This person is dumb as hell, but they still get to grade me. (yay)

[Lolscan]

Hard-working "quiet kids" often receive excellent evaluations. Look at the students getting AOA at your school...it's not all quarterbacks and homecoming queens. My AOA class had zero dumb blondes, but several quiet Asians, as you have described yourself.

Also, don't distort the wording of my post. Mediocre students receive mediocre evaluations more than excellent students. It's not "foolish" to point this out. To be honest, I have a lot more experience than you when it comes to evaluating performance as well as being evaluated, and I know how the numbers fall into place.

Medical school is hard on our egos because it's the first time that we are surrounded by intellectual equals. Most of us soared through college without having to try too hard, but we get to med school and we are surrounded by valedictorians, PhDs, etc. Now, we have to try hard to do well, and sometimes even our best effort is not enough to end up on top. For many of us, it's our first taste of defeat and disappointment.

Some people cope well with this new disappointment, but many students choose instead to project their failures onto others. I am not immune to this behavior, and I've done it myself a hundred times. However, looking back, for every 10 bad evaluations I've seen, maybe 2 or 3 are unfair, and the other 7-8 are just students with poor insight into their shortcomings.

I have almost never met a student who believed he or she actually deserved a bad evaluation. I've rarely even met a student who believed he or she deserved an average evaluation. We are all above-average snowflakes, after all.

LOL give me a break. You have jack **** over anyone else in terms of evaluating people. How you judge people is based on what you value in others. Sorry to break it to you but every other attending will have a different idea about whats important in an clinician.

If you look at the AOA in my class you will see an overwhelming majority are white and outspoken. Yes they aren't all jocks or beauty queens but there are sure a lot of them. Even if we ignore the fact that quiet students are at an disadvantage, just look at the study done by APAMSA, you will see that blacks, hispanics, asians all receive inferior clinical grades relative to whites. That is a statistical fact and it is a product of an subjective grading system. At least the shelf exam is a reflection of the effort you put into studying. Third year grades is a reflection of ass kissing and pretending to know ****.

" Most of us soared through college without having to try too hard"

Sorry to break it to you but medical school is not hard compared to college. Being a doctor is like being a glorified plummer. I have yet to be challenged intellectually by any of the subjects. You memorize, regurgitate and pretend to be smart. "Clinical skills" is just another word the crap "I pull out of my ass to not look stupid." I have had attending that hand out percocet for sore throats because of "clinical judgement" and another attending who treat meningitis outpatient with 2nd gen cephalosporins because "based on my experience it tastes better". The sooner we realize that third year grades is a load of crap, the faster we will change the way medical students are taught.

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[45408]

LOL give me a break. You have jack **** over anyone else in terms of evaluating people. How you judge people is based on what you value in others. Sorry to break it to you but every other attending will have a different idea about whats important in an clinician.

If you look at the AOA in my class you will see an overwhelming majority are white and outspoken. Yes they aren't all jocks or beauty queens but there are sure a lot of them. Even if we ignore the fact that quiet students are at an disadvantage, just look at the study done by APAMSA, you will see that blacks, hispanics, asians all receive inferior clinical grades relative to whites. That is a statistical fact and it is a product of an subjective grading system. At least the shelf exam is a reflection of the effort you put into studying. Third year grades is a reflection of ass kissing and pretending to know ****.

" Most of us soared through college without having to try too hard"

Sorry to break it to you but medical school is not hard compared to college. Being a doctor is like being a glorified plummer. I have yet to be challenged intellectually by any of the subjects. You memorize, regurgitate and pretend to be smart. "Clinical skills" is just another word the crap "I pull out of my ass to not look stupid." I have had attending that hand out percocet for sore throats because of "clinical judgement" and another attending who treat meningitis outpatient with 2nd gen cephalosporins because "based on my experience it tastes better". The sooner we realize that third year grades is a load of crap, the faster we will change the way medical students are taught.

Link to said study? And do you think you would you have been AOA if you were white?

And you're saying college is harder than med school?

Your post is the perfect example of "the plural of anecdotes is not data." I've never seen clinical "maneuvers" like you're citing, and they are most certainly not representative of the clinical abilities of the physicians I work with. You mentioned that you did your rotations at a place you would never go back to:

Good advice. My rotations were at baystate medical center. Safe to say I would never go back because it is a night and days difference at the boston clinical locations.

 

[username456789]

Being a doctor is like being a glorified plummer. I have yet to be challenged intellectually

The juxtaposition here is just so beautiful, it hurts.

I don't know about you, but I learned about the silent "b" in elementary school, and that was definitely not harder than medical school.

 

[45408]

I see a recurring theme in your posts.

Now for the most part, we found this situation incredibly hilarious. However, on the other side of the issue, if they can't recognize you as an individual how are they suppose to grade you? I've gotten **** for things my teammate did and I have also been paged because they mixed up the wrong asian. And this happens on EVERY rotation.

Now do you guys think of this? Not necessarily malicious racism but racism out of ignorance. Because all in all, I do feel like asians get graded harder (especially if you fit into the "quiet book worm" stereotype).

I am going to take a guess and say that you are probably asian? People (white people) equate being loud with confidence which in turn infers that they "know their stuff". It's a completely ******ed concept and unfortunately many asians get stuck either in racial stereotypes that they can't dig themselves out of. Unless you are 2 SDs above the normal for being outgoing. They will always see you as the "quiet yet polite and knowledgeable asian". Which gets you a high pass.

My institution gives honors out like candy to blonde, blue eyed white chicks. Then screws all the asians.

Clearly a quiet intelligent person will never get honors but a ******* blonde that flirts will always honor. I have seen this over and over and it is absolutely ******ed.

I suspect some racism playing here.

 

[Perrotfish]

If I'm not mistaken, at my school, only 10% of the class will get honors and 10% will get a high pass. That means 80% of the class will get pass. I figured it was the same at most schools. I guess not.
t

At my school it varried by rotation, but the average seemed to be 20%, 25-30%, 50%, 0-5% got H, HP, P, and F respectively. Someone told me once that they need to publish those percentages for each class in the deans letter so that schools know how to evaluate you and to keep grade inflation from going through the roof. No idea if that's true.

 

[FSU2013]

If you look at the AOA in my class you will see an overwhelming majority are white and outspoken. Yes they aren't all jocks or beauty queens but there are sure a lot of them. Even if we ignore the fact that quiet students are at an disadvantage, just look at the study done by APAMSA, you will see that blacks, hispanics, asians all receive inferior clinical grades relative to whites. That is a statistical fact and it is a product of an subjective grading system. At least the shelf exam is a reflection of the effort you put into studying. Third year grades is a reflection of ass kissing and pretending to know ****. .

Let me start by saying 2 things:
1) I realize undergrad GPA and mcat scores don't correlate linearly with med school performance, but, even still, this is an objective way to look at things.
2) I'm not racist, so don't wast your breath saying anything of the sort.

Based on objective data, students who are accepted to medical school who are white have significantly higher GPA and mcat scores than African Americans, Hispanics and native Americans.

Whites have a 74% acceptance rate with a GPA of 3.6-3.8 and mcat of 30-32 - a pretty strong app
The aggregate of AA, Hispanics and native Americans have a 74% chance of acceptance with a GPA of 3.4-3.6 and mcat of 27-29.

Whites have only a 12% acceptance rate with 3.2-3.4 and 24-26; AA, H and NA have a
50% chance of admission.

Again, I'm not saying anything derogatory about people of different races, but if they are accepted at higher rates and not matched accordingly, it would not be surprising if they recieve lower scores in med school.

Ok, someone can call me a racist now.....

https://www.aamc.org/download/157958/data/table25-mcatgpa-grid-white-0911.pdf
https://www.aamc.org/download/157590/data/table25-hbn-mcatgpa-grid-3race.pdf

 

[45408]

At my school it varried by rotation, but the average seemed to be 20%, 25-30%, 50%, 0-5% got H, HP, P, and F respectively. Someone told me once that they need to publish those percentages for each class in the deans letter so that schools know how to evaluate you and to keep grade inflation from going through the roof. No idea if that's true.

I know for a fact that it's true at my school. I saw the sheets with my grades and the bar graphs of the grade distributions for each course (pre-clinical as well as rotations).

 

[username456789]

I know for a fact that it's true at my school. I saw the sheets with my grades and the bar graphs of the grade distributions for each course (pre-clinical as well as rotations).

Same with my school.

 

[SLUser11]

I have yet to be challenged intellectually by any of the subjects. You memorize, regurgitate and pretend to be smart.

That's great that you feel there are no intellectual challenges in med school...maybe some spelling challenges, but close enough.

However, it seems that you are facing social and professional challenges in med school that you are unable to overcome, which goes further to prove my point that doctors need to be well-rounded, and grades should be based on a balance of several factors. People may be great at memorizing facts, but below-average in professionalism/problem solving/relating to other medical professionals and patients.

The juxtaposition here is just so beautiful, it hurts.

I don't know about you, but I learned about the silent "b" in elementary school, and that was definitely not harder than medical school.

Love it.

 

[Chaoticsheath]

If I'm not mistaken, at my school, only 10% of the class will get honors and 10% will get a high pass. That means 80% of the class will get pass. I figured it was the same at most schools. I guess not.

not at mine. the majority get high pass where i go.

 

[C O M 2014]

And you're saying college is harder than med school?

A lot of college majors are much more difficult that the material in medical school. Med school is easy. It is rote memorization and regurgitation. Almost any can do that. Pikeville and other medical schools with extremely subpar students are evidence of this.

 

[C O M 2014]

If you want to talk about a dumb evaluator, one of my classmates just finished a rotation with an FNP. The preceptor had previously tried to get into med school but failed because of a low GPA and dismal MCAT score. Gave up and joined an 18 month FNP program. Never worked as an RN. Graduated less than a year ago and is now working solo in a peds clinic. Dude had some stories of how much really basic stuff that this NP doesn't know, really scary that this person has a prescription pad. So basically this NP was one of our college peers who didn't have what it took for med school but somehow leapfrogged us and is now writing evaluations for her intellectual superiors. My classmate is a better person than I. I don't think I could put up with that.

 

[username456789]

A lot of college majors are much more difficult that the material in medical school. Med school is easy. It is rote memorization and regurgitation. Almost any can do that. Pikeville and other medical schools with extremely subpar students are evidence of this.

No, "getting by" in med school is pretty easy. But not anywhere near as easy as "getting by" in college.

Much of medical school is not significantly more intellectually challenging than undergrad; however, the sheer volume of information and expectations is not even comparable. If the blanket statement "med school is easy" were true, you wouldn't have a ****-ton of 4.0/36+ kids who get there and struggle to stay above the class average or score near the national average on Step I. Because of the fierce competition, medical school is by definition more difficult. That is, if you're able to delineate "course material" from "medical school experience" effectively.

Medical schools work very hard to decrease attrition rates (well, US ones at least). And most medical students do rise to the challenge and make it through. But if you asked any of the bottom-of-the-classers whether they had ever thought they would settle for "barely making it through" in undergrad, they'd look at you like you had three heads.

 

[C O M 2014]

No, "getting by" in med school is pretty easy. But not anywhere near as easy as "getting by" in college.

Much of medical school is not significantly more intellectually challenging than undergrad; however, the sheer volume of information and expectations is not even comparable. If the blanket statement "med school is easy" were true, you wouldn't have a ****-ton of 4.0/36+ kids who get there and struggle to stay above the class average or score near the national average on Step I. Because of the fierce competition, medical school is by definition more difficult. That is, if you're able to delineate "course material" from "medical school experience" effectively.

Medical schools work very hard to decrease attrition rates (well, US ones at least). And most medical students do rise to the challenge and make it through. But if you asked any of the bottom-of-the-classers whether they had ever thought they would settle for "barely making it through" in undergrad, they'd look at you like you had three heads.

Like I said, I'm not speaking of every college major, but some are way more difficult than any material in medical school. It's true that there is a larger volume of material in med school, but it has required way less time and effort for me to stay an average-above average med student than it did for me to stay an average-above average student in my major.

 

[Top Gun]

A lot of college majors are much more difficult that the material in medical school. Med school is easy. It is rote memorization and regurgitation. Almost any can do that. Pikeville and other medical schools with extremely subpar students are evidence of this.

I kind of think this is true to a certain extent. I actually did better in my med school classes than in my college ones. Plus, as a premed, you're required to take courses like physics and analytical chemistry, which I couldn't give two $*#s about. In med school, I was taking classes that were much more interesting, because they were more related to what I wanted to do.

 

[username456789]

I kind of think this is true to a certain extent. I actually did better in my med school classes than in my college ones. Plus, as a premed, you're required to take courses like physics and analytical chemistry, which I couldn't give two $*#s about. In med school, I was taking classes that were much more interesting, because they were more related to what I wanted to do.

But by definition, that is the exception and not the rule. Most people come into medical school having been close to the top of their class, and never sniff the top of their class in medical school. That is just how it goes, since you're distilling it down to a more and more "competitive" field of people.

 

[illegallysmooth]

I kind of think this is true to a certain extent. I actually did better in my med school classes than in my college ones. Plus, as a premed, you're required to take courses like physics and analytical chemistry, which I couldn't give two $*#s about. In med school, I was taking classes that were much more interesting, because they were more related to what I wanted to do.

 

[45408]

A lot of college majors are much more difficult that the material in medical school. Med school is easy. It is rote memorization and regurgitation. Almost any can do that. Pikeville and other medical schools with extremely subpar students are evidence of this.

You're not synthesizing new methods and techniques, but even Step 1 requires thinking through several levels. It's not like filling out a test where you have to list all the countries and their capitals. Rote memorization is a spelling test, which even SDNers have shown that they wouldn't necessarily do well on. I'm sure the plummer could do it.

it has required way less time and effort for me to stay an average-above average med student than it did for me to stay an average-above average student in my major.

What did all of those above average students in your major go on to do?

 

[Perrotfish]

But by definition, that is the exception and not the rule. Most people come into medical school having been close to the top of their class, and never sniff the top of their class in medical school. That is just how it goes, since you're distilling it down to a more and more "competitive" field of people.

To some extent its a rule because medical school selects for people who are at the top of their class, which means that most people who managed an acceptance come disporprtionately from undergrad expereiences heavy on grade inflation. I was on the border of failing out of my undergrad, and I was mostly an an above average medical school student. I didn't work harder in med school, I didn't change my study style, it was just easier. However it took an extra year and a lot of luck for me to get in in the first place, because they just don't let people in with GPAs as low as mine. I know several engineers who wanted to switch into premed that were basically screwed before they even started because the avergae GPA is so low in engineering and they had accumulated so many credits. They're all still engineers.

 

[C O M 2014]

But by definition, that is the exception and not the rule. Most people come into medical school having been close to the top of their class, and never sniff the top of their class in medical school. That is just how it goes, since you're distilling it down to a more and more "competitive" field of people.

That's because most people in med school majored in biology or some other easy major. Math/physics majors are few and far between.

 

[username456789]

That's because most people in med school majored in biology or some other easy major. Math/physics majors are few and far between.

Oh good, let's turn this into a sobfest about how engineers and physics majors are the most persecuted people in the med school process.

 

[Perrotfish]

Oh good, let's turn this into a sobfest about how engineers and physics majors are the most persecuted people in the med school process.

I don't know what you're getting touchy about. The system is what it is and some schools/majors have lower average GPAs than others. No one is sobbing, or making excuses about why they can't get accepted, you're talking to medical students and residents.

For whatever reason medical school likes to take people who were, until medical school, a big fish in a small pond. During first year I was amazed at how many of my classmates were reeling from the fact that they couldn't go drinking on a Tuesday night, or that they were meerely in the middle of the pack come exam time. That's how I had felt for all of undergrad. Employers seem to be able to figure out that a 3.0 student from certain schools/majors is worth several times what a student with a 3.8 from a different school/major is worth, but medical schools don't seem to be capable of making the distinction.

 

[beeitchness]

That's because most people in med school majored in biology or some other easy major. Math/physics majors are few and far between.

Those majoring in physical sciences (such as biochem, chem, physics, biomed eng, chem eng) have a higher acceptance rate than those majoring in biological sciences..

 

[MilkmanAl]

Employers seem to be able to figure out that a 3.0 student from certain schools/majors is worth several times what a student with a 3.8 from a different school/major is worth, but medical schools don't seem to be capable of making the distinction.

That fact has always baffled me.

 

[FSU2013]

Oh good, let's turn this into a sobfest about how engineers and physics majors are the most persecuted people in the med school process.

I got my BS in physics and I got a wield vibe from people when I interviewed. It was generally a "wow, people actually do that?" kind of thing.

And yes, I would put my quantum mechanics, theoretical physics or thermodynamics course well above any medical school course for intellectual difficulty, but I worked many fewer hours a week in undergrad.

I think med school might be a little tougher in the beginning for people like me based on previous exposure. I was flipping out in my histo course the first month while everyone else was talking about how they loved having time to study neuro since histo was a review of undergrad courses. Also, I didn't really "learn anything" in undergrad. I learned how to think through problems and how to manipulate equations, but I could write the number of facts I learned on a 3x5 card (shoot, most of the physics equations were even given to us in our higher level courses). I was proud of the fact that i never actually memorized anything - it was almost a badge of honor. In the long run, I think physics, engineering, etc majors are going to do better in med school because, although we are not initially accustomed to memorization, we are taught to analytically process information much more than our peers from the biological sciences.

 

[45408]

That's because most people in med school majored in biology or some other easy major. Math/physics majors are few and far between.

Not at all subtle bragging post.

Is biology harder than chemistry, physics or engineering? No. It was certainly harder than most of the other majors though. It wasn't exactly underwater basket weaving.

I wouldn't argue that undergrad biology is mostly memorization though. I had a few classes (entomology being the worst offender) that were solely memorization of lists.

 

[Mass Effect]

A lot of college majors are much more difficult that the material in medical school. Med school is easy. It is rote memorization and regurgitation. Almost any can do that. Pikeville and other medical schools with extremely subpar students are evidence of this.

When you make generalizations, you're often wrong. The vast majority of exam questions at my school tested concepts with clinical vignettes. Very few questions were rote memorization/regurgitation.

 

[Mass Effect]

I kind of think this is true to a certain extent. I actually did better in my med school classes than in my college ones. Plus, as a premed, you're required to take courses like physics and analytical chemistry, which I couldn't give two $*#s about. In med school, I was taking classes that were much more interesting, because they were more related to what I wanted to do.

That has nothing to do with the difficulty of med school versus undergrad. That's just what you prefer. Also, when I applied to med school (I'm in the C/O 2014), there was no requirement for analytical chemistry. It was general chem and organic chem.

 

[rocketbooster]

None of the majors listed are harder than med school. No major period is harder than med school. I measure difficulty based on how much studying is required. Med school requires 10x more studying than any major.

I was a bio major and took the engineering physics and many extra math classes since I always liked math. Didn't major in math bc nothing sounded more useless than a math major haha. Math/physics was about understanding, which I learned mainly from class and doing a few homework problems. Didn't require that much work to get As on tests. I had to study way more for just undergrad bio tho since it's mainly memorization with some understanding mixed in.

The difficulty level of the content in med school is equal to upper level college bio courses, but the sheer volume makes it way harder.

 

[amine2086]

Easy there, Guillemot. You sound a lot like Dr. Sheldon Cooper.

 

[Top Gun]

That has nothing to do with the difficulty of med school versus undergrad. That's just what you prefer. Also, when I applied to med school (I'm in the C/O 2014), there was no requirement for analytical chemistry. It was general chem and organic chem.

Analytical chem was our version of general chem. Also, my major was bio, and bio came pretty easy to me. Med school classes are by-and-large biology based, and that may have been a reason I found med school classes easier, besides it being more related to what I wanted to do. Sure, there's a larger volume of material to study, but the concepts are very easy to understand.

 

[The kitchen sink]

LOL give me a break. You have jack **** over anyone else in terms of evaluating people. How you judge people is based on what you value in others. Sorry to break it to you but every other attending will have a different idea about whats important in an clinician.

If you look at the AOA in my class you will see an overwhelming majority are white and outspoken. Yes they aren't all jocks or beauty queens but there are sure a lot of them. Even if we ignore the fact that quiet students are at an disadvantage, just look at the study done by APAMSA, you will see that blacks, hispanics, asians all receive inferior clinical grades relative to whites. That is a statistical fact and it is a product of an subjective grading system. At least the shelf exam is a reflection of the effort you put into studying. Third year grades is a reflection of ass kissing and pretending to know ****.

" Most of us soared through college without having to try too hard"

Sorry to break it to you but medical school is not hard compared to college. Being a doctor is like being a glorified plummer. I have yet to be challenged intellectually by any of the subjects. You memorize, regurgitate and pretend to be smart. "Clinical skills" is just another word the crap "I pull out of my ass to not look stupid." I have had attending that hand out percocet for sore throats because of "clinical judgement" and another attending who treat meningitis outpatient with 2nd gen cephalosporins because "based on my experience it tastes better". The sooner we realize that third year grades is a load of crap, the faster we will change the way medical students are taught.

Ive only finished my first week of rotations in my first rotation ever (surgery) but I have a feeling that this guy is right.

 

[C O M 2014]

I was a bio major...didn't major in math bc nothing sounded more useless

Sounds completely backwards.

The difficulty level of the content in med school is equal to upper level college bio courses, but the sheer volume makes it way harder.

Our undergrad experiences sound very different. Coming to med school was like a vacation for me. Stay home for a month watching tv all day then start studying a couple days before block exams and do fine? Wow. You can't really do that when you're taking 20 hours of hard sciences.

 

[StephenMaturin]

If you want to talk about a dumb evaluator, one of my classmates just finished a rotation with an FNP. The preceptor had previously tried to get into med school but failed because of a low GPA and dismal MCAT score. Gave up and joined an 18 month FNP program. Never worked as an RN. Graduated less than a year ago and is now working solo in a peds clinic. Dude had some stories of how much really basic stuff that this NP doesn't know, really scary that this person has a prescription pad. So basically this NP was one of our college peers who didn't have what it took for med school but somehow leapfrogged us and is now writing evaluations for her intellectual superiors. My classmate is a better person than I. I don't think I could put up with that.

Holy crap, what school do you go to that you rotate under NPs? It's hard to believe that gets accreditation.

 

[C O M 2014]

Holy crap, what school do you go to that you rotate under NPs? It's hard to believe that gets accreditation.

It's under an MD on paper, but the doctor went on vacation for a month and then had to cover for another dude for a few weeks. The dr has 3 or 4 clinics that are largely run by NPs anyway, so worked continued as normal I guess.

 

[VisionaryTics]

It's under an MD on paper, but the doctor went on vacation for a month and then had to cover for another dude for a few weeks. The dr has 3 or 4 clinics that are largely run by NPs anyway, so worked continued as normal I guess.

Aside from the fact that you're learning to be an MD, not an NP.

 

[Rockytop00]

I think the problem with malignant residents/attendings is most likely a result of them going from college directly into medicine and directly into residency. They have no life experience out side of medicine, and didn't spend a few years as a corporate underling to some hot shot banker, or some hard-ass president of a corporation. I think these folks go from immature college kid, to immature med student, to immature resident, to malignant attending.

It's poor socialization.

I grin and bear it when I come across these people. So far I've seen more than I've expected to... hopefully life will be better when I get off this surgery rotation.

 

[OveractiveBrain]

Is biology harder than chemistry, physics or engineering? No. It was certainly harder than most of the other majors though. It wasn't exactly underwater basket weaving.

That actually sounds rrrrrrrealy hard. I suppose if it were your major, you probably got a lot of practice in doing it, but still. Plumbing, er... i mean plumming... not so tough. I have enough trouble trying to weave baskets on dry land, cant even imagine doing it underwater.

 

[OveractiveBrain]

Sounds completely backwards.



Our undergrad experiences sound very different. Coming to med school was like a vacation for me. Stay home for a month watching tv all day then start studying a couple days before block exams and do fine? Wow. You can't really do that when you're taking 20 hours of hard sciences.

More importantly than underwater basket weaving is the erroneous perception of the basic science curriculum. If your goal in life is "derm, cause d00d, the hours are great and the pay is AWESOME!" maybe all you need out of medical school is the H. But if you went to medical school to become a doctor, to make decisions, and to make a difference in someone's life, then everything matters. Ok... not the Kreb cycle, but you'll get what i mean in a minute.

The thing that separates the average doctors (who serve a purpose, providing the standard of care for the standard 80% of people) and the excellent physicians is understanding. We have set up our health care system such that peasant monkies can practice decent health care. Click the "chest pain" template in CPRS, and it tells you which buttons to click. Click the "chest pain" premade order in EPIC, and bam, patient is admitted. No thought at all. Even without our system, most people can do pretty well for most patients by just following algorithms and wrote memorization. And, from a population perspective, it works. Most people, most of the time, get what they need.

But I, personally, didn't go into medicine for a good gig. I could have gone to wall street (and probably kept my job with the economic fallout). I could have started an internet company (wish I had... my college roommate just sold for 60 million). I could have been a fire fighter on a beach (actually had the job offered to me). But instead, I came to medicine. I came to medicine because I knew there would be a reward. A reward that wouldnt make my pockets full (im 200,000 in debt), that wouldnt be worth the cost to my life for just a job (I lost my 20s), but a reward that would be deep in my soul. The reward is doing good while doing great.

What about the 20% of people that don't fit a prefilled template, or an order sheet? What about what happens when two separate conditions are present at the same time. The wrote memorizers, the machines, the inhuman robots that do very well on tests can't process change or complexity. That's where true clinical reasoning comes into play. Its why the first two years require more than just "cramming for the test." If you don't understand it, you can't build on it, so everything just sounds like memorization and guideline reading.

That being said, I am dissapointed by some of the people I call my colleagues. Because medicine is perceived as automaton regurgitation, it is selecting for the machines. we do it with the SAT, the MCAT and the USMLE. You are rewarded for the amount of detail you can recall, and only moderately tested on clinical reasoning (vignettes try, but still select for people good a MC test taking). True brilliance goes elsewhere. It goes into finance, because the financial payback is so short. It goes into free enterprise because the emotional reward is so great; internet startups, cheap energy for third world countries, etc. Or, it goes where it can be truly appreciated, into academia.

In any case, some people who evaluate students shouldn't being doing the evaluating (see my posts previously). Some people who are smart lack the ability to play as a team, or play the leadership role, and should be evaluated poorly. Humans are human, so it doesn't hurt to kiss up to your resident (unless its me, in which case I tell you that you are kissing up, and it hurts you). Being angry, blaming everything else but yourself, and not knowing how to spell (damn! I get hit by this one all the time), doesnt help anyone!

 

[colbgw02]

I could have been a fire fighter on a beach (actually had the job offered to me).

That sounds awesome. Most fires taken care of my high tide. Very little dry wood around. Essentially endless supply of water. I think you made the wrong choice.

 

[45408]

Our undergrad experiences sound very different. Coming to med school was like a vacation for me. Stay home for a month watching tv all day then start studying a couple days before block exams and do fine? Wow. You can't really do that when you're taking 20 hours of hard sciences.

Out med school experiences sound very different. Most of the rest of us had to study more than a few days per month.

 

[Lolscan]

Link to said study? And do you think you would you have been AOA if you were white?

And you're saying college is harder than med school?

Your post is the perfect example of "the plural of anecdotes is not data." I've never seen clinical "maneuvers" like you're citing, and they are most certainly not representative of the clinical abilities of the physicians I work with. You mentioned that you did your rotations at a place you would never go back to:

Ugh learn to use google. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574397/

Yes college was harder at UCs because it was graded and it took actual thinking to process organic chemistory, physics etc...

I am glad you have nothing better to do than waste your time going through my post history. FYI again, I never said I would have gotten AOA if I were white. My post was about, has anyone else gotten **** because they couldn't not be physically recognized (which is a bare minimum for being evaluation IMO). If you aren't asian, then you would never understand the feeling and anger associated with being deindividualized and perceived as a perpetual foreigner. I don't expect you grasp anything associated with those posts. And yes racism exists and white privilege is awesome.

 

[Lolscan]

Let me start by saying 2 things:
1) I realize undergrad GPA and mcat scores don't correlate linearly with med school performance, but, even still, this is an objective way to look at things.
2) I'm not racist, so don't wast your breath saying anything of the sort.

Based on objective data, students who are accepted to medical school who are white have significantly higher GPA and mcat scores than African Americans, Hispanics and native Americans.

Whites have a 74% acceptance rate with a GPA of 3.6-3.8 and mcat of 30-32 - a pretty strong app
The aggregate of AA, Hispanics and native Americans have a 74% chance of acceptance with a GPA of 3.4-3.6 and mcat of 27-29.

Whites have only a 12% acceptance rate with 3.2-3.4 and 24-26; AA, H and NA have a
50% chance of admission.

Again, I'm not saying anything derogatory about people of different races, but if they are accepted at higher rates and not matched accordingly, it would not be surprising if they recieve lower scores in med school.

Ok, someone can call me a racist now.....

https://www.aamc.org/download/157958/data/table25-mcatgpa-grid-white-0911.pdf
https://www.aamc.org/download/157590/data/table25-hbn-mcatgpa-grid-3race.pdf

I understand your point however, Asian american have comparable undergrad scores and GPAs to white. Whereas hispianics and AA traditionally had lower scores. Yet as a group and individually, all the minorities do much poorer in terms of clinical grades. There is also the problem with legacy admission as well.

Also you can't look at admission rates, since most medical schools employ quotas as well.

 

[OveractiveBrain]

Ugh learn to use google. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574397/

Yes college was harder at UCs because it was graded and it took actual thinking to process organic chemistory, physics etc...

I am glad you have nothing better to do than waste your time going through my post history. FYI again, I never said I would have gotten AOA if I were white. My post was about, has anyone else gotten **** because they couldn't not be physically recognized (which is a bare minimum for being evaluation IMO). If you aren't asian, then you would never understand the feeling and anger associated with being deindividualized and perceived as a perpetual foreigner. I don't expect you grasp anything associated with those posts. And yes racism exists and white privilege is awesome.

Jackie Chan was on my medicine team... Twice! It was awesome. I don't think Tae Diggs is very good at medicine, though, I've seen him at least once a month for the past two years, and always with a short white coat on! Amazing how he can work on two separate teams at once...

 

[Lolscan]

Jackie Chan was on my medicine team... Twice! It was awesome. I don't think Tae Diggs is very good at medicine, though, I've seen him at least once a month for the past two years, and always with a short white coat on! Amazing how he can work on two separate teams at once...

Nice! Ethan hawke is always on my team as well!

 

[sanityonleave]

... everything lolscan has posted...

And I thought Shnurek was the most intentionally asinine poster on SDN... Lolscan, congrats on stealing away his crown.

Sucks that you got crappy clinical grades. I'm sure it had absolutely nothing to do with your holier-than-though attitude and everything to do with the fact that your residents/attendings are racist against Asian folks.

 

[Lolscan]

And I thought Shnurek was the most intentionally asinine poster on SDN... Lolscan, congrats on stealing away his crown.

Sucks that you got crappy clinical grades. I'm sure it had absolutely nothing to do with your holier-than-though attitude and everything to do with the fact that your residents/attendings are racist against Asian folks.

Again my grades are completely fine. I was merely reflecting on the ignorance in the hospital outside of boston ON A SEPARATE THREAD. Yeah I am completely asinine since I am the only person that actually cite evidence that clinical grades aren't what they are cut out to be.

Now Mr.Alabama, If you and theprowler want to get into a discussion on cultural dynamics within the hospital then post on my other thread. Otherwise post actual evidence to back up you are somehow have the magic power to perfectly grade everyone.

 

[SLUser11]

Ugh learn to use google. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574397/ .........

Yeah I am completely asinine since I am the only person that actually cite evidence that clinical grades aren't what they are cut out to be.

Now Mr.Alabama, If you and theprowler want to get into a discussion on cultural dynamics within the hospital then post on my other thread. Otherwise post actual evidence to back up you are somehow have the magic power to perfectly grade everyone.

There are so many problems with the paper you quoted that I don’t know where to start. I guess I’ll start by saying you aren’t really “citing the evidence” as well as you’ve implied.

First of all, this is a low-quality paper by design because it is an anonymous online survey study with self-reporting of scores, race, and personality traits. The fact that it is anonymous prevents any fact checking from being performed. The fact that it’s self-reported data allows for significant deviation from the truth, and how students perceive themselves is often nothing like how they are perceived by their evaluators.

Looking at the response rate, it is almost 2400 students from 101 schools, but this really means that only 20-30 students from any given class really responded. This means there is potential for severe reporter bias. People wanting to brag or people wanting to complain are possibly more likely to respond to such a study. I was offered to participate in that study during my 4th year of med school, but I deleted the email because I didn’t feel like filling it out….certainly other 4th year students had a similar disinterest. Also, only 57.8% of the responders offered “unique codes and contact information,” so there’s no way to know if one student entered multiple accounts, etc.

The students with grades of “D or F” were excluded, as were students from osteopathic or foreign schools….16% of respondents didn’t even report which grading system was used at their school.

42.7% of respondents were still in their second or third year, and the study only required the completion of a single clerkship to participate in the survey, once again contributing to possible bias. Many of these respondents had not experienced enough clerkships to give a response that could applicable to clerkships in general.

In addition, we know nothing of the objective baseline characteristics of the survey respondents. We don’t know their MCAT or USMLE scores, or if those scores correlate with their clinical performance. We also know nothing of their performance during the first 2 years of medical school, so we can’t see if their academic success has changed with the 3rd year’s “subjective evaluations.” I’d be interested to see how different or similar the results would be if MS2’s were polled. Certainly perceiving yourself as assertive may affect study habits and preclinical performance.

We also don’t know the percent of emphasis placed on clinical evaluations and shelf scores to determine clerkship grades at these different schools. Ultimately, we have no idea how different things were weighted to determine a grade, and so we can’t discover how evaluations factored in. We all know that this varies at different institutions.

As for the determination of assertiveness or reticence, the questionnaire was created by the author after “informal discussions” with students and “extensive review of the literature.” That means it was not a validated instrument.


Where are the Indians? Seriously, where are the Indians in this study?


And, my biggest problem with the study: The ratio of highest grade (A/Honors) to lowest grade (HP/Pass/B/C) does not represent the national average (e.g. IM was 482:796, Surgery 467:798, OBGYN 452:808). This means the students who responded to this survey had higher grades (self-reported, of course) than an average cohort. This is major sample bias.


Now, let’s look at some actually objective information, since that is what you supposedly crave. All of this, BTW, was mentioned in the paper that you read…I mean, there’s no way you just read the abstract.

This one shows that whites score better than Asian-Americans on NBME exams.


This one controls for MCATs and GPAs, and still finds that white students score better than Asians on NBME and USMLE exams.


This study shows Asians are out-performed in Europe as well.

....I think you are mad at the wrong people. It's really the people who designed the USMLE that are racist against Asians.

Now, I don't believe for a second that Asian medical students are less intelligent or inferior in any way to their non-Asian classmates. The best student hands I've ever seen in the OR belonged to a Chinese student, and the most intelligent and academically accomplished student I ever had was Korean. The worst hands and worst brain belonged to the same student, and he was super super white.

However, I don't think you can use the available evidence to support a theory that Asians suffer from poor grades due to discrimination. The paper you cited is not designed to make those conclusions.

 

[Lolscan]

There are so many problems with the paper you quoted that I don't know where to start. I guess I'll start by saying you aren't really "citing the evidence" as well as you've implied.

First of all, this is a low-quality paper by design because it is an anonymous online survey study with self-reporting of scores, race, and personality traits. The fact that it is anonymous prevents any fact checking from being performed. The fact that it's self-reported data allows for significant deviation from the truth, and how students perceive themselves is often nothing like how they are perceived by their evaluators.

Looking at the response rate, it is almost 2400 students from 101 schools, but this really means that only 20-30 students from any given class really responded. This means there is potential for severe reporter bias. People wanting to brag or people wanting to complain are possibly more likely to respond to such a study. I was offered to participate in that study during my 4th year of med school, but I deleted the email because I didn't feel like filling it out….certainly other 4th year students had a similar disinterest. Also, only 57.8% of the responders offered "unique codes and contact information," so there's no way to know if one student entered multiple accounts, etc.

The students with grades of "D or F" were excluded, as were students from osteopathic or foreign schools….16% of respondents didn't even report which grading system was used at their school.

42.7% of respondents were still in their second or third year, and the study only required the completion of a single clerkship to participate in the survey, once again contributing to possible bias. Many of these respondents had not experienced enough clerkships to give a response that could applicable to clerkships in general.

In addition, we know nothing of the objective baseline characteristics of the survey respondents. We don't know their MCAT or USMLE scores, or if those scores correlate with their clinical performance. We also know nothing of their performance during the first 2 years of medical school, so we can't see if their academic success has changed with the 3rd year's "subjective evaluations." I'd be interested to see how different or similar the results would be if MS2's were polled. Certainly perceiving yourself as assertive may affect study habits and preclinical performance.

We also don't know the percent of emphasis placed on clinical evaluations and shelf scores to determine clerkship grades at these different schools. Ultimately, we have no idea how different things were weighted to determine a grade, and so we can't discover how evaluations factored in. We all know that this varies at different institutions.

As for the determination of assertiveness or reticence, the questionnaire was created by the author after "informal discussions" with students and "extensive review of the literature." That means it was not a validated instrument.


Where are the Indians? Seriously, where are the Indians in this study?


And, my biggest problem with the study: The ratio of highest grade (A/Honors) to lowest grade (HP/Pass/B/C) does not represent the national average (e.g. IM was 482:796, Surgery 467:798, OBGYN 452:808). This means the students who responded to this survey had higher grades (self-reported, of course) than an average cohort. This is major sample bias.


Now, let's look at some actually objective information, since that is what you supposedly crave. All of this, BTW, was mentioned in the paper that you read…I mean, there's no way you just read the abstract.

This one shows that whites score better than Asian-Americans on NBME exams.


This one controls for MCATs and GPAs, and still finds that white students score better than Asians on NBME and USMLE exams.


This study shows Asians are out-performed in Europe as well.

....I think you are mad at the wrong people. It's really the people who designed the USMLE that are racist against Asians.

Now, I don't believe for a second that Asian medical students are less intelligent or inferior in any way to their non-Asian classmates. The best student hands I've ever seen in the OR belonged to a Chinese student, and the most intelligent and academically accomplished student I ever had was Korean. The worst hands and worst brain belonged to the same student, and he was super super white.

However, I don't think you can use the available evidence to support a theory that Asians suffer from poor grades due to discrimination. The paper you cited is not designed to make those conclusions.

You make great points. I agree it was survey and the study isn't perfect. But honestly there are problems with every single study but it does not mean that the conclusions aren't valid whatsoever. Yes the study doesn't cite racism as the cause of lower grades but it does show a certain relationships. You know as well as I do that medical schools would NEVER release students grades nor will they ever release their step 1 scores. Every survey you find can have reporter bias, sample bias, etc and you can nit pick about baseline characteristics and what the studies should have included all day long. At the end of the day the quality of the survey can be debated. But until the medical schools release the grades, this is the best you have. If you want to do an prospective or RCT study on grades then by all means go ahead and prove me wrong.

I am glad you brought up those other studies. Should I pick them apart too? Because I can certainly bash on them all day to prove MY point. I want to have a discussion with you about the the study and address each point you made about the study. But this ought to be over PM as it will be quite long winded.

 

[SLUser11]

I am glad you brought up those other studies. Should I pick them apart too? Because I can certainly bash on them all day to prove MY point.

You certainly could, but you would unintentionally prove my point instead. My point is that anyone with a little knowledge of the literature can find some BS studies to support his/her bias....and then selectively ignore literature that argues against that bias.

In my chosen field, we say that a surgeon uses a the literature much like a drunk uses a lamp post: more for support than illumination.

I believe that discrimination is very prevalent in medicine. However, I don't think that Asian-Americans are getting the worst of it. There is discrimination against foreign doctors with English as a second language, there is discrimination against DOs and IMGs, and there is discrimination against women. Most of us whities are afraid to be openly discriminatory against Asians because we assume you all know karate.

As for grades, I believe that strong students of all races and backgrounds consistently get good evaluations and good grades. My AOA class certainly wasn't full of quarterbacks and homecoming queens.

I've already mentioned in my previous post how I think students cope with disappointment, and I think this coping mechanism is more prevalent than racism and unfair grading.

Anyway, I'm getting too old and boring to get into big SDN arguments. Five or six years ago I would have loved it, but now it seems exhausting. Please don't have hard feelings about me using you to illustrate my points. It's okay to be upset about the subjectivity of third-year grading....but I don't think anyone has suggested a better method so far, and I certainly don't think grades should be based entirely on a multiple-choice test.