High Pass Grades

[pvabc15]

Currently on clerkships and have gotten high pass on 3 rotations so far. Starting to get worried as I'm interested in plastic surgery. I keep missing the honors mark because of the shelf exams.....evals have been great. Will this be a problem? Automatic DOA? Any advice?

Will say that I'm currently at a top institution for plastic surgery (doximity).

---

Members don't see this ad.

 

[chord]

You'll be okay. Do well on your sub-Is, try to allocate more time to studying for shelves. Clinical grades are just one piece of the puzzle.

 

[GoSpursGo]

Overall you’re probably fine. I will however give two caveats. First, if you’re at a top plastics place, talk to your home program and ask what they look for and whether other students who have a fair mix of HP have had any trouble (probably not but may as well get real feedback rather than our best guesses).

Second piece is you should figure out why you’re not hitting top marks on your shelf. Obviously you want to crush step 2, so figuring out how to go from very good to great on exams would be important

 

[Billiam95]

Are you not honoring the shelf 2/2 a high 'honors' threshold, or just not doing great on the exams?

 

[pvabc15]

Overall you’re probably fine. I will however give two caveats. First, if you’re at a top plastics place, talk to your home program and ask what they look for and whether other students who have a fair mix of HP have had any trouble (probably not but may as well get real feedback rather than our best guesses).

Second piece is you should figure out why you’re not hitting top marks on your shelf. Obviously you want to crush step 2, so figuring out how to go from very good to great on exams would be important

Will do this for sure.

Recently been in a tough mental spot just because I keep thinking back to the past. I had the option to go to P/F clinical school and I didn't take it. I don't know what I was thinking. It's like clinicals change people. The boot licking, *** kissing, the fakeness is insane. I know I shouldn't be fixated on the past but haven't been able to help it recently.

 

[pvabc15]

Are you not honoring the shelf 2/2 a high 'honors' threshold, or just not doing great on the exams?

Not reaching the honors threshold for the shelf. I get infected with airhead when I sit down for it, my focus gets lost.

 

[GoSpursGo]

Will do this for sure.

Recently been in a tough mental spot just because I keep thinking back to the past. I had the option to go to P/F clinical school and I didn't take it. I don't know what I was thinking. It's like clinicals change people. The boot licking, *** kissing, the fakeness is insane. I know I shouldn't be fixated on the past but haven't been able to help it recently.

First of all, obviously what's done is done, and there is no "right" answer. If you were at a P/F clinical school you likely would be sweating how you were going to distinguish yourself without any objective measures.

Second of all, and more importantly--the stuff you're complaining about isn't the reason you're not getting honors. Figure out test taking strategies that will enable you to not lose focus.

 

[Billiam95]

Echo above - found that percentiles from shelf exams is roughly equivalent to step 2 performance; obviously for applying plastics, you'll want to maximize your s2 score.

 

[ChordaEpiphany]

Not reaching the honors threshold for the shelf. I get infected with airhead when I sit down for it, my focus gets lost.

Would be helpful to know where the cutoff is and how things are graded at your school. The way my school grades it can very easily look like the shelf is the problem, but really the system is just designed to spare attendings/residents the burden of writing bad evals. A lot of people hit the Honors threshold with clinical grades, but in reality the shelf acts as the spoiler and the true Honors cutoff is quite a bit higher than what it is on paper (i.e., everyone gets 85-95 on clinical grades, but really you need 92+ to have a chance for 90 overall since the shelf will inevitably bring you down unless you can score 99th percentile consistently). So the attending can basically say, "I gave you an Honors eval" or "oh you just missed Honors, but very good performance" while knowing they are truly giving a HP eval unless that student can somehow score >90 raw on the shelf.

So it comes down to where you're actually falling on the shelf exam. If you're at 80 or above, think carefully about your school's grading system and whether clinical evals could be the real issue. If you're in the 70s, then the issue is the shelf and you need to revise your study habits/strategies, probably most importantly for Step 2.

 

[esob]

I can't speak for plastics residencies, but I know from my perspective on a residency committee in general that what is written in your evals is unlikely to have any significant impact on your application. In fact, we mostly screen evals on MSPE for red flags rather than anything that boosts an application.