Unfair Grading in 3rd year?

[pigglewiggle]

So...I need advice about whether or not to appeal a grade. I did really well on the shelf and on an in-house exam but then out of the blue got a poor clinical evaluation. 1 line was written about me and I was given a pass overall. My preceptor happens to be the course director so I met with her and she said that she thought I was just a pass student so that is what she gave me. She couldn't cite any specific examples and said that several people graded me (a lie I think) but then said she would have to email them and find out what there comments were and get back to me. I can appeal to the chair of the dept if I want but I am hesitant to make a big deal of all of this although I find it totally unjust. Do you think it is worth pursuing or should I just chalk it up to 3rd year subjectivity. I am so mad though that I can't seem to let it go because I am worried that it is going to affect my chances for residency, blah blah blah (

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[BigRedBeta]

If you can point to aspects of your care where you feel like you exceeded expectations of a third year student, then it's possible. However, you have to realize that knowledge by itself does not equal good M3, does not equal good intern, does not equal good resident, and certainly doesn't equal good attending.

If you were simply at the same level as everyone else, then there's nothing you can do except make changes for the next rotation.

 

[cpants]

Unfortunately an appeal is unlikely to be successful. You will need people to go to bat for you, like other attendings type people, and that's probably not gonna happen. You may have gotten the screw job here. Alternatively, you may just be a pass student. No comments is certainly unacceptable, and I would reapproach this clerkship director with a different attitude. Yes I'm upset about the grade, but I'm more upset that I was only considered an average student. I want to exceed expectations, and I need your feedback to improve.

 

[jackieMD2007]

. Alternatively, you may just be a pass student. No comments is certainly unacceptable, and I would reapproach this clerkship director with a different attitude. Yes I'm upset about the grade, but I'm more upset that I was only considered an average student. I want to exceed expectations, and I need your feedback to improve.

Here's the deal: everyone in medical school who is moving forward and passing things and meeting expectations is a "pass" student. Not everyone can get high pass or honors every clerkship. Just because you did great on 1 or 2 aspects of the clerkship does NOT entitle you to get a certain grade. People need to get over the "I'm entitled to an A" attitude all the time.

At our school anyway, the MAJORITY of persons "PASS" a clerkship and a MINORITY of persons "HP" or "H" the clerkship and there are specific departmental grading and policies for each.

I agree with the above poster that you should seek feedback about how to improve your clinical performance but NOT from a grading standpoint!

I know that it is really hard on the old ego and on the old self-esteem to not be "special" among a group of peers. Resist the immature temptation to assume that "the grading's unfair" or that you are "getting screwed" when really, you performed just like everyone else. And, for the record, "everyone else" comprises those OTHER talented and VERY BRIGHT and VERY HARD WORKING people you go to school with.

 

[ZagDoc]

Welcome the third year. I got screwed on my surgery grade by an eval from an attending I scrubbed with once.

 

[SouthernSurgeon]

I know that it is really hard on the old ego and on the old self-esteem to not be "special" among a group of peers. Resist the immature temptation to assume that "the grading's unfair" or that you are "getting screwed" when really, you performed just like everyone else. And, for the record, "everyone else" comprises those OTHER talented and VERY BRIGHT and VERY HARD WORKING people you go to school with.

Agree. It isn't necessarily an "unfair" grade; just a lower grade than the OP hoped for.

 

[Deferoxamine]

piggle,

Unfortunately, as you will see and probably begin to hear about from classmates, most rotations have a sometimes unexplainable bias against handing out H or HP on the first rotation. I think a lot of times they want to truly reflect that a student just isn't at their 3rd year peak yet, and they'll more liberally give out HP and H later in the year.

Strange, but not much we as students can do about it. Agree with the above advice - go schedule a meeting with the course director - make it clear from the beginning that it is NOT a grade complaint or a request for a regrade (they love this); but tell them straight up that it's different from what you expected and that you'd like to know how to improve so that you don't make the same mistakes again.

Again, AVOID the complainer's angle on this - schools sometimes have a funny internal way of keeping track of chronic troublemakers and whiners.

 

[SGuttenberg]

This whole system is just absolutely idiotic. If you get a 90th percentile+ on your subject exam you deserve at least high pass plain and simple because OBJECTIVELY you know your stuff. Throw in a few brief clinical skills simulated patient encounter for 10% of your grade and that should be it. How many of us are going to be ob/gyns or surgeons anyway?

I'm tired of seeing ******ed shmucks get good evals and 50th percentiles on subjects getting good grades. How do you get a good eval? Being socialble and likable, no need to have great clinical knowledge. Just making alot of bs smalltalk w/ residents/attendings and feigning interest gets you better grades. This is a HUGE problem because no two attendings/residents will rate someone the same way and alot of them make idiotic summary decisions filling out evals.

I'd rather go to an knowledgeable careful doctor (who probably got bad evals) than a ***** jock doctor (who probably got good evals).

 

[PharmaTope]

i would talk to the person taht did your grading and ask for specific comments.

STRESS that you want to do the BEST you can for patients and be fully prepared for any case.

i would also show some humility because frankly a lot of people get off on power trips.

say you know you are very "green" in this process and learning; however you are very dedicated not for yourself but for mankind kinda stuff.

also say how you studied frequently and you want to improve. ask specifically, how can i improve? what things can improve upon? is it my speed (that comes with experience).

also ask what determines a pass vs high pass student to them. some people just have no reasoning. fighting grades never works in students favor (sometimes but RARELY). too much politics involved.

 

[go lakers]

Welcome the third year. I got screwed on my surgery grade by an eval from an attending I scrubbed with once.

 

[dantt]

I am in a similar situation and did a formal appeal (wrote to the site director and copied the clerkship director) with no response, not even acknowledgment of receipt. Any thoughts on how to proceed? Like the OP, I was assed out of a grade except by particularly malignant and unprofessional midlevels, everybody else gave me excellent evaluations.

 

[BigRedBeta]

This whole system is just absolutely idiotic. If you get a 90th percentile+ on your subject exam you deserve at least high pass plain and simple because OBJECTIVELY you know your stuff. Throw in a few brief clinical skills simulated patient encounter for 10% of your grade and that should be it. How many of us are going to be ob/gyns or surgeons anyway?

I'm tired of seeing ******ed shmucks get good evals and 50th percentiles on subjects getting good grades. How do you get a good eval? Being socialble and likable, no need to have great clinical knowledge. Just making alot of bs smalltalk w/ residents/attendings and feigning interest gets you better grades. This is a HUGE problem because no two attendings/residents will rate someone the same way and alot of them make idiotic summary decisions filling out evals.

I'd rather go to an knowledgeable careful doctor (who probably got bad evals) than a ***** jock doctor (who probably got good evals).

There's far more that goes into an eval than this. Until you've done the eval, it's certainly easy to think that this is what matters. Certainly being likable is helpful, but every eval form I've seen (from my own medical school, from a 4th year away rotation and now as a resident at a 3rd different medical school) has very specific areas to evaluate and rate. While clinical knowledge is important, it's NOT ANYWHERE close to 90% of what matters as a clinician. Junior medical students do need to be evaluated on their ability to take an accurate history, to elicit and notice important - sometimes subtle - physical exam signs, to create a cohesive, easy-to-follow presentation, to develop a logical, reasonable and appropriate treatement plan, and to play nice with ancillary staff. These are skills that extend beyond the boundaries of any one particular specialty.

Yes there is subjectivity, just like there is subjectivity of how patients perceive you.

 

[Perrotfish]

There's far more that goes into an eval than this. Until you've done the eval, it's certainly easy to think that this is what matters. Certainly being likable is helpful, but every eval form I've seen (from my own medical school, from a 4th year away rotation and now as a resident at a 3rd different medical school) has very specific areas to evaluate and rate. While clinical knowledge is important, it's NOT ANYWHERE close to 90% of what matters as a clinician. Junior medical students do need to be evaluated on their ability to take an accurate history, to elicit and notice important - sometimes subtle - physical exam signs, to create a cohesive, easy-to-follow presentation, to develop a logical, reasonable and appropriate treatement plan, and to play nice with ancillary staff. These are skills that extend beyond the boundaries of any one particular specialty.

Yes there is subjectivity, just like there is subjectivity of how patients perceive you.

Yeah, but... horse****. The subtle evaluation of our clinical reasoning skills that everyone keeps telling me about always gives the HPs and Honors to kissasses and hot women. Also considering that I can very rarely get an attending to remember my name or any specific thing I've done I have a hard time believing they're carefully evaluating me in dozens of areas. This is less complicated than you're making it.

 

[PharmaTope]

Yeah, but... horse****. The subtle evaluation of our clinical reasoning skills that everyone keeps telling me about always gives the HPs and Honors to kissasses and hot women. Also considering that I can very rarely get an attending to remember my name or any specific thing I've done I have a hard time believing they're carefully evaluating me in dozens of areas. This is less complicated than you're making it.

i gotta agree with you here. i saw some real slutty people HP and HONOR stuff. it was insanity to see these people skate by with minimal effort....

btw, the girl slept with 2 attendings

 

[jackieMD2007]

i gotta agree with you here. i saw some real slutty people HP and HONOR stuff. it was insanity to see these people skate by with minimal effort....

btw, the girl slept with 2 attendings

1-You don't know what people's final grades are for sure, do you?
2-I guess it is easier on your ego to believe that people sleep their way to the top rather than outperform you.

I'm sure there are occasional, rare instances where this is the case but I doubt you could confirm it even if it was true. The sort of people that attend most good medical schools don't need to sleep with other people to get good grades.

 

[aa62]

i gotta agree with you here. i saw some real slutty people HP and HONOR stuff. it was insanity to see these people skate by with minimal effort....

btw, the girl slept with 2 attendings

can't wait til I'm an attending

The sort of people that attend most good medical schools don't need to sleep with other people to get good grades.

damn

 

[SGuttenberg]

Guys this issue isn't just about clerkship evaluations, this is about life! It's a proven fact that good looking people are treated better. It's a proven fact that people rate other people better on supposedly objective measures when they "like" a person. Everyone has their own prejudices to some degree and as much as they believe they are objective their own prejudices influence how they perceive people. Look at the work in sociology or psychology. Hundreds of studies prove this. It's a fact of life. Denying that there is a problem is just delusional. Also attendings are human beings not the gods they perceive themselves to be. They are every bit as prone to rash judgements as anyone else.

Yes grading is (at least somewhat) unfair. Remember that LIFE IS UNFAIR. Anyone can theoretically get honors, but some people will have to work ten times as hard and really play the system to get it. Suck it up and play the game as well as you can with what you were born with. That's all we can do. ...But man inequality/injustice just pisses me off so much.

I think we've hijacked this thread so that's enough out of me.

 

[cartoondoc]

One thing to consider is whether this is a field you're entering as a career. If you got a Pass in ob/gyn and you're going into peds, I wouldn't worry too much about it.

Clinical evaluations are biased not just toward hot girls or kissasses, but also toward people who are just generally more charismatic or outgoing. If you're a quiet, hard worker, you may ace your exams and take good care of your patients, but you might not get as good evaluations. Ultimately, this may translate into what your patients think of you. If you are personable and "connect" with your patients, they are more likely to listen to your medical recommendations and give you repeat business. It's not clear to me, OP, that you're doing anything wrong or if you just got screwed over.

I don't know if you want to keep harassing your clerkship director, even if it's just for "advice." It seems kind of desperate to me. My advice is that when you start your next rotation, ask for frequent feedback from attendings and residents. After all, there are different expectations on each rotation. At the very least, they will appreciate that you're so eager to please.

 

[Perrotfish]

Guys this issue isn't just about clerkship evaluations, this is about life! It's a proven fact that good looking people are treated better. It's a proven fact that people rate other people better on supposedly objective measures when they "like" a person. Everyone has their own prejudices to some degree and as much as they believe they are objective their own prejudices influence how they perceive people. Look at the work in sociology or psychology. Hundreds of studies prove this. It's a fact of life. Denying that there is a problem is just delusional. Also attendings are human beings not the gods they perceive themselves to be. They are every bit as prone to rash judgements as anyone else.

Yes grading is (at least somewhat) unfair. Remember that LIFE IS UNFAIR. Anyone can theoretically get honors, but some people will have to work ten times as hard and really play the system to get it. Suck it up and play the game as well as you can with what you were born with. That's all we can do. ...But man inequality/injustice just pisses me off so much.

I think we've hijacked this thread so that's enough out of me.

See, this isn't nearly as true in the rest of life as it is in education. In life, while people certainly will retain their instincts to favor the attractive people, they have real financial incentives to make sure that they're also rewarding their best producers. In the real world the best emloyees are the ones that make their boss's life easier, either by making them look good on the quarterly report or by not creating a bunch of messes that the boss needs to clean up. And if the employee isn't appreciated they can find a more appreciative employer. As such the boss has a real, tangible reason to reward the good employees even if he/she doesn't actually have a close relationship with them: they need to retain the good people or they will soon find themselves out of a job.

In medicine, though, you're just about useless to your attendings, residents, and you're even mostly useless to your interns. Also even if you do manage to make someone's life easier they still don't have any reason to give you a good eval other than grattitude because there's no hope of retaining you: when the rotation is over you are done, no matter what. That's why standardized, objective measurements are so much more important in academics than in the real world.

 

[VoiceofReason]

ive made peace with the fact that its all basically bull****.

 

[PharmaTope]

1-You don't know what people's final grades are for sure, do you?
2-I guess it is easier on your ego to believe that people sleep their way to the top rather than outperform you.

I'm sure there are occasional, rare instances where this is the case but I doubt you could confirm it even if it was true. The sort of people that attend most good medical schools don't need to sleep with other people to get good grades.

1.) i do know her grades for sure bc i know her and her bf.
she was cheating on her bf with an attending who was married and she admitted it blamed the guy. i saw all the drama unfold.

2.) i didnt even go to that school but i actually know the girl and guy lol so there is no ego thing i just know what went down.

girl slept with an attending before even going to the med school. he was a big shot and she was working in healthcare before going to med school.

dont be a fool, you realize this stuff happens all the time in the hospital especially.

 

[Deferoxamine]

1.) i do know her grades for sure bc i know her and her bf.
she was cheating on her bf with an attending who was married and she admitted it blamed the guy. i saw all the drama unfold.

2.) i didnt even go to that school but i actually know the girl and guy lol so there is no ego thing i just know what went down.

girl slept with an attending before even going to the med school. he was a big shot and she was working in healthcare before going to med school.

dont be a fool, you realize this stuff happens all the time in the hospital especially.

Sorry this is just too funny.

Do yourself a favor and worry about what YOU can control --- yourself.

 

[NAGNAM]

i gotta agree with you here. i saw some real slutty people HP and HONOR stuff. it was insanity to see these people skate by with minimal effort....

btw, the girl slept with 2 attendings

pics or it didn't happen

 

[jackieMD2007]

pics or it didn't happen

 

[DarknightX]

Here's the deal: everyone in medical school who is moving forward and passing things and meeting expectations is a "pass" student. Not everyone can get high pass or honors every clerkship. Just because you did great on 1 or 2 aspects of the clerkship does NOT entitle you to get a certain grade. People need to get over the "I'm entitled to an A" attitude all the time.

At our school anyway, the MAJORITY of persons "PASS" a clerkship and a MINORITY of persons "HP" or "H" the clerkship and there are specific departmental grading and policies for each.

I agree with the above poster that you should seek feedback about how to improve your clinical performance but NOT from a grading standpoint!

I know that it is really hard on the old ego and on the old self-esteem to not be "special" among a group of peers. Resist the immature temptation to assume that "the grading's unfair" or that you are "getting screwed" when really, you performed just like everyone else. And, for the record, "everyone else" comprises those OTHER talented and VERY BRIGHT and VERY HARD WORKING people you go to school with.

Unfortunately, that is not the deal. It has nothing to do with ego or being special, and has everything to do with a system that is fundamentally flawed.

The grading during third year is an absolute joke. Some attendings give everyone a pass, irregardless of their performance, while others give everyone honors. It's based on luck more than anything else. I know for myself, when I got honors, I didn't work any harder or do anything special, I just had an attending who was an easy grader.

This is the problem when you try to give an objective value to something so subjective. The grading in third year is a sham and a fraud, and that the fact you defend it so vehemently makes you sound like a giant tool (don't know if you are or not, but you just sound like it). The immature thing is when evaluators can't take their roles as educators seriously.

 

[Deferoxamine]

Here's the deal: everyone in medical school who is moving forward and passing things and meeting expectations is a "pass" student. Not everyone can get high pass or honors every clerkship. Just because you did great on 1 or 2 aspects of the clerkship does NOT entitle you to get a certain grade. People need to get over the "I'm entitled to an A" attitude all the time.

At our school anyway, the MAJORITY of persons "PASS" a clerkship and a MINORITY of persons "HP" or "H" the clerkship and there are specific departmental grading and policies for each.

I agree with the above poster that you should seek feedback about how to improve your clinical performance but NOT from a grading standpoint!

I know that it is really hard on the old ego and on the old self-esteem to not be "special" among a group of peers. Resist the immature temptation to assume that "the grading's unfair" or that you are "getting screwed" when really, you performed just like everyone else. And, for the record, "everyone else" comprises those OTHER talented and VERY BRIGHT and VERY HARD WORKING people you go to school with.

I like you, semi-newbie Jackie.

Another message to future MS3's: You must assume, at all costs, that your social skills, bedside manner, skills on the phone, etc. are no better than anyone else's. I am fed up with people with inflated social egos walking around thinking they should be getting the highest clinical grades because they are more popular in the class, "have a life", or have more friends. Here's a newsflash: No one cares. Your attendings don't care, your residents don't care, the classmate on your team doesn't care, your patient doesn't care, and the lady that brings lunchtrays to your patients certainly doesn't give a crap.

What this means: Yes, you must bust your ass in other areas if you want to do well. If you're not getting the grades you want, don't complain about it. Fix it the next time. Personally, I got HP after my first 2 months of 3rd year. I didn't sit there and cry that the "system is broken" or blame "the gunners" for my shortcomings.

Sure, I was still disappointed in myself and knew I could do better. So you know what I did? The first day of my next rotation, I GOT OFF MY ASS AND DID SOMETHING ABOUT IT. I drank my caffeine each morning, stepped up my game, brought new energy and enthusiasm, read up on my patients, tried to think one or two steps ahead of my attendings/residents to help them, and absolutely studied my ass off... not to just "do well" on the shelf exam, but to absolutely take a sledgehammer and smash the shelf exam into a million pieces of broken glass. Get into this routine on each rotation, hit your first "Woah" score on a shelf exam - you'll be surprised how addicting it is. Your confidence will start going up, you develop a plan with each rotation, and every 3-12 weeks, you pick up a brand new baseball bat, step up to the plate, and take care of business.

Say what you will, but here's the question: If you're not going to bring your "A"-game to the table in 3rd year, then when the hell do actually plan on bringing it, if at all? KILL IT; otherwise, you. might. not. get. honors.

Basically, stop blaming your grades on your attendings. You have more control over your fate throughout 3rd year than you think - the sooner you realize this, the sooner you will find happiness in 3rd year.

 

[HopefulDoc1984]

I had an attending tell me on the first day of the rotation, "show up on time, be nice to the patients and don't piss off people I work with and you will get an A". Evals are a crapshoot if you ask me. It all depends on the person filling it out and doesnt really have anything to do with the student, unless you are a complete jacka** during your rotation.

But in order to get honors/HP you have to kill the exam and whatever else your school grades you on, so in the end the better students prevail.

 

[jackieMD2007]

I like you, semi-newbie Jackie.

Another message to future MS3's:
Say what you will, but here's the question: If you're not going to bring your "A"-game to the table in 3rd year, then when the hell do actually plan on bringing it, if at all? KILL IT; otherwise, you. might. not. get. honors.

Basically, stop blaming your grades on your attendings. You have more control over your fate throughout 3rd year than you think - the sooner you realize this, the sooner you will find happiness in 3rd year.

I like you too, Def. And way to keep it real.

It is amazing how when people work hard and get good grades that other people think that is being a "sham" and a "fraud" because it is easier to blame the system than own up to our own shortcomings as doctors in training.