Received only Pass for both of my core IM rotations

[wearethechamp12]

Hi everyone,
Just wanted to receive some advice on how my future looks... after receiving a Pass for BOTH of my IM core clerkships (my school has a total of 8 weeks of IM core divided into two rotations). I tried my best to get a better grade on the second one, but by the luck of the draw, of the many attendings I worked with, I spent the least amount of time with got to evaluate me and I received a Pass again for the second time. However, the evaluation itself was not negative at all ("eager, receptive to constructive criticism, compassionate, always willing to learn...etc")

My current goal is university IM, though location comes first, and I am willing to sacrifice the program prestige if it meant I could move back to west coast where my family lives. My advisor says those two clinical grades are still okay because I received honors in rotations that are tangentially related to IM (neuro and endo electives). However, a number of people also told me that IM programs give relatively more emphasis to clinical grades than other specialties.

What can I do at this point to maximize my chance at university IM? I have a sub-I planned at one of my top 5 programs, and I am not even sure if I should do it given how my IM clinical grades have been so awful. For other aspects of my residency application -- my Step 1 is 235-240. 2 bench research pubs as 2nd author. I'm just really frustrated with how subjective the clinical grades can be, but its disproportional impact on residency applications... any advice would be greatly appreciated.

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[BorntobeDO?]

You'll match. Do that subi, some IM programs will care, I would personally either pick a program that is a big reach for you, or one that your less interested in to try and keep the pressure down. It has to be academic tho. If you can get a letter from it, great, if not, thats okay too. Will say, if you audition at reachs try to be realistic about your chances if they give you an interview. Courtesy interviews are still a thing. Connections with people are great, but some programs are just more motivated by scores than they let on.

For instance at my program, they would definately interview you if you did a subi and were normal. And a interview is almost always a rank. But that rank location will be strongly effected by your board score and last year we didnt go below the top half of our list. My program used to be a program that took chances on people that we liked, but then one year had a bad pass rate and now they are all about the board scores. I am sure others are the same. So aways are good, and my program definately wants medical students who at least did one away, but if you do it here, your board score will still be primary rank factor. I dont like it at all as a resident, cause lots of FMG have very high boardscores, but really struggle clinically. We have at least 1 in each of the last couple classes. Would rather have the people I know, but the whole board pass rate/wanting lots of fellows really drives it.

 

[wearethechamp12]

You'll match. Do that subi, some IM programs will care, I would personally either pick a program that is a big reach for you, or one that your less interested in to try and keep the pressure down. It has to be academic tho. If you can get a letter from it, great, if not, thats okay too. Will say, if you audition at reachs try to be realistic about your chances if they give you an interview. Courtesy interviews are still a thing. Connections with people are great, but some programs are just more motivated by scores than they let on.

For instance at my program, they would definately interview you if you did a subi and were normal. And a interview is almost always a rank. But that rank location will be strongly effected by your board score and last year we didnt go below the top half of our list. My program used to be a program that took chances on people that we liked, but then one year had a bad pass rate and now they are all about the board scores. I am sure others are the same. So aways are good, and my program definately wants medical students who at least did one away, but if you do it here, your board score will still be primary rank factor. I dont like it at all as a resident, cause lots of FMG have very high boardscores, but really struggle clinically. We have at least 1 in each of the last couple classes. Would rather have the people I know, but the whole board pass rate/wanting lots of fellows really drives it.

Thank you for taking your time to reply. I did not know that programs could rank that many people that they interview. The sub-I I mentioned is not really a reach, but more of a ballpark? Residency explorer says my Step 1 score is within 25% of matched applicants of the program. Should I not do the sub-I in case it backfires (e.g. I show subpar performance)? I also have a good network/connection there. Any input in this regard would be greatly appreciated.

Lastly, on VSLO programs listed currently shows dates available in current academic year. Words say that usually around spring time is when the new dates for the next academic year show up?

 

[BorntobeDO?]

Thank you for taking your time to reply. I did not know that programs could rank that many people that they interview. The sub-I I mentioned is not really a reach, but more of a ballpark? Residency explorer says my Step 1 score is within 25% of matched applicants of the program. Should I not do the sub-I in case it backfires (e.g. I show subpar performance)? I also have a good network/connection there. Any input in this regard would be greatly appreciated.

Lastly, on VSLO programs listed currently shows dates available in current academic year. Words say that usually around spring time is when the new dates for the next academic year show up?

It was end of March during my third year. Just check every week tho cause each institution is a little different. On the picking aways I can only speak to my experience. I did 3 aways. 2 were reachs (one ended up matching all MD from home institute, and the other was 7/8 MD with one instate DO) and the last one was a residency that had a mix of DO, IMG, and MD and I felt like I was competitive for. The last one was were I spoke to the chair and told them I ranked them number 1. I had residents vouching for me, and the chair gave me a ranked 'very highly' email. Reality is I didn't match there at all and they took a decent amount of DO's/IMG. So in my opinion, not worth it to do aways at places you are competitive for. The first two were worth it, cause without the away, I had basically no shot, so therefore no real pressure to perform. Thats a better place to rotate at IMO.

 

[FutureDoctor5000]

Hi everyone,
Just wanted to receive some advice on how my future looks... after receiving a Pass for BOTH of my IM core clerkships (my school has a total of 8 weeks of IM core divided into two rotations). I tried my best to get a better grade on the second one, but by the luck of the draw, of the many attendings I worked with, I spent the least amount of time with got to evaluate me and I received a Pass again for the second time. However, the evaluation itself was not negative at all ("eager, receptive to constructive criticism, compassionate, always willing to learn...etc")

My current goal is university IM, though location comes first, and I am willing to sacrifice the program prestige if it meant I could move back to west coast where my family lives. My advisor says those two clinical grades are still okay because I received honors in rotations that are tangentially related to IM (neuro and endo electives). However, a number of people also told me that IM programs give relatively more emphasis to clinical grades than other specialties.

What can I do at this point to maximize my chance at university IM? I have a sub-I planned at one of my top 5 programs, and I am not even sure if I should do it given how my IM clinical grades have been so awful. For other aspects of my residency application -- my Step 1 is 235-240. 2 bench research pubs as 2nd author. I'm just really frustrated with how subjective the clinical grades can be, but its disproportional impact on residency applications... any advice would be greatly appreciated.

Your fine. I had scores simmilar to yours and got many university IM invites. Do a sub-I at places your interested in but are reaches don't do them at places your competitive for, it won't make a huge difference. As the poster above me said, that despite the away and residents vouching for him/her they still didn't match there. So in IM it ultimately comes down to scores(for now till step1 is pass/fail). You likely won't match at your away unless you were competitive on paper for it to begin with. If you want a specific program for which your scores are competitive for and you want to really match there(location, spouse, family etc), then doing an away there would really show commitment and can help you. In a scenario like that def do that away. But if that program is out of your reach scores wise then it likely won't help all that much, you'd get an interview but that's it. With your scores tho, your competitive for mid and low tier university programs, just need to apply broadly. I don't think IM programs really care about away rotations(this isn't surgical subs), do a sub-I either at your school or somewhere else, because I was asked about my sub-I on my interviews, but you should expect to match at places where your competitive for on paper at the end of the day.

As far as clinical grades go in third year, they can be a total crapshoot, my school has so many different sites and attendings and each has a unique grading style. Same thing happend to me on my second core IM rotation which was a wards based one and the attending doing my evaluation barely even spent time with me. Ultimately tho it won't make a huge difference. Try to honor your sub-I but my school didn't even put my sub-I on the MSPE lol. It is strange that they gave you a low enough grade to tank your overall grade to a pass tho? Unless you didn't do that well on the shelf?