H/P/F ?? How crucial is that?

[Guest Mimimowmow]

Someone probably have asked this before, so please forgive me if this seem like a stupid question.

I know that different canadian med school has different grading system (ie, percentage, P/F, or H/P/F system). How much does it weight in terms of ur mark when u do ur residency match. I assume for those very competitive specialty like derm, opthalmology, surgical specialties, u'll need Honour across the board?? Can someone please enlight me on that? Or there is a chance that a "P" student could also be competitive in those tough to get specialties?? Thanks.

[Guest jmh2005]

Most schools are going to a Pass/Fail/honours system if they aren't already.

 

Generally the word on the street is that it doesn't matter. At Mac we only have satisfactory or unsatisfactory...but we do have very wordy qualitative evals that detail the particulars of our performance.

 

Of course, I'm sure there is the odd program director out there when he/she has several comparable candidates (when everything else is equal), may take the easy way out and look more favorably on the applicant with documented 80's/90s in med courses, but apparently that is not supposed to happen...and I'm not sure if any med schools still give out numerical grades??

 

Last year at Mac we had many people match into ultra-competitive spots, plastics, urology, optho...and like I said we are simply 'Satisfactory or Unsatisfactory', so I wouldn't worry...

[Guest UWOMED2005]

Wow, that's a really complicated question. Yep, it has been asked before - and I'm sure it will be asked again.

 

How programs view the H/P/F question (particularly in 1st and 2nd year) is entirely PROGRAM specific. And when I say PROGRAM I am referring to a particular specialty program at a particular school (ie general surgery at Western) rather than a particular specialty/discipline (ie assuming you need high marks for ophtho.

 

The problem is there are, I believe, 13 med schools in Canada and (very roughly) 20 specialties to apply to, for (even much more roughly) about 200 different programs to apply to for residency. So there's absolutely no way I can claim to tell you how all programs perceive H/P/F marks. But I can tell you that whether or not a program cares about H/P/F marks in 1st and 2nd year is NOT dependent on whether it is in a competitive specialty or not. And I can remark on the following observations I've picked up during medical school:

 

- I know of one Gen Surgery resident at U of T who had ZERO honours courses in 2nd year and just a few in first year, and beat out a bunch of his classmates for that spot, classmates who had all Honours throughout. He did have lots of research though, and great clerkship evaluations.

- The Gen Surgery program director at UWO, in contrast, has gone on record a number of times saying that 1st + 2nd year marks DO matter for UWO Gen Surg. But more important is having lots of awards (at least according to another faculty member of the residency program selection committee.)

- Internal Medicine at UWO counts H/P/F marks at roughly 10% of their overall eval. If someone is strong (or weak) otherwise, that is much more important in their evals.

- Someone from U of T Internal Medicine went on record as stating H/P/F marks were important to matching to that program

- UWO Emerg (a very competitive program) gives applicants a mark out of 100 to decide on interviews. 10 marks are assigned for your 'marks,' but you get 8 out of 10 for passing all your courses. Someone with a PhD might get 9 out of 10. In other words - H/P/F marks mean pretty much diddly squat.

- I know of one UWO Opthalmology resident (from a particularly competitive year for Ophtho matching, traditionally one of the more competitive specialties) who is very proud to boast that he had not one single hnoours on his entire medical school transcript. That was because he never went to class in 1st or 2nd year, spending his time instead doing research and/or clinical electives in programs he was interested in (urology, plastics, ophtho)

 

So what do you learn from this? Well, UWO gen sx cares about marks whereas U of T gen sx doesn't. In contrast, UWO internal med doesn't really care about marks whereas U of T internal med does. And it's still possible to match to Emergency medicine and Ophthalmology (extremely competitive programs) without a single honours mark on your transcript.

 

In other words, the answer to your question is: it's freakin' complicated.

 

Truth is, having honours on your transcript is probably better than not having them. So work hard - but you should be working hard anyways so you know your stuff. But I certainly wouldn't freak out if you weren't getting all honours, whether it be because you didn't get over 80% on some test, or because your school is now P/F.

[Guest Mimimowmow]

Wow....now I can say, it's FREAKING COMPLICATED~~

with no easy solution as this is.....I guess........it's time to dive right in that textbook......8o

Thanks for all u guys' prompt reply, really appreciated!! Help me in a great DEAL!!

[Guest endingsoon]

I can second the importance of HPF for matching to Internal at Toronto. Its probably the single most important factor from what we hear.

[Guest peachy]

Really? More important than research? Even H/P/F grades from back in first year?

[Guest endingsoon]

Sorry didn't mean to scare you like that!

 

For internal medicine at Toronto, your grade in internal medicine yr3/4 should be H's, and your other 3rd year marks should be majority H's as well. I don't think they looks at your yr1 makrs at all.

 

Some programs do look at year 1/2, but usually only the crazy ones like plastics and urology.

[Guest UWOMED2005]

That's kind of funny, and somewhat unfortunate.

 

My experience has been that in clerkship your marks are often more reflective of who is doing the marking rather than your performance itself. Truth is, on many rotations you actually don't have that much contact with the consultants, rather you are mostly working with the residents. I'm not sure how detailed a report is sought by the consultants from the residents, dependent on the consultant. As a result, I found many of the consultants picked up on minor details they observed to assess your performance, rather than a detailed analysis of your rotation as a whole. And of course, what mark your consultant gives you is going to be highly dependent on whether the consultant is an "easy marker" versus a "difficult marker."

 

Western switched to P/F for clerkship two years ago, partly because students noted their H/P status was quite subjective and perceived, by some students, to be quite random. I remember speaking to a 2002 grad from UWO, who had H/P/F for clerkship. He noted that you had to work hard and know your stuff to be considered for honours, but as most students were in that category, on some rotations the awarding of "honours" was mostly a factor of how well you got along with your consultant. . . and at its worst, a factor of how good you were at brown nosing. On other rotations, consultants were afraid to give out a "P" as it might jeopardize a students chances in the match - as a result, you had to screw up not to get the "H." 80-90% of clerks on such rotations ended up with "H"s, making such an honour a rather useless assessment of how you had done.

[Guest moo]

I second the randomness of third year clerkships. My first three week of clerkship was with an attending who couldn't care less whether we showed up or not--since he rounded with us (rather informally too) at most once or twice a week (he was an administrator and not very interested in teaching). On the other hand, I now have an attending who rounds with us every day and pimps us on everything even patients who are not our own (so as to make sure we are not falling asleep on other students' presentations). Everyone "works hard" in medical school... we "want" to be there and put in 110%. It is very rare that someone doesn't show the initiative. I feel also that most of us are at about the same level of knowledge with the exception of the few obvious superstars... but then these tend to also be the ones that annoy everyone else to death, even the residents. It is a school policy that at most 20% can get H and the rest P's. Next year my school is adding in a high pass to the mix, which I think is good. But anyway, I think third year is such a crapshoot, for the above mentioned reasons... It used to be that if you do well on the exam you would have a good chance at H but doing well on the shelf only qualifies you to get H now.

[Guest endingsoon]

Those are all good points. UofT's Internal yr3 however is only 50% evals and 50% exams, so you can still get an H if you do well on exams.

 

Plus, they way they do your evals is MUCH different than any other rotation. All the consultants and senior residents and CMR meet on the last day and discuss every clerk together and then give out the H/P. Usually less than half the people get H's, unless it is an allstar group. I do have to say that in this one rotation the evals are generally deserved.

[Guest Valani9]

From everything I've heard, H/P/F in year 1/2 means virtually nothing. Maybe clerkship marks matter - but as everyone has noted, those vary a lot from school to school.

 

And I strongly disagree with the advice to work your ass off for the H. For the tiny bit that it could possibly matter, you would be way better off spending a day a week working with a doctor, or doing research, or even just continuing to be a sane, well-rounded person.

 

This is just what I've gleaned in the last couple of years. At least 4 or 5 doctors have said to me, unprompted, that the best doctors usually are the average students in medical school.

[Guest endingsoon]

Well I have since learned a little bit more about the marks as it applies to programs at UofT.

 

For IM, they tend to want 2 main things:

 

1. H in yr3/4 medicine

2. Honours standing overall in Yr 1/2/3

 

Basically Honours standing means that when they calculate a weighted avg. you get an H overall in that year. People have been known to get in with less than the above, but it is the exception.

 

For family medicine, they like to see an H in family, but its not critical.

 

Obviously urology/ophtho are almost entirely marks based.

 

Radiology values marks a TON and you bascially need to be into award mode to get in.

[Guest UWOMED2005]

Before getting into the nitty-gritty, I'll repeat my main point:

 

EVERY program is different. Specialty to specialty AND center to center. So you can't take one or two examples and spread it across the board. Too do so would be pretty ignorant of the intricacies of CaRMS.

 

That being said, it will be interesting if U of T internal meds values year 3/4 honours for several people in my class who've ranked U of T #1. We've been P/F for years 3 and 4, and it will be interesting to see how U of T handles that. I honestly don't see it making that much of a difference (ie someone getting a 'P' in a P/F system. . . they might easily have been one of the ones with an 'H') but this could an interesting, non RCT, experiment in the matter.

 

And I DO know people with not a single 'H' on their transcript who are in Ophtho. As well as Emerg. The ophto guy was a standout, but the general consensus among the ophtho residents is that it doesn't matter what your transcript says if you're a jac*as-.

 

Traditionally, thought, I understand U of T is a bigger stickler for meds marks then other centers. So the contect might be different.

[Guest endingsoon]

UWOMED:

 

Yes it will be interesting to see how it affects out of towners. I was talking about more in relation to UofT medical students applying for UofT positions (thats the info that we all recevice obviously) so I have no idea how out of towners are selected. Traditionally, UofT hands out about 60% of the spots to UofT students (for IM) so I think thats why they use the marks so principally in the admissions process.

 

I am sure that schools without an HPF are not penailized for a P (afterall you cannot get much higher).

[Guest noncestvrai]

A person "high-up" at my school told me that UofT grads all seem to have Hs...hard to discriminate on that basis! Albeit, this could be specific to the programme...

 

noncestvrai

[Guest not rex morgan]

Just to add to the discussion, I got into a discussion on my tour over coffee with one of the residents and a med student from that school. The med student was great and asked all the questions I wanted to know the answers to but couldn't ask. (ie. what do you guys make your decisions based on).

 

The resident said that they care that you're competant (you will be looking after the staff's patients).

 

They care that you're easy to get along with (schools have suffered ALOT b/c of a couple of bad apples; poor morale, people leaving the program...leading to more bad morale...leading to less people ranking their program...leading to more mean people).

 

They care that you have committment to the field (will you stick with this program).

 

Beyond that, each school has their own thing be it a bias for research, people who stated that they definitely want their city in their letter, if it's a surgical field-something documented that says you're good with your hands, height, haircolour, whether or not your shoes were pointy enough...who knows. This resident said that personally, she hadn't seen grades looked at ever, but some schools value them.

 

As for grades, I don't know how much they can honestly get out of them. True, I believe that some schools look at them and may have worked something out, but each school has such a different method of handing out grades. As mentioned, U of T is strictly pass/fail now. At UBC you can get an H, but it's not that easy to get. We are graded by our clinical marks + results from a national board exam for our big rotations. As for clinical marks, I've noticed alot of tutors here live under the "there's always room for improvement" pretense. They just don't give out H's or if they do, it's a rarity. (I had one evaluation where the doc wrote down alot of constructive criticism....all very helpful...and gave me a P. In different handwriting that looked like one of my residents', next to the checkmarked P was written "above average.") The national board exams we write are a standardized test, and you get better at writing these things with practice. You have to H the clinical AND the board exam to get an H at UBC.

[Guest Valani9]

H/P in year 1 and 2 *does not matter*, and the faster we recognize that, the better. You'd be a thousand times better off getting into the clinic, doing research, making contacts, than worrying about every single toxicity of aminoglycosides so you can ace a multiple choice exam.

 

Half of the schools in the country already don't have H, and soon most/all of them won't. I highly doubt any program would penalize somebody for coming from a P/F school.

 

I'm saying this from the position of having gotten more H's than not, and I wish I'd have spent less time doing academic stuff. Every person I've asked (including people who sit on selection commitees) have told me that, at most, those marks are used as "tie-breakers". But first you have to worry about getting to the "tie" - and that takes a whole lot more than doing well on multiple choice exams.

 

It's a tough thing for med-students. We're conditioned to worry about marks - but it really has so little to do with that now......

[Guest endingsoon]

m saying this from the position of having gotten more H's than not, and I wish I'd have spent less time doing academic stuff. Every person I've asked (including people who sit on selection commitees) have told me that, at most, those marks are used as "tie-breakers". But first you have to worry about getting to the "tie" - and that takes a whole lot more than doing well on multiple choice exams.

 

 

Not to be a stickler, but I know for pretty much a certaintity that there *ARE* programs out there that look at yrs 1/2 and the number of Hs you get (of course this is secondary to any awards you might get).

 

I think the point is that whe you really get down to it, almost everyone has good letters and good electives. People on the selection committee work with a ton of good candidates. So, when they are sitting around the table discussing you, sure your letters/electives will get you talked about, but it only puts you into the 'A Pool' with a ton of other people all looking for that spot.

 

There has to be ways that they cut this list down, be it with research, marks, eye colour, ethnicity, looks, money, cars, height...I don't know (and of course as has been said many times it totally differs from program to program) but I do know that there are some programs that use marks.

 

I just think that the worst possible feeling is to be applying for a residency and be told that you will not get if b.c of one lousy P on your transcript (I know people that this has happened to). So, I would still advocate working hard in the first couple of yrs and trying for the H, within reason of course.

 

If you are lucky enough to be from a P/F school then it probably means that it will rest on some other menisual thing in your application.

 

Just don't want people to get the impression that the first couple of yrs mean nothing and then realize in 4th year that they might be in trouble b.c of that attitude. We all know it counts form MUCH less than clerkship grades/letters/evals, but at least for some programs it still counts. No need to close doors prematurely.

[Guest Valani9]

I guess it's a matter of opinion- and people will pick their battles accordingly.

 

In my experience, it's seems to be a commonly held opinion that marks are unimportant. But that is just my experience, and no doubt there are other views out there.

 

Good luck endingsoon (I'm assuming you're ending soon?)

 

Cheers.

[Guest endingsoon]

Good luck endingsoon (I'm assuming you're ending soon?)

 

 

Let's hope...dday is March 1st....

[Guest UWOMED2005]

In my experience, it's seems to be a commonly held opinion that marks are unimportant.

 

but I know for pretty much a certaintity that there *ARE* programs out there that look at yrs 1/2 and the number of Hs you get

 

I have to admit, I agree with endingsoon on that one. . . only because they qualified their statement by suggesting that it is SOME programs that care about H/P.

 

I think I've said this a gazillion times before, but every program at every university in each specialty is allowed to come up with their own criteria for ranking residency applicants. If a program wishes to rank its applicants based on how fast they can peel a banana, that's their right.

 

So whether marks matter is an extremely program specific issue. To say marks are important or unimportant in a general sense meant to include all programs is a whole lot of junk. Much the same way it's junk to ask what the single best way to every patient bad news is - it depends on the patient.

 

Overall though, I've heard of more programs rating marks as less important than other things.

[Guest frogcanada]

"

Radiology values marks a TON and you basically need to be into award mode to get in.

 

I met with the residency program head at U of T for Rads and they specifically told me that marks were not that important. They don't ask to see the actual marks and don't expect students to provide them (beyond P/F).

 

So was that just BS?

[Guest endingsoon]

Well I know the people that matched to UofT rads this year had amazing marks and many of them have won awards.

[Guest UWOMED2005]

Yeah, I people who have fantastic marks and awards who matched to the UWO internal and emergency medicine programs.

 

These are two programs which have repeatedly go on record as stating that marks matter. . . like 10% of the eval. . . and you get 8/10 for passing all your courses. . . the only way to get 9/10 for academics is to have a PhD. In other words, marks matter for these two programs. . . but the guy with all 'H's (and no PhD) gets the same mark evaluation as the guy with all 'P's. . . and less than the guy with all 'P's and a PhD.

 

So I think I can honestly say the people I've seen with "amazing marks and many of them have won awards" matched to UWO internal or emerg medicine for reasons other than marks.

 

Could this also be the case for your friends who matched to Rads?

 

I think the question for people worrying about matching to a program in a few years is not if there are people who've matched to who have "amazing marks and many of them have won awards," but rather if there are people who matched to that program WHO DIDN'T!

[Guest nahcadi]

To dispell the idea that you need all H's to get into something like rads--

 

I matched to UT Rads. I have one H (in surgery) is my core clinical subjects that did not include rads (which is elective, so only P/F). And a handful of H's in first and second year. I did get a scholarship each year, though. My undergrad isn't particularly spectular either.

 

I think to match to Rads (having only experience in this area) or any other competitive specialty you have to stick out in some way other than grades, be it references, papers, the time you spent in Somalia deworming little kids; show devotation to the speciality (let your elective experience speak for itself, although I heard AFTER my interview that UT doesn't like that); and have a good grasp of the challenges of the field and how you alone are specially qualified for it. For rads, I would say that research is the best way to demostrate all three, and get you stellar references-- and I am sure this is the case for most competitive fields. (Although during interview they ignored research and started talking my extracurricular life for half an hour. So this might be all B.S.)

 

Of course, the caveat is that spending too much time in the department will also shoot you in the foot.

 

Just bored of studying for the LMCCs.