<p>how much the shelf is incorporated into the final grade is definitely school dependent, and even rotation dependent at some schools.</p>
<p>I might be wrong, but I doubt the shelf is literally disregarded at your D’s school if you do well. My guess is that it’s weighted in such a way that from a practical standpoint, a perfect shelf score won’t bump you up into honors without the evals (my computer tried to autocorrect evals to evils) already being at that level.</p>
<p>iwbb, Correct about shelf score, low one will lower the grade, for sure, high one will not bring final grade up.</p>
<p>In case anyone is interested, I was wandering around on AAMC and found “A Guide to the Preparation of the Medical Student Performance Evaluation”</p>
<p><a href=“https://www.aamc.org/download/139542/data/mspe.pdf”>https://www.aamc.org/download/139542/data/mspe.pdf</a></p>
<p>These are the agreed upon guidelines all AAMC member schools must use when preparing their student evaluation letters.</p>
<p>(Even font size, typeface and margins are specified!)</p>
<p>
I could easily see this happening. In certain rotations because no matter how much knowledge you have, if you can’t communicate it (whether verbally, writing a good medical note or whatever) to the satisfaction of the attending you may have a very high shelf score and not get an H. That is something that is going to be looked at differently depending on the attending. Certain rotations have a high “how good a teacher are you” quotient. I am sure it IS frustrating to students who never had to deal with this level of subjectivity. I would be interested in knowing if the typical liberal arts major as compared to engineering, math or science, has a little more of a handle on being annoyed but moving on from this because of the nature of their undergraduate work and how grading had a high level of subjectivity from day one.</p>
<p>D had an opposite experience to that of a very high board score not helping after a rotation where every review of her work and her ability to present to patients and the team had her off of the charts. The final evaluation was something along the lines of “this student has the potential to be a very fine ___<strong><em>. In fact, she is one of the best third year students and one of the most natural _</em></strong>___s that I have ever taught. If not for her shelf exam score I would recommend that she receive Honors.”</p>
<p>The score was not terrible but it was not high enough. Such is life.</p>
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</p>
<p>S’s MSPE followed the above format. If you’re wondering what actually could go into each of those sections, S’s included stuff like </p>
<p>Unique Characteristics: two short paragraphs: one summarizing med school years and one summarizing college years (academics, research, work, etc.).</p>
<p>Academic progress
Pre clinical years: A total of 2 sentences long.
Clinical years
A summary of each required/elective clerkship which included grade received and factors (clinical evals, shelf exam, etc.) used in determining how grade was determined. Also included shelf score along with where shelf score fit nationally/percentile. Bulk of these sections were exact quotes cut and pasted from attendings, residents, fellows evals received during clerkships. </p>
<p>Summary
Talked about overall academic performance including GPA and class ranking. Comment about S’s character and professionalism. Comment about Step 1 score and where it put S among peers on national level. Highlighted some shelf exam scores he did well on. Discussed appendices that are a part of MSPE in areas such as clinical competency/clinical skills and professionalism. Lastly provided a two sentence summary of S with I’d say the various code words that seem to be referenced in various posts.</p>
<p>Also note that S was allowed to see and review MSPE prior to its submission. Students were encouraged to report errors, but also were told that “significant revisions” (these are my words) of their performance was not going to happen. I know S found at least one error which was corrected. I would encourage students to let someone else read over to check for errors. </p>
<p>IMHO, students have to do well on shelf exams, no doubt about it. Standardized shelf exams test the most common diseases, most common presentations, most common treatments and any “zebras” that you just can not miss. </p>
<p>For a student who attended a basic science program that focused on locally derived exams, dealing with standardized exams during the clinical years can be daunting. Years ago as a student, I remembered using the “Secrets” books and Medicare and Medicaid top 10 diagnoses and expenditures to finally ace those exams. The reality is that these covered more than 90% of the patients in the hospitals. The subjectivity of the clinical years really suck, pardon my French. But the students have to nail down the standardized material that may be there only objective evaluation. Also, the tests are a preview to the USMLE steps II and III.</p>
<p>DD’s MSPE letter including information about some hobbies and other non-med school info, too.</p>
<p>honestly, at this point of my training, i’m a lot more jaded about grades than i am about patients, patient care, medicine, etc. and i would say i’m primarily annoyed at the subjectivity of evals and that they have so much weight, and that it rarely seems like there is any inter- or intra rater reliability. </p>
<p>“one of the best students i’ve ever worked with. notes are a joy to read. physical exams are practically perfect in every way.” -satisfactory</p>
<p>“fine student in OR, did not contaminate field, pleasant to talk with” -honors
“fine student in OR, did not contaminate field, pleasant to talk with” -satisfactory (same doc, different student)</p>
<p>“outstanding student with outstanding knowledge of the field and outstanding potential to be an outstanding doctor in whatever field she chooses.” -honors</p>
<p>“below average compared to peers, at times seemed unprepared for patient, but mostly was ok” -satisfactory</p>
<p>i’m paraphrasing a few evals of myself and my friends this year. it’s maddening at times. my solution? do my best and let the cards fall how they may. </p>
<p>@kristin, such is the nature of the profession we selected. We will be judged subjectively for our entire careers, by supervisors, peers. patients, and staff. I think I will seek feedback whenever and wherever I can get it and hopefully improve any deficiencies in perceptions over time. But I do think it’s important as a physician, how others see you. Trust and confidence is such a huge part of being an effective healer. </p>
<p>" primarily annoyed at the subjectivity of evals and that they have so much weight, and that it rarely seems like there is any inter- or intra rater reliability."
-Exactly my D’s feelings that are completely disconeected from her previous experiences in life. I feel though, that it is a great lesson in maturity. Maturity is learning to focus and worry strictly about things that are in your control, even if it is not your FULL control. Maturity is to tell yourself that I am done everything that I could possibly do, there is nothing else for me to do to improve the situation and the rest of outcome is simply out of my control. It is the hardest thing in life to learn to think this way. However, thinking any other way will lead to depression if you are stuck in the same loop over and over. Got to learn to let it go even if all your previous life experiences tell you that it is wrong. unfair, inhuman, outrageous. I keep repeating this lecture to my D. who I consider a very mature person, but I got few more decades to draw from. The most important feature of the physician is how well he/she listens to the patient. I see it over and over and over in my own visits to the doc. So, guys, remember there is a human being who needs your healing, not the desease. Without an input from this human being, you will be on a wrong path to make him/her feel better. And unfortunately young guns with all their confidences tend NOT to follow this simple rule (just another experience from my yesterday visit to dentist)</p>
<p>I think it is hard to see something that feels random affect ones choices in life, no honors in XYZ rotation, no ZJohns Hopkins residency for you, etc. But, que sera, sera is about the best attitude they can take. This is why some students get the reputation of gunner, they seek to overcome the randomness by overwhelming everyone proving their excellence at the cost of others.</p>
<p>DD had a rotation with a friend and hated the feeling of trying to “win” over the friend to get to participate in the treatment activity.</p>
<p>I have heard a few stories about personality really affecting marks, students who were seen to be arrogant or unpleasant or bored or anything else other than wonderful got bad marks and I heard about one who was threatened with failure. I never heard the outcome on that one, but sounds like the attendings are trying to work on peer & bedside manner.</p>
<p>Don’t try to win friends and don’t suck up. But absolutely do your best to learn and work with others. No one cares how great you are because you aren’t. When groups are choosing who will be their new employees and who will be their partners, it definitely starts with who they get along with first. So, there will be a lot of bad subjective comments from your attendings, but also everyone else. Then again, there will be great comments even when you knew you were at your weakest. My rule of thumb, for me, is to win over the housekeepers. They are the ones that are often overlooked, mistreated, and seen as disposable. If I can be respectful and earn their friendship, then I know I developed the interpersonal skills to talk to everyone up the ladder. At the private practice level, so much rides on your interpersonal skills for referrals. You have to start developing those during your third and fourth years.</p>
<p>One clear talent that D. has is talking to a patient. In fact, one doc. told her that she should consider specialty where she needs to talk a lot…he was dissapointed with her choice (needless to say, he was a psychiatrist), but she will stand on her own as always with our everlasting support. But she has always enjoyed psych., (minus overmedication).</p>
<p>Just learned that DS might do the additional research year. His residency application cycle will therefore be one year later.</p>
<p>Wonder whether there is any downside because of this “interruption” in his clinical training if he chooses to do so.</p>
<p>It is his life. We are just listeners when he wants to talk about it with us. It is up to him to decide which way to go.</p>
<p>^ @mcat2, I don’t know about any “downside”, but my question would be “what’s the upside?”. It seems to me that you better have a very good reason and some clear goal to delay your training for a year. </p>
<p>increasing the likelihood of matching where you want to match (which is generally the reason people do research years) seems like a pretty good reason to me.</p>
<p>Mcat2, my daughter has decided to do an extra research year as well. Although strenghtening her application is not the reason, she was told it most definately will help. What’s another year in the whole grand scheme of things? :rolleyes:</p>
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<p>I understand that that’s the conventional wisdom, but does it really have a significant effect on your chances? And if so, why? What do these “research years” entail? I could understand perhaps an additional rotation(s), or advanced clinical training, but research? </p>
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<p>Absolutely, especially so for certain competitive specialties, certain competitive residency programs or for those individuals interested in pursuing academic medicine.</p>
<p>Research conducted during medical school or a research year usually isn’t basic bench science research, but is often more narrow applied research topics specific to one’s specialty interest. Topics can range from public health issues to best clinical practices to the material science implications of graft materials to cross-comparisons of surgical knots to psychiatric neuro-imaging studies.</p>
<p>D1 will not be pursuing a research year (she just doesn’t love research that much), but will <crosses fingers=“”> have a first author journal publication relevant to her probable specialty. </crosses></p>
<p>plumazul, One reason that was often cited here is that the student could more easily ask for LORs. In this regard, it is somewhat similar to how a premed does “premed work” here.</p>
<p>I think the focus of a physician working in the academic medicine (like one working in a teaching hospital or in a research lab in the medical school) is somewhat different from that of a typical practicing physician.</p>