<p>*The only thing I think of that it could be is an NBME shelf exam, *</p>
<p>My son said something about it being a national exam and he may have used the above acronym. </p>
<p>although my school started using them for the first years the year after me)</p>
<p>That’s probably it.</p>
<p>Do other SOMs keep telling their students what quartile they are? Is that typical? I’m guessing that doing this gives the students a guideline as to how strong they’d be for the more competitive residencies?</p>
<p>M2CK, I asked my daughter about her school and she says that they are told the class mean and standard deviation on finals, and that is how they can approximate how they are doing but are not told anything past that.</p>
<p>My school gives the mean and standard deviation on each exam do you know where you are but it’s not recorded anywhere official so it’s not part of a student’s record.</p>
<p>WayOutWestMom - Wishing your D a speedy recovery! Ouch!
i<em>wanna</em>be_Brown - re: your friend’s hospital visit… :eek:<br>
D’s class did have ‘patients’ for the more invasive exams. She had one patient ask her, “Did you feel that colorectal polyp?” Yikes! She remained calm…</p>
<p>This is, by far, my favorite thread on CC, and there haven’t been any posts since the big change-up. In order to bump the thread up, I’ll share that my D, a MD/PhD student, took her Step 1 in December, and did quite well! Yay! Another big ‘step’ on this long path! She’s now in the grad school years, and her impression so far is that the classes move really slowly compared to the MD classes!</p>
<p>Turning to CC to clear up a question related to medical residencies…I’m told a hospital with which I am only remotely familiar is going to soon have a DO orthopedic residency residency. They’d wanted to have an MD residency program for orthopedics but didn’t meet the criteria. Not sure what those criteria are but they fell short. </p>
<p>Seems to contradict something I thought was factual: Residency programs for specialists are the same for MD’s and DO’s. I thought if I had a hip replacement, for example, performed by a DO he/she would have had the same residency/fellowship/specialist training as an MD orthopod. In this case, it implies qualifying for an MD residency program is more rigorous.</p>
<p>I always remember back to my undergrad days when those who were really bright matriculated into MD med schools. Those who were less bright went to DO med schools. Thought that had changed. Perhaps not.</p>
<p>Can somebody shed some light on the differences between DO/MD specialty care and their training. I’m not asking about the basic differences in philosophy between osteopathic and allopathic rather the specialist training. </p>
<p>Thanks in advance for clearing up a mystery for me!</p>
<p>“The only thing I think of that it could be is an NBME shelf exam”
-If we are talking about MS1, they do not take shelf exams. They take end of block exams. Shelf exams are for specific rotations, as far as I know. </p>
<p>The above few posts remind me of what DS told us quite some time ago: the whole class needs to travel to another in-state public med school where they will take some tests (likely they are not tested by the faculty of that school; rather, the examiner is likely some physician or somebody from some state government department related to the “state level licensing”.) </p>
<p>This is neither STEP-1 nor STEP-2 (not STEP-3 either.) He said it is important not to do too badly on it. He mentioned although most students would do well enough to pass (it seems the only requirement is to pass), once in a while there may be some student who may not do well enough, for whatever the reason it may be (maybe too lopsided toward a narrow research area or some other special interest, rather than being reasonably trained as a well-rounded doctor?)</p>
<p>I am not sure whether it has happened already or not for his class. Likely it has as he mentioned it quite a long time ago.</p>
<p>Regarding whether the med school tells the percentile of a student’s academic performance to a preclinical year student, DS once told us he had received such a “grade report” for his MS1 physiology test (likely his “final” at the end of the MS1.) But the grade is just for the student’s information only. No record is kept as all grades in the first 2 years are P and NP.</p>
<p>After the CC site was revamped, it gets harder and harder for me to visit the end of such a long thread unless I use a real computer (I rarely did recently.) Once in a while, I would be taken to the end of a thread, but most of the time, I would not. It is very unpredictable.</p>
<p>I think the schools must keep track of the marks, at least for the ability to say top 10%, top 25% etc. Yes, the transcript is P/NO, but not the school records!</p>
<p>I am guessing the test you are talking about is an OSCE where they have to do some sort of physical exam, it’s good practice for the Step 2CS.</p>
<p>Glad that I couple help, that’s what this is all about, helping each other. DD wishes she could be making more of her decisions the past couple of years with more knowledge…as in, “if I knew then what I know now, I could have scheduled so much smarter!”</p>
<p>I heard there is really no record about the “mark” (other than P or not) in the preclinical years at DS’s school. Also, I had the impression that his school postpones the decision of AOA status even if there is such a list eventually (really not sure - we avoid talking about this as well as the grades at all cost, as it would be well too stressful if that would be any med student’s concern.)</p>
<p>But you are probably right in saying that the school could still somehow inform the residency program directors of how the student stacks up among the peers in one way or another. But I do not know how it works. For example, will it work somewhat like a “premed committee” for premed students who attend a college with a premed committee (I just use the med school application cycle just as an analogy here)? The premed advisor could write anything on the committee letter how the students perform in some “code” that we may not understand?</p>
<p>BTW, DS now volunteers a day in every weekend at a hospital (he even needs to commute to it, unlike at his teaching hospital which is just across the street from where he lives.) He just briefly mentioned this to us and commented it may be good for residency application in the future. Do MS3 students do this on a regular basis? It seems to be a very much like “premed-ish” activity but I really do not know. (But he did not do very much, just barely necesities, on the hospital volunteering front as a premed. It seems he is more willing to do this now than before. But he told us that he is not a very “aggresive/ambitious” premed or med school student like some of his peer premed or med school students. He just dutifully does his student’s job in his own pace.</p>
<p>The life seems to be quite tough for him right now as he is in some very busy MS3 rotation now.</p>
<p>it really depends on the school. At my school for example, they do end up stratifying us into quintiles for the MSPE letter that goes out to residencies, and it’s based on a whole list of things, but grades in the 1st/2nd year are not part of that list. They figure Step 1 score is a good enough proxy for that anyway. At some schools, they do use 1st and 2nd year grades even though they are “pass/fail.” That’s why you always have to ask what exactly pass/fail means and how they put together the MSPE.</p>
<p>Our school MSPE is written in a way that it’s basically totally neutral except for the last sentence where there is one word that they change based on which of the five quintiles you are in.</p>
I guess this one word is what I referred to as the “(secret) code”.</p>
<p>I remember reading somewhere that the 1st and 2nd year grades are not recorded anywhere by DS’s school. Should I believe what they said?</p>
<p>Some competitive students still compete aggressively by other way when the preclinical grades do not count, e.g., by doing research and receiving research related awards - just a continuation of their “research focused” life in their premed years.</p>
<p>In one year (not DS’s class year), the school found the need to send an email to all students to ask them to attend the preclinical classes in MS2 because what they learn is useful when they get to the clinical years. I guess it was the months before STEP-1.</p>
<p>I did get to read DDs Dean’s letter and as I recall (man this stuff is fuzzy already!) there was some info telling her the five adjectives and what they represented…secret code! DD was not sure how it was calculated, but felt that the ranking was ‘about right’ based on her marks to date. In her class, it was P/NP but she always got her score and how it related to the rest of the class- median, standard deviations, etc.</p>
<p>DD told me that when she met with her residency advisors some of the questions that went into whether one had a strong application were things such as whether the student had ever failed a class, had to remediate, had to expand, etc. It was not uncommon for friends of hers to fail a final or a class or even a rotation in clinicals. Not that they were dropping like flies or anything, but I distinctly remember being surprised how many people she mentioned needing to retake a final or even an entire class.</p>
<p>I also have been surprised how much personality can factor into clinical marks, raising or lowering the impression a student makes, DD definitely feels like she has been ranked highly where she really clicked with her preceptors and knows a couple of friends who just don’t come across well, they might come across as cranky or arrogant or b****y and though they do good medical work, they inadvertently offend people and it damages their overall mark. </p>
<p>if they tell you the grades are not recorded anywhere, you can believe them. The schools I am referring to will admit that the grades are used internally if you press them.</p>
<p>All schools have “the code” but the point is many schools don’t use 1st/2nd year grades to determine what word they get. There’s plenty to use outside of the preclinical coursework.</p>
<p>I never heard of anybody failing class. But I can only say what I am communicated to by my D. she tends NOT to discuss academics with her firends, well, she is ususally seeking people who tend not to discuss academics.<br>
“think the schools must keep track of the marks, at least for the ability to say top 10%, top 25% etc. Yes, the transcript is P/NO, but not the school records!”
-D’s school do not grade pre-clinical tests. Yes, they are only P/F, there are NO grades. That is why their rotations’ grades have more values, since they are the only ones that are going to transcript / school records. In addition, these are NOT really connected to the Shelf exam scores, but based mostly on evals, which are very subjective. You are in luck or out, basically, not much control, other than not performing at all. But the huge above and beyond effort might not result in the highest grade at all. And people who think of you very highly and express it many times, might shoose not to write your eval because of their general dislike of doing them. All student can do is to try absolutely best and above and beyond the best and hope that she has a luck of getting what she deserves. Ones D. felt that she did not deserve an H, but she got it. Another time, she went completley out of her way with huge efforts and verbally got great compliments and received a very high score on the shelf exam, but she did not have one think - LUCK. Basically, take whatever comes your way, and do not think very hard if it does not work out.</p>
<p>Yes, clinical evaluations can be very inconsistent across different doctors, different rotations, different sites, there is a certain roll of the dice factor to it all.</p>
<p>I tend to look at med school grading differently. I understand how some version of a numerical grade (A, B, C or H/HP/P) can be given in preclinical courses. One student knows more than 90% plus of the material, another knows 80% plus of the material, and so on. I get that there is arguably an objective way to measure performance. And since a final grade is usually totally connected to this exam performance, I’m not particularly bothered by preclinical grades other than P/F. I view shelf exams in the same light. </p>
<p>What drives me simply nuts about med school grading in the clinical years is the subjective component of a final grade. In S’s case shelf exam counted for less than half final grade. But with all the clinical variables (e.g., “different doctors, different rotations, different sites,” and adding different patients presenting with different needs, etc.,) that go into this subjective aspect of any med student’s grade, I struggle with the notion of putting a student’s performance into a number which results in a grade other than P/F. You’re talking about students who are probably doing a procedure for the first time or second time, or may have to be involved for the first time in the discussion of a patient’s heart disease, diabetes, etc. C’mon, how good can each attending be that they can put a number on it? How good can third year students be at this early point in their clinical training? What’s the difference between a third year student who gets an 82 in his evals and one who gets an 87? To say, no it’s not broken down into that level of detail, it’s more like a 5 is H, 4 is HP, etc. Okay but I still reserve the right to go nuts where I hear how the subjective component can be weighted so heavily that it impacts a student’s future. Don’t ask me what alternative I offer as I don’t have an answer. To me students who are doing anything clinical in the third year deserve a P/F. To me it’s kind of like being in right church, wrong pew kind of thing. I can appreciate that residency programs directors want something more objective to sink their teeth into, but isn’t that what Steps 1 and 2 are for?</p>
<p>I wonder if there’s a name for my going nuts with this topic and do you think it’s treatable? Maybe wine or a nap or both?</p>
<p>I know at D1’s program ( and I would assume at most programs), attendings/ senior residents have grading rubrics with clearly specified clinical competencies they use to evaluate students in each rotation. At D1’s program, students either exceed expectations/meet expectations/need remediation or fail. (A/C/D/F) As you might guess, most students get “meets expectations”.</p>
<p>I’ve written similar types of behavioral objectives when I was teaching gifted/spec ed so I don’t really have an issue with med students getting grades during clinicals. Behavioral objectives have been around for more than 3 decades now. The process of developing them and training individuals in their use pretty well documented and understood.</p>
<p>At D1’s program, her final grade is 1/3 evaluations of the attending/senior residents, 1/3 oral exam (3-4 hours long at the end of each rotation and dealing mostly, I believe, with Dx and case management), plus 1/3 shelf exam. </p>
<p>Just wanted to chime in that I agree with all of you, grading in clinical years is nuts, figuring out MSPE is nuts, etc. My school also divides us into “clusters” and a lot of “things” go into your “cluster” and the “clusters” aren’t all the same size so there might be 3 “really really really awesome” students and 10 “really really awesome” students and 15 “really awesome students” and the rest “awesome” students. Apparently, programs to which many students from my school apply are theoretically aware that “awesome” isn’t the best and that “really really really awesome” is actually the best, but other programs might think “awesome” is “really good.”</p>
<p>It’s crazy.</p>
<p>And to the prev poster re MD vs DO residency for orthopedics: </p>
<p>As far as I understand it, there are MD and DO orthopedics residencies, and DO students can apply for MD residency programs if they meet all the requirements, but they are apparently different things altogether. Note that orthopedics is not a fellowship–it’s a residency–and there’s a chance that orthopedics fellowships–eg hand, hip, etc–are the same regardless of whether one completed a MD or DO residency.</p>
<p>(Other surgical specialties are different. ENT, urology, and ophthalmology are specialties that do a good amount of surgery but don’t start with a general surgery residency. Some surgical specialties start with a gen surg residency and then allow for future fellowships–surgical oncology comes to mind as an example. Other surgical specialties are their own thing entirely–orthopedics and neurosurgery come to mind. So it really just depends!)</p>