
