How indicative is preclerkship performance in clerkship?

[noneed2live]

Hi. I am a first-year med student in a Canadian medical school. So basically, my school is P/F. And I am barely passing these examinations, like by 1-2 %. Yes I pass, and at the end of the day, all I need to do is pass, but I still want to perform well on these examinations. I am worried that my preclerkship performance, which is poor (barely passing) will translate into poor clerkship performance. I do understand that clerkship involves more than just clinical knowledge (i.e communication, collaboration, work ethic, being a good person, etc). But I am wondering if there is any correlation between clerkship and pre-clerkship performance on the wards. 

[Lactic Folly]

Have you determined where you are struggling? Difficulty with question format, memorization, clinical reasoning, lack of time to study, etc.? Good for you for working to address this early on. Is there advice/support from your school?

[noneed2live]

4 minutes ago, Lactic Folly said:

Have you determined where you are struggling? Difficulty with question format, memorization, clinical reasoning, lack of time to study, etc.? Good for you for working to address this early on. Is there advice/support from your school?

Hey I just have to get better at studying the management plan/treatment for a lot of the conditions. That seems to be my issue. I guess it is the clincial reasoning I should work on.

But do you have any comments regarding my question of Clerkship? Like how do they assess performance on clerkship.

[Lactic Folly]

If you are having difficulty coming up with a good management plan, then yes, that would cause concern as that is also one of the main competencies assessed in clerkship.

Clinical reasoning is a complex skill and not necessarily intuitive, but it can be broken down and taught. There are many resources out there for faculty on the topic of teaching clinical reasoning to medical students. If you are barely passing, hopefully your school would reach out to you to review how things are going, but you can also take initiative to request some tutorials in this area.

[1D7]

Barely passing is an indication you'll struggle in clerkship if you're already trying/applying yourself. In terms of the utility/applicability of preclinical knowledge, at my school I think 25-35% of my preclerkship class time was a complete waste, but that means that the other 65-75% of knowledge was actually either directly or indirectly useful.

Clerkship evaluations are somewhat similar to job performance evaluations. To do well you need to work well with your team & preceptor. To be able to do that you'll need to be able to make decisions, i.e. diagnosis, assessment, management plan. To be able to confidently make those decisions, you'll need knowledge. Often you'll be indirectly showing off/applying your knowledge, but relatively frequently attendings pimp you on different medical facts to directly test your knowledge.

And of course there is much, much more than just knowledge when it comes to doing well in clerkship, but I would say a strong knowledge base is very helpful, at least for IM and surgery blocks. Even if you forget most of the material later on, relearning it is much easier if you've had a solid understanding of it some point prior.

[goleafsgochris]

12 hours ago, 1D7 said:

Often you'll be indirectly showing off/applying your knowledge, but relatively frequently attendings pimp you on different medical facts to directly test your knowledge.

 

This is definitely true.  I found this is where my knowledge was evaluated, MUCH more often than on patient care decisions.

OP- just passing isn't a GOOD sign (obviously haha), but it may or may not make a ton of difference for clerkship.  I remember in med school a senior who had just matched once told me that if you just read and know the "case files" book of every rotation, you can be a star in clerkship.  I remember thinking STFU at the time, but looking back on it its weirdly pretty true.  Theres some material from pre-clerkship that's important especially for background, and pre-clerkship stuff can be helpful for the LMCC, but the pre-clerkship clerkship overlap in terms of what you are evaluated/pimped/tested on in clerkship can be pretty limited

[GrouchoMarx]

study more.

i know i talk about preparing for usmle but i think it would be a good idea for you, if only to cement your study habits and knowledge.

UFAP.

[Edict]

The truth of the matter is that most students handle the communication, social, hardworking part of clerkship well. What ends up differentiating students is going to be the knowledge aspect. 

If you manage to keep things the way they are and are a hardworking likeable member of the team wherever you go, you will probably match somewhere if you apply broadly. But if you want those reference letters to really have the punch you need to get your first choice or match to a more competitive specialty, you want to "drop the knowledge" on your attendings.