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Hey! A few points to consider:

Impostor syndrome is real. Being "below average" in medical school is extremely common - objectively 50% of students will be below average overall and nearly everyone will be below average in a handful of courses. Even failing courses/clerkship blocks is common but people obviously don't talk about it.

When you say you're scoring below average, the question is really how much below average? You scoring in the 25% percentile on a course is very different from borderline passing or your school notifying you of deficiencies. Are you below average in every course or only some courses? Are there specific topics that you are struggling with? Are you keeping up with lecture material or cramming before tests?

It's important to keep your frame of reference realistic and realize that having below average grades will not impact your career in Canada as long as you are working hard and develop the right habits to succeed. One of my closest friends in medical school was literally in the bottom 20% on every course and had to re-write 2 exams in clerkship and matched to a very competitive specialty with an extremely strong CaRMS application. 

The most important things are that you are learning the material you need to and that you are taking care of yourself. There may be some lessons to gain from comparison with your peers in terms of improving studying habits and diligence, but beyond that extensive comparison when even your school hasn't flagged anything is counter-productive.

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You got into medical school, so I have to assume you are already a good student! I'm not saying you shouldn't strive to get better grades, but it may not be as big of a deal as you think. I know it was a big deal in undergrad because your grade point average is a big deciding factor for your success getting into a med school. But here you are, and the game has changed. 

Medical school grades are not all that important in the grand scheme of things. As a former residency program director I can tell you that your med school grades, unless you're failing, are a very small part of your residency application success. Much more important are your preceptor evaluations in clerkship,  your reference letters, and your electives. 

My advice would be to focus your energy on learning the material - not for grades, but for understanding and application to real life. Honing your clinical skills will make the difference in clerkship. 

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From my experience no one asks about grades when it comes to residency. I think the only benefit to having good grades is if you have retained useful knowledge from your studying. Realistically grades are a test of examinship and learning to study the high yield material. If you are doing below average you and you are doing the work, you are likely studying inefficiently. I'd recommend reflecting on what you study and what you skip, not for the purpose of getting better grades but so you can spend less time studying and more time doing whatever you want. 

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23 hours ago, rice said:

Hey! A few points to consider:

Impostor syndrome is real. Being "below average" in medical school is extremely common - objectively 50% of students will be below average overall and nearly everyone will be below average in a handful of courses. Even failing courses/clerkship blocks is common but people obviously don't talk about it.

When you say you're scoring below average, the question is really how much below average? You scoring in the 25% percentile on a course is very different from borderline passing or your school notifying you of deficiencies. Are you below average in every course or only some courses? Are there specific topics that you are struggling with? Are you keeping up with lecture material or cramming before tests?

It's important to keep your frame of reference realistic and realize that having below average grades will not impact your career in Canada as long as you are working hard and develop the right habits to succeed. One of my closest friends in medical school was literally in the bottom 20% on every course and had to re-write 2 exams in clerkship and matched to a very competitive specialty with an extremely strong CaRMS application. 

The most important things are that you are learning the material you need to and that you are taking care of yourself. There may be some lessons to gain from comparison with your peers in terms of improving studying habits and diligence, but beyond that extensive comparison when even your school hasn't flagged anything is counter-productive.

How common is it to fail blocks in clerkship? I thought it is not very common! 

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41 minutes ago, medicine2019 said:

How common is it to fail blocks in clerkship? I thought it is not very common! 

Well this is obviously not the thing that students and schools will advertise. I know a small handful of people in my class that failed clerkship blocks.

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On 4/18/2020 at 10:30 PM, rice said:

Well this is obviously not the thing that students and schools will advertise. I know a small handful of people in my class that failed clerkship blocks.

When talking to med students, I have been told it is only 1 or 2 students that fail a clerkship block.. it may be school dependant though!

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On 4/20/2020 at 6:35 PM, medicine2019 said:

When talking to med students, I have been told it is only 1 or 2 students that fail a clerkship block.. it may be school dependant though!

Umm, no chance it's that low. Those students are either lying or their classmates haven't admitted it to them (the latter is usually the case). If anyone's from a Canadian school where the administration have confirmed only 1 or 2 people in their class failed a block in all of clerkship, feel free to correct me. This is definitely not the case at my school. Clerkship exams, especially the US shelf exams for medicine and surgery, are no joke.

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1 hour ago, rice said:

Umm, no chance it's that low. Those students are either lying or their classmates haven't admitted it to them (the latter is usually the case). If anyone's from a Canadian school where the administration have confirmed only 1 or 2 people in their class failed a block in all of clerkship, feel free to correct me. This is definitely not the case at my school. Clerkship exams, especially the US shelf exams for medicine and surgery, are no joke.

Are you at US school?  Perhaps it is different in Canadian schools!

In Canadian schools, it is probably less than 3 students  a year fail a clerkship block! Maybe Canadian clerkship block exams are easier!

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5 hours ago, medicine2019 said:

Are you at US school?  Perhaps it is different in Canadian schools!

In Canadian schools, it is probably less than 3 students  a year fail a clerkship block! Maybe Canadian clerkship block exams are easier!

Probably depends on the block and the school. I know in my year there were double to 4x that amount who allegedly failed a certain block *per rotation* (so not a high denominator as not everyone is taking that block at the same time). So that supposedly got admin’s attention and things were restructured for the next year. Then it got better supposedly.

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6 hours ago, medicine2019 said:

Are you at US school?  Perhaps it is different in Canadian schools!

In Canadian schools, it is probably less than 3 students  a year fail a clerkship block! Maybe Canadian clerkship block exams are easier!

It is definitely much higher. I go to a Canadian school and probably at least half of my class has failed at least one Clerkship exam and I've heard this is the norm across Canadian med schools. I'm not sure how many fail an entire block (ie. not just exam) but I'm sure it's more than 3. Likely just none of your classmates are talking about it because of specifically what you said which is the incorrect mindset that no one fails in Canadian med schools. It is much more common than you think! 

 

 

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For clerkship examinations my rotating cohort (~20) had 1 failure the entire year, so about 5%. We were not using NBME though and I've heard that past failure rates with NBME were significantly higher.

For clerkship block failures, in the entire class of over >150, we had ~1% fail. To fail the block usually you needed to have poor clinical evaluations, fail the examination, and fail the retake, so it was very rare that this happened.

 

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You sound like a conscientious student. 

I feel the most important thing is consolidating all of the information for the sake of your patients as opposed to worrying about exams. For example, reviewing cards in Anki on a daily basis outside of exam preparation. As long as you are passing, does it really matter?

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On 4/22/2020 at 2:02 AM, medicine2019 said:

Are you at US school?  Perhaps it is different in Canadian schools!

In Canadian schools, it is probably less than 3 students  a year fail a clerkship block! Maybe Canadian clerkship block exams are easier!

No, I'm at a Canadian school.

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The other reason its hard to fail a clerkship block is that its not like you show up at your final clinical evaluation and are suddenly told "you failed, sorry."

There are requirements for mid rotation evaluations and preceptors are obligated to tell you if you are not meeting clerkship requirements so you can make appropriate adjustments etc... Most med students who struggle are able to take this feedback and improve their clinical performance, hence, usually fairly difficult to fail the clinical portion.

There was a well known incident at UBC  probably around 10 years ago, where two med students failed their surgical block but were able to successfully appeal it as they were able to show that there was no documented feedback on their performance nor suggestions for improvement from their preceptor, throughout the clinical block.  

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1 hour ago, medisforme said:

The other reason its hard to fail a clerkship block is that its not like you show up at your final clinical evaluation and are suddenly told "you failed, sorry."

There are requirements for mid rotation evaluations and preceptors are obligated to tell you if you are not meeting clerkship requirements so you can make appropriate adjustments etc... Most med students who struggle are able to take this feedback and improve their clinical performance, hence, usually fairly difficult to fail the clinical portion.

That can happen (wouldn't say "Sorry" is part of it) - despite "adequate" mid-rotation evaluation.

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