If I got high passes for all of third year with some honors, and did well on STEP 2, what are my chances for residency?

[CuriousMDStudent]

Title sums it up. At the moment, I think I'm fated for a year of high passes and some honors. I got my family medicine grade back and got high pass, which I expected because the preceptor gave me a high pass because I was "not working at the level of an intern" and she reserves hoors for resident level medical students.

I'm on IM and so far in my evaluations I've gotten 1 honors and 2 high passes because one of the attendings didn't like my organization of my problem list when I only got one opportunity to present to her and no chances to improve and another told me I am at the crux of honors but she will be giving me high pass.

I am realizing I need to stop caring so much about honors for the sake of my mental health. I am noticing that I am stressing about it a lot and it's not doing me any good in terms of productivity and just happiness. So I want to ask, if I were to get mostly high passes and some honors throughtout third year but did well on STEP 2. What would be my chances at residency in orthopedics surgery, anesthesiology, and PM&R?

Background:
At the moment, I'm a third year at a T15 that's true P/F during preclinical. Passed all of 1st and 2nd year and STEP 1 with no remediation or fails. I have ortho research in my back pocket with 1 fifth author pub and 5 projects in the process of being submitted to journals.

I am interested in orthopedics surgery, anesthesiology, and PM&R. Below are potential STEP 2 score I could get and my perception of my chances at each specialty. I want to hear people's thoughts.

STEP 2 Potential Scores
260+ : Good chance at ortho. Great chance Anesthesia and PMR
250-260: Decent chance at ortho. Good-Great chance Anesthesia and PMR
240-250: Low chance ortho. Good chance Anesthesia. Good-Great chance PMR
230-240: No chance ortho. Low chance Anesthesia. Good chance PMR

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[Hzreio]

Honors is reserved for med students that function like residents? What a joke…

 

[CuriousMDStudent]

Honors is reserved for med students that function like residents? What a joke…

Literally. It's like what do I do at this point.

 

[cj_cregg]

Honors is reserved for med students that function like residents? What a joke…

Yes, for the medical students who are truly exceptional - as it should be. If everybody is getting honors what's the point? Worth noting that your MSPE will show what percentage of your class got honors/high pass/whatever - at least at my program, we take that into account. If you got honors but so did 50% of your class I don't really care and it's that much more difficult for me to evaluate you as an applicant. If 5% of your class honors a rotation and you honored, I'm impressed because I understand that honors is reserved for the rock star students. If 5% of your class honors a rotation and you passed/high passed, that's fine because I understand that honors is reserved for the rock star students.

OP: Relax. If you feel like you're doing the best you can on your rotations, then what is there to change? Continue to seek feedback early and often and improve the things that can be improved. That said...it is okay not to honor every rotation. The ACGME releases a survey of program directors in every specialty that tells you what they feel is most important for applicants when being selected to interview and for the rank list, which may give you a sense of how much this actually matters for your specialties of interest and what else you should be focusing on.

 

[Lawpy]

Yes, for the medical students who are truly exceptional - as it should be.

Exceptional is one thing, but it makes no sense to expect a new MS3 to function at the level of a resident

 

[CuriousMDStudent]

It is what it is. Thanks everyone. But yeah I'll keep trying my best and hoping for the best.

 

[mrbreakfast]

I once had a preceptor give me a 4.8/5 (as opposed to straight 5s) because "you were essentially perfect, but if I gave you a perfect score, you'd have nothing to work on." I did poorly on the shelf, so that tiny difference dropped me from a honors to high pass. It's the name of the game.

Now, I give honors to exemplary students. You don't have to be at "intern level" but need to go above and beyond in some way. I've given fresh clinical students higher reviews than some acting interns before. There is (or, in my opinion, should be) more to it than just showing up early and getting pimping questions correct.

STEP 2 Potential Scores
260+ : Good chance at ortho. Great chance Anesthesia and PMR
250-260: Decent chance at ortho. Good-Great chance Anesthesia and PMR
240-250: Low chance ortho. Good chance Anesthesia. Good-Great chance PMR
230-240: No chance ortho. Low chance Anesthesia. Good chance PMR

Just FYI: Anesthesia had a 86% match rate for step 2 of 231-240. Don't stress too much.

 

[cj_cregg]

Exceptional is one thing, but it makes no sense to expect a new MS3 to function at the level of a resident

Fair, I'd hope there's at least some adjustment of that curve to accommodate what time of year it is. But I guess when I'm evaluating medical students/early interns, the things I'm looking for are not so much clinical acumen-related - that can be taught with time, and it's not really their fault if they haven't been exposed to something as a medical student yet. I'm thinking more of things like are they on top of their tasks, are they self-motivated or do they need to be spoon-fed the next step, are they taking responsibility for their patients, are they writing halfway decent notes, seeking and responding appropriately to feedback, recognizing when they need help and asking for it, and doing a thorough job at the information-gathering/reporting roles and at least taking a stab at the assessment and plan. Honestly more behaviors and characteristics vs things like procedural skills or medical knowledge. Others may feel differently about what's important in these evals but I think using those metrics, it's reasonable to have "at the level of an (early) intern" as a threshold for honors, and I've certainly had some exceptional M3s that have met that even early in their clerkships.

 

[Hzreio]

Yes, for the medical students who are truly exceptional - as it should be. If everybody is getting honors what's the point? Worth noting that your MSPE will show what percentage of your class got honors/high pass/whatever - at least at my program, we take that into account. If you got honors but so did 50% of your class I don't really care and it's that much more difficult for me to evaluate you as an applicant. If 5% of your class honors a rotation and you honored, I'm impressed because I understand that honors is reserved for the rock star students. If 5% of your class honors a rotation and you passed/high passed, that's fine because I understand that honors is reserved for the rock star students.

OP: Relax. If you feel like you're doing the best you can on your rotations, then what is there to change? Continue to seek feedback early and often and improve the things that can be improved. That said...it is okay not to honor every rotation. The ACGME releases a survey of program directors in every specialty that tells you what they feel is most important for applicants when being selected to interview and for the rank list, which may give you a sense of how much this actually matters for your specialties of interest and what else you should be focusing on.

Except that’s not the case. With many schools giving honor to 50% or more of the class, the lack of standardization is here is pretty dumb.

Histogram distribution help in this regard, but the grade is the first thing people see.

Exceptional != functions as a resident

 

[GoSpursGo]

Except that’s not the case. With many schools giving honor to 50% or more of the class, the lack of standardization is here is pretty dumb.

Histogram distribution help in this regard, but the grade is the first thing people see.

Exceptional != functions as a resident

Meh. I think students underestimate how important the histogram is. If a school gives honors out like candy, it’s known, while if it’s really difficult to get that is known too.

Keeping in mind that the OP is coming from a T15 and has 6 pubs in various stages of development, I really think the OP is a shoe-in for anesthesia and PM&R regardless. With a 250+ on step 2, I also think they would stand a very good chance at matching ortho (the current match rate for students who get >250 on both step 1 and step 2 is 84%, and coming from a "top tier" school would probably give them the benefit of the doubt that they would have performed well on step 1 also).

I know it's easy to say this from afar, but don't sweat the small stuff. You are coming from a great school where they know you're competing against other great students. Focus more on ensuring your comments on surgery are glowing.

 

[cj_cregg]

Except that’s not the case. With many schools giving honor to 50% or more of the class, the lack of standardization is here is pretty dumb.

Histogram distribution help in this regard, but the grade is the first thing people see.

Exceptional != functions as a resident

Histograms help A LOT. The grade is listed literally right next to the histogram on every MSPE I've seen so it's not like we're flipping through pages and pages of material to find it.

Personally, I think the percentage of medical students I see functioning at the level of a new intern is an appropriate percentage to set that as a threshold for honors, but I can see how others might disagree on that point. I agree there should be better standardization between and within schools for what qualifies as honors vs whatever else, but until that time, the histogram is pretty helpful.

 

[Dral]

I got the equivalent of high passes my whole year and ended up in Derm. You're fine. The more important thing is to honor your specialty rotations. So if you're going for Ortho and you just get a pass in your ortho rotation, that's no bueno.

 

[deleted1079620]

Histograms help A LOT and at least speaking for my program we absolutely, 100% look at the histogram along with the grade every time (the narrative evals also help when they are done well). The grade is listed literally right next to the histogram on every MSPE I've seen so it's not like we're flipping through pages and pages of material to find it. We have one school we get a lot of applicants from where like 80% of students honor each rotation...in that case I really do not care if an individual applicant honored and I'm looking at other parts of the app to try to get a sense of their knowledge base and clinical skills.

Personally, I think the percentage of medical students I see functioning at the level of a new intern is an appropriate percentage to set that as a threshold for honors, but I can see how others might disagree on that point. I agree there should be better standardization between and within schools for what qualifies as honors vs whatever else, but until that time, the histogram is pretty helpful.

How is a medical student on their 1st rotation supposed to function as an intern? I’m genuine in this question, I just finished my first block but I haven’t got my eval back yet.

 

[srirachamayonnaise]

Title sums it up. At the moment, I think I'm fated for a year of high passes and some honors. I got my family medicine grade back and got high pass, which I expected because the preceptor gave me a high pass because I was "not working at the level of an intern" and she reserves hoors for resident level medical students.

I'm on IM and so far in my evaluations I've gotten 1 honors and 2 high passes because one of the attendings didn't like my organization of my problem list when I only got one opportunity to present to her and no chances to improve and another told me I am at the crux of honors but she will be giving me high pass.

I am realizing I need to stop caring so much about honors for the sake of my mental health. I am noticing that I am stressing about it a lot and it's not doing me any good in terms of productivity and just happiness. So I want to ask, if I were to get mostly high passes and some honors throughtout third year but did well on STEP 2. What would be my chances at residency in orthopedics surgery, anesthesiology, and PM&R?

Background:
At the moment, I'm a third year at a T15 that's true P/F during preclinical. Passed all of 1st and 2nd year and STEP 1 with no remediation or fails. I have ortho research in my back pocket with 1 fifth author pub and 5 projects in the process of being submitted to journals.

I am interested in orthopedics surgery, anesthesiology, and PM&R. Below are potential STEP 2 score I could get and my perception of my chances at each specialty. I want to hear people's thoughts.

STEP 2 Potential Scores
260+ : Good chance at ortho. Great chance Anesthesia and PMR
250-260: Decent chance at ortho. Good-Great chance Anesthesia and PMR
240-250: Low chance ortho. Good chance Anesthesia. Good-Great chance PMR
230-240: No chance ortho. Low chance Anesthesia. Good chance PMR

Really obnoxious to tell you that you are on the cusp but she would not give you honors.. here, I would report her for medical student abuse lol. Good I am at a true P/F clinical school.

 

[cj_cregg]

How is a medical student on their 1st rotation supposed to function as an intern? I’m genuine in this question, I just finished my first block but I haven’t got my eval back yet.

On my phone or I'd type more/quote it lol, but I have a post higher up with the kind of stuff I look for in my evals. For me it's more about behaviors, seeking/responding to feedback appropriately, work ethic, taking ownership/responsibility, etc vs the clinical knowledge or skills. Because in my mind med students/early interns aren't responsible for what they were exposed to in medical school, their preceptors are - so I'm not going to fault them for not having learned some particular piece of info or skill yet or for not knowing what they don't know. Obviously other people may feel differently or have different criteria, but that's my n=1 opinion.

 

[Banco]

OP you will be more than fine. Mostly HP and a couple honors is a good performance overall. The most important one to try and honor would be surgery.

Aim for the average step score of applicants that match for your specialty of interest.

Overall, I would not concern myself too much with this and just put your best foot forward. Your Family Medicine grade has literally no bearing on how you will be evaluated for other rotations. Unfortunately it ends up being subjective - but you don't have to "function like an intern" to get honors - that's stupid.

The research portion of your app is already very strong btw.

 

[throwaway123342]

Title sums it up. At the moment, I think I'm fated for a year of high passes and some honors. I got my family medicine grade back and got high pass, which I expected because the preceptor gave me a high pass because I was "not working at the level of an intern" and she reserves hoors for resident level medical students.

I'm on IM and so far in my evaluations I've gotten 1 honors and 2 high passes because one of the attendings didn't like my organization of my problem list when I only got one opportunity to present to her and no chances to improve and another told me I am at the crux of honors but she will be giving me high pass.

I am realizing I need to stop caring so much about honors for the sake of my mental health. I am noticing that I am stressing about it a lot and it's not doing me any good in terms of productivity and just happiness. So I want to ask, if I were to get mostly high passes and some honors throughtout third year but did well on STEP 2. What would be my chances at residency in orthopedics surgery, anesthesiology, and PM&R?

Background:
At the moment, I'm a third year at a T15 that's true P/F during preclinical. Passed all of 1st and 2nd year and STEP 1 with no remediation or fails. I have ortho research in my back pocket with 1 fifth author pub and 5 projects in the process of being submitted to journals.

I am interested in orthopedics surgery, anesthesiology, and PM&R. Below are potential STEP 2 score I could get and my perception of my chances at each specialty. I want to hear people's thoughts.

STEP 2 Potential Scores
260+ : Good chance at ortho. Great chance Anesthesia and PMR
250-260: Decent chance at ortho. Good-Great chance Anesthesia and PMR
240-250: Low chance ortho. Good chance Anesthesia. Good-Great chance PMR
230-240: No chance ortho. Low chance Anesthesia. Good chance PMR

the most important part of your application is that you go to a T15. If you crush step 2 and your ortho sub-Is you will match 100%.