My pediatrics grade is essentially divided equally between three parts - first month evaluation, second month evaluation, and the exam. For the first time in my life, I received a "Pass" as an written evaluation for my performance. Now, I've gotten "pass" on plenty of tests. I know I'm not the strongest test take. But in the real world? Never. I felt a lot of things but pissed off was probably the strongest one. I was told to be happy for it given all of the stress I've been under for....I can't even recall anymore. First my brother, then my dad, and finally my son. Somewhere in there, I went to medical school but I'm not quite sure I recall it. So I was supposed to be grateful that I passed given the circumstances. Pardon my language but $*%^ that.
So the second month of pediatrics rolled around in February. Different location, different attending, different everything. And the stars aligned just right for me to be in the type of situations where I do best in. Lots of work, an attending willing to let me take on as much responsibility as I wanted (and actually listened to my plans), and it was outpatient. I was going to be damned if I let another month of "Pass" come across my ego. I put my head down and plowed on handling things as simple as well baby checks to rather complex patients. And my performance was not undervalued. I redeemed myself and got "Honors" with rather good comments on the written part. Those are actually probably the most important part. At the end of your med school career when you apply to residency programs, probably one of the biggest thing besides your first licensing exam score, is the Dean's Letter. On the letter goes ALL of your comments from Every. Single. Rotation. I've known a few students who apparently didn't play up the resident's ego enough and got a bad comment on the review, despite passing the class. I knew the students. They were not slackers. But doctors can be assholes just like any other profession. And that one comment can tank your application. No one wants to have to explain in an interview the comment "student was disinterested" or "lackadaisical in their approach" even though the rest of the comments were good. You want to spend your limited interview time talking about other things because your letter has line after line after line reiterating "hard worker", "will make an excellent clinician", "was able to handle the most complex of patients", or my personal favorite "functioned at the level of a resident." And then there's that one that matters more in Family Medicine than other specialties, "great at developing relationship with patients."