How to choose who evaluates you?

[Medstuy]

I'm a soon-to-be clerk who has not yet chosen his cores or electives. I want to understand how we can control who ultimately writes your eval and puts comment that goes into your MSPR.

I understand we are supposed to choose electives and cores by the division and the hospital (eg Pediatrics, Ottawa Hospital).

Is there any way to know who will evaluate you or is there a way to choose this? Without any doubt, some supervisors will be kinder in their wording and I'm wondering if we have any leeway in this. Otherwise, I don't really see the point of doing electives outside your home school if there is a 50% chance you get some jaded attending and ruining your chance of matching at that program. I believe even a single slight negatively worded comment could compromise your application.

How can we know in advance the specific attendings you will work with and the one who will grade you? Any tips on choosing electives at your own school? 

How common are "negative" comments in the MSPR? Is there a general tendency to only keep positive comments in the MSPR? Can you argue with your school over certain wordings?

[bearded frog]

Unfortunately it is going to be luck of the draw a lot, unless for something outpatient like family where you can reach out ahead of time at some schools prior to going through the portal. Otherwise you will be applying months in advance and often the staff schedules for hospital specialties will not have been arranged yet. Usually supervisors through the portal will have experience with local med students and resident supervision. Usually they won't throw you under the bus and the worst you'll get is "met expectations" unless you do something serious to screw up. Choosing electives at your own school may be easier since you don't have to go through the portal and you can approach Dr. X and ask them when they will be on service and if you could arrange an elective with them at that time.

[ralk]

Every school has their own way of setting what goes or does not go on an MSPR. Most are fairly forgiving, to the point that usually only positive feedback makes it there, even if some negative comments are given in evaluations. To that end, MSPRs are not relied upon much in the CaRMS process.

Most clerkship evaluations are beyond your control to decide who does them, as they're typically set in advance. You might be able to get some more face time with one preceptor or another, and their feedback will contribute to a final evaluation, but you won't be able to do that on any regular basis. Clerkship evaluators generally aren't trying to screw you over, however, and while their is certainly inconsistency in preceptor-to-preceptor feedback, overall rotation feedback should be relatively consistent (often for core rotations, one person does all the final evaluations for all clerks, using feedback from multiple preceptors). Point is, if you've reached the point that you have to fight for time with a particular preceptor to get a decent evaluation, either you're doing something really, really wrong, or the program is.

[ellorie]

May as well work on radically accepting that a large chunk of what happens in clerkship, electives, and CaRMS (and residency for that matter), you have minimal control over.

For core rotations, rely on upper year medical students to give you the dirt on various services/rotations.  For electives, ask residents in your chosen specialty.  Electives are a little easier, because if you get a bad feeling from a preceptor, you can always choose not to use the letter or not ask for a letter, so at least it only harms you at that school.  I'm pretty sure I got blackballed at one program and I still matched to my top choice.

As the others have said, you'll generally get a lukewarm evaluation at worst, and in most places you have some control over which evaluations go on your MSPR.  I had a head injury during my surgery rotation and kept having to leave early and do nothing due to concussion symptoms and I still got a passable evaluation.