Why Did You Not Make Honors on a Clerkship?

“Why did you not make honors on your [fill in the blank] clerkship?” Believe it or not, this was an actual question I got on an interview. I was caught completely off guard. Thankfully, I gave an answer that worked to my benefit. I want to help you prepare an answer to this question that bolsters your case as a worthy applicant.

Ambiguity of Honors

Medical students notoriously seek ways to impress attendings and residents in order to gain the status of “honors”, but this designation means something different to everyone. There is no universal definition of an honors student. Each school has their own unique criteria. Not only that, but attendings and residents within the same medical school will apply the same criteria differently. There are always attendings who are notoriously harsh evaluators, while some are known to be more lenient. Additionally, many schools blind their “honors” grading in some fashion. This means many medical students may not receive specific feedback on why they were or were not given honors.

“Present your answer as a positive display of humility, ownership of your education, and efforts to improve yourself.”

Dr. Alan Gambril, Contributor, Med Student Edge

Why Do Interviewers Ask the Question?

Program directors and interviewers know how much variation there is in honors grading. So why do they ask the question? They are not trying to point out a flaw. If it was too big a flaw for them, then you wouldn’t have been granted an interview in the first place. If programs limited themselves to only students who honored in their field, they would limit their applicant pool too heavily, missing out on students with valuable experiences outside of clerkships. They really want to test your ability to reflect on performance, acknowledge areas that need improvement, and actively work to progress your skills. They also have the opportunity to expose any red flags, such as lack of humility, inability to take ownership of your own training, defensiveness and blaming others, or lack of self-reflection. It’s just a more specific formulation of the classic questions “what is your biggest weakness” and “tell me about a time you made a mistake”.

Know Yourself

In order to effectively answer this question, you have to know yourself well. Hopefully, you asked for feedback consistently throughout your clerkships and know where you are strong and where you need improvement. Reflect on the clerkships you weren’t granted honors, the feedback you received, and your evaluations. Formulate reasons why you were graded the way you were. How did the feedback help you? What could you have done better? What did you learn about medicine and working with a team? What steps did you take to improve moving forward? What was different in clerkships you did get honors? This information will form the meat of you answer.

Image taken from Pixabay.com

Putting It All Together

I’lI start here with the answer I gave when asked this question. I matched into Med-Peds. I did not receive honors on my Internal Medicine Clerkship. I answered with something like this:

“Internal Medicine was my second clerkship. At the beginning of the rotation, I was still struggling to find an effective pre-rounding routine. My presentations often felt unorganized and choppy. I think I was trying too hard to jump to resident-level presentations and skip the fundamental steps. A few weeks in, after asking for feedback and more practice, I started to figure it out. By the end of the rotation I had a routine and a template for pre-rounding and presentations. I was much more comfortable and was able to move on to my next rotation feeling confident in my oral presentation skills.”

Being honest here is important. If you aren’t honest, the interviewers will pick up on it. Tackle the question head on. Excuses and defensiveness are red flags to programs that signal you can’t take responsibility for your own weaknesses. After taking responsibility, mention how you addressed areas needing improvement (feedback, practice, new templates for presenting, more reading, etc.) and how that improvement played out (positive feedback, honors on future rotations, etc.). The point here is to present your answer as a positive display of humility, ownership of your education, and efforts to improve yourself.

In conclusion, the “honors” title is a bit mysterious, and the overwhelming majority of students do not receive honors on at least one clerkship. But when asked about why this is the case by interviewers, you can now use the opportunity to show them qualities that will make you an outstanding resident.

Are you nervous about not getting honors in the field you are applying to for residency? Why or why not? Comment below.

Back to more interview questions and response aids.

Alan Gambril, MD
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