At each Canadian medical school, how many exams can you fail without having to repeat the year?

[Tullius]

Just wondering how many exams you can fail in each preclerkship year at each Canadian medical school before you have to repeat the year?  I heard some you can fail as many as you want, as long as you pass the re-write.  But for others, if you fail more than one exam then you have to repeat the year.

Perhaps people could just say what the policy is at their own school, or a school they are aware of? Thanks!

[Snowmen]

Sherbrooke Let's you do one repeat during the summer. 2 fails and you have to retake the year. Obviously, the best option is to not fail a single class, especially for CaRMS.

[JohnGrisham]

Another related question to inquire about, is what shows up on the transcript.

Apparently some schools, if you write a re-write exam, it doesnt appear on your transcript. Obviously advantageous over those schools that DO show the notation on your transcript. Very few people are in this situation generally though.

[DermJuly2018PGY1]

Do most schools in the pre-clinical years still have question banks from past years? During my pre-clinical years, if you just did these question banks, you would be set to pass the exam (although you wouldn't be getting the top score... but who cares, it's P/F)

[JohnGrisham]

52 minutes ago, DermJuly2018PGY1 said:

Do most schools in the pre-clinical years still have question banks from past years? During my pre-clinical years, if you just did these question banks, you would be set to pass the exam (although you wouldn't be getting the top score... but who cares, it's P/F)

Wasn't historically a thing at my school for pre-clinical (believe me, I asked upper years from grad classes year before ha!)

[Birdy]

McMaster: What exams?

Okay, to be fair, we did have tests. Things like the Concept Application Exercises (CAEs) at the end of each unit, and the rotation-end exams in clerkship (some of which were NBMEs.) But if you failed, my understanding is usually you'd just rewrite. I haven't heard of anyone having anything worse than that happen, as far as I'm aware. 

The CAEs were primarily formative and while we did get marks, they weren't stated on your transcript. The CAEs were just one component of each preclerkship block (MF) evaluation. 

I never particularly felt like any of my exams were super high-stakes, and thanks to early pregnancy exhaustion and the white noise of computer fans, actually fell asleep during my internal medicine NBME (still finished with around an hour to spare, and passed.)

 

[indefatigable]

20 hours ago, Snowmen said:

Sherbrooke Let's you do one repeat during the summer. 2 fails and you have to retake the year. Obviously, the best option is to not fail a single class, especially for CaRMS.

You could be referring to the new P/F system rather than the old graded system.  In the old system, It's more complicated than that - you can have  zero fails even and have to repeat the year - I know a case of this.  With 2 fails one would be at risk of being excluded from the program ..  

[Hanmari]

http://www.md.utoronto.ca/sites/default/files/Standards for grading and promotion of undergraduate medical students in the Foundations Curriculum.pdf

[JohnGrisham]

19 hours ago, Birdy said:

McMaster: What exams?

Okay, to be fair, we did have tests. Things like the Concept Application Exercises (CAEs) at the end of each unit, and the rotation-end exams in clerkship (some of which were NBMEs.) But if you failed, my understanding is usually you'd just rewrite. I haven't heard of anyone having anything worse than that happen, as far as I'm aware. 

The CAEs were primarily formative and while we did get marks, they weren't stated on your transcript. The CAEs were just one component of each preclerkship block (MF) evaluation. 

I never particularly felt like any of my exams were super high-stakes, and thanks to early pregnancy exhaustion and the white noise of computer fans, actually fell asleep during my internal medicine NBME (still finished with around an hour to spare, and passed.)

 

I wonder, how does McMaster actually set the passing mark for the NBME for clerkship exam? Some Canadian schools are actually fairly bad. One school out west sets the passing mark for some NBME exams at the 11th percentile mark. So while our US colleagues are vying for 90+ percentile to honour their clerkship rotation, we have some schools at least where you can pass with 11h percentile.

Not saying its the case at McMaster, just curious. 

[Birdy]

50 minutes ago, JohnGrisham said:

I wonder, how does McMaster actually set the passing mark for the NBME for clerkship exam? Some Canadian schools are actually fairly bad. One school out west sets the passing mark for some NBME exams at the 11th percentile mark. So while our US colleagues are vying for 90+ percentile to honour their clerkship rotation, we have some schools at least where you can pass with 15th percentile.

Not saying its the case at McMaster, just curious. 

Quite honestly I don’t know how they set the pass mark. I know they do take into account that some of the content is not consistent with expectations for Canadian medical students, so that’s part of the decision, but otherwise I don’t know how they set the pass mark. 

[goleafsgochris]

18 hours ago, Birdy said:

McMaster: What exams?

Okay, to be fair, we did have tests. Things like the Concept Application Exercises (CAEs) at the end of each unit, and the rotation-end exams in clerkship (some of which were NBMEs.) But if you failed, my understanding is usually you'd just rewrite. I haven't heard of anyone having anything worse than that happen, as far as I'm aware. 

The CAEs were primarily formative and while we did get marks, they weren't stated on your transcript. The CAEs were just one component of each preclerkship block (MF) evaluation. 

I never particularly felt like any of my exams were super high-stakes, and thanks to early pregnancy exhaustion and the white noise of computer fans, actually fell asleep during my internal medicine NBME (still finished with around an hour to spare, and passed.)

 

I don't even remember anyone having to rewrite any exams.  As you mentioned in pre-clerkship they weren't really exams so you couldn't really "fail".  I heard of someone getting held back for professionalism, but that was more lack of effort/showing up.  They used to say you needed 60 on the clerkship NBMEs, but no one in my group at least failed.  

[Organomegaly]

1 hour ago, JohnGrisham said:

I wonder, how does McMaster actually set the passing mark for the NBME for clerkship exam? Some Canadian schools are actually fairly bad. One school out west sets the passing mark for some NBME exams at the 11th percentile mark. So while our US colleagues are vying for 90+ percentile to honour their clerkship rotation, we have some schools at least where you can pass with 15th percentile.

Not saying its the case at McMaster, just curious. 

I think the pass mark is 60. Not sure what that equates to for percentile. 

 

Definitely agree about the US students studying more for them. It's too bad, because they're actually very well-written exams and students could learn a lot by preparing for them. 

[Organomegaly]

5 minutes ago, goleafsgochris said:

I don't even remember anyone having to rewrite any exams.  As you mentioned in pre-clerkship they weren't really exams so you couldn't really "fail".  I heard of someone getting held back for professionalism, but that was more lack of effort/showing up.  They used to say you needed 60 on the clerkship NBMEs, but no one in my group at least failed.  

 

Two people failed the Internal Medicine NBME in my stream. 

 

Not mentioned here is the PPI score. You're compared to your class mates on the basis of your mark compared to the class average. If you fall below 1.5 to 2.0 standard deviations on a consistent basis, you may get flagged for academic concerns and referred to the APC. But that's very few people. 

[goleafsgochris]

1 hour ago, Organomegaly said:

 

Two people failed the Internal Medicine NBME in my stream. 

 

Not mentioned here is the PPI score. You're compared to your class mates on the basis of your mark compared to the class average. If you fall below 1.5 to 2.0 standard deviations on a consistent basis, you may get flagged for academic concerns and referred to the APC. But that's very few people. 

Out of curiosity, what happened when they failed?

[Organomegaly]

7 minutes ago, goleafsgochris said:

Out of curiosity, what happened when they failed?

They must repeat the exam, at least for internal medicine. The NBME has several exam forms and they can offer different versions of the test. 

For the PPIs, they'll continue to monitor your progress on future PPIs to see how you compare to your peers.

 

For what its worth, there was a study that showed failing any NBME exam gave an odds ratio of ~10 for failing the LMCC. 

[goleafsgochris]

12 minutes ago, Organomegaly said:

 

For what its worth, there was a study that showed failing any NBME exam gave an odds ratio of ~10 for failing the LMCC. 

This makes sense.  I Remember appreciating how objective those exams were in evaluating your knowledge; and I liked that there was actually study materials (case files) basically directed at them.  In retrospect I learned way more on clerkship rotations at Mac where they had an NBME, vs a random poorly written exam that you can possibly get answers to from the years above you.

[Organomegaly]

29 minutes ago, goleafsgochris said:

This makes sense.  I Remember appreciating how objective those exams were in evaluating your knowledge; and I liked that there was actually study materials (case files) basically directed at them.  In retrospect I learned way more on clerkship rotations at Mac where they had an NBME, vs a random poorly written exam that you can possibly get answers to from the years above you.

Oh yes no doubt that NBMEs are good exams. Challenging, but good. People will complain of the few American oriented questions but 95% of the test is equally suitable for a Canadian cohort that it becomes a moot point to complain about. 

[Tullius]

My understanding is that failed exams are not that uncommon. 10-15% of medical students fail at least one exam in their first year of preclerkship at the school I'm thinking of.

[FailureToThrive]

At Sherbrooke, with the new pass/fail system, it's quite complicated and very gray, most of the administration doesn't know what's going on. We can't complain though, because at least it's pass/fail and no longer a GPA system.

If you get about 10% within the failing grade (will show as a Pass on your transcript), or failed (will show as a Fail on transcript, re-write exam during summer), you'll get what they call a "preoccupation". This means that after the school year, there's a "promotion committee" who reviews your file and if you have a few bad evaluations in the small groups (for example, not speaking enough, not "showing that you have enough knowledge", there is actually no specific criteria, each small group tutor kinda just writes how they feel about you based on about 6 hours of interaction spread over 2 weeks.), then you may have to repeat the year. 

Oh Quebec... Always making things more complicated than they need to be.

I heard that at McGill, if you fail an exam, you just have to re-write it a week later and it won't show on your transcript. Clearly advantageous if you ever have a bad day or were too busy publishing 12 articles during that block. 

[goleafsgochris]

2 hours ago, MD_2021 said:

 This means that after the school year, there's a "promotion committee" who reviews your file and if you have a few bad evaluations in the small groups (for example, not speaking enough, not "showing that you have enough knowledge", there is actually no specific criteria, each small group tutor kinda just writes how they feel about you based on about 6 hours of interaction spread over 2 weeks.), then you may have to repeat the year. 

This is one of the bad things about PBL--its almost impossible to evaluate.  Some preceptors at Mac would zone out completely and give everyone basically the same eval.  But some would essentially evaluate based on how much you talk.  If youre in a group of ~8 students, you sometimes have to force yourself to say a bunch of bs that doesn't add anything just to increase the percentage of time you are talking.  Harder than you think if there are 5-6 extroverts in your group. Also it goes without saying, but talking more in no way correlates with how much you learn in a PBL setting.

[FailureToThrive]

3 hours ago, goleafsgochris said:

This is one of the bad things about PBL--its almost impossible to evaluate.  Some preceptors at Mac would zone out completely and give everyone basically the same eval.  But some would essentially evaluate based on how much you talk.  If youre in a group of ~8 students, you sometimes have to force yourself to say a bunch of bs that doesn't add anything just to increase the percentage of time you are talking.  Harder than you think if there are 5-6 extroverts in your group. Also it goes without saying, but talking more in no way correlates with how much you learn in a PBL setting.

Absolutely agree, but I have a feeling that we'll be evaluated the same way during clerkships.

[brady23]

8 hours ago, goleafsgochris said:

This is one of the bad things about PBL--its almost impossible to evaluate.  Some preceptors at Mac would zone out completely and give everyone basically the same eval.  But some would essentially evaluate based on how much you talk.  If youre in a group of ~8 students, you sometimes have to force yourself to say a bunch of bs that doesn't add anything just to increase the percentage of time you are talking.  Harder than you think if there are 5-6 extroverts in your group. Also it goes without saying, but talking more in no way correlates with how much you learn in a PBL setting.

Yes!! one of the things I hate about PBL! You are basically just a broken record trying to get your speaking time in. Luckily, how UofT has been evaluating group sessions seems to be fair, they don't mind if you talk a lot or don't. 

[Tullius]

Can you say more about how u of t evaluates small group sessions? How is it different/better than the usual?

[brady23]

14 hours ago, Tullius said:

Can you say more about how u of t evaluates small group sessions? How is it different/better than the usual?

Just a pass/fail type of thing, they rank you on a Likert scale, everyone does fine on these.

[F508]

Ugh I hated that about PBL too. Sometimes people who ask a lot of questions (and thus talked a lot) got better evaluations than those you spoke less but actually contributed pertinent information to the group.