One of the coolest things about going to school here is that we are constantly supported, advised, and mentored by faculty interested in our medical education. The experience is so extensive here that it sometimes verges on too much. For instance, here are the titles of the people involved under the general category of “advisors” to first-year students: 

• Dean of Students
• College mentors
• Faculty affiliate advisors
• Student affiliate advisors
• Case-based learning facilitators
• Continuity clinic small group facilitators
• Course directors (become “advisors” if you start failing, I guess)
• Portfolio coaches

If you’re counting, there are coaches, mentors, advisors, facilitators, and directors. Lots of active job titles there. But the subject today is the last one on the list, the “portfolio coach.”

At my school, only a part of your paper record is your grades. Test scores and quiz averages are in there, sure, but we are continually “evaluated” – code for “people fill out forms” – on how well we are doing. Everything is evaluated. You’re evaluated by your peers, you’re evaluated by your mentors, you’re evaluated by your facilitators, and you’re evaluated by yourself. It’s so meta.

Interestingly, to “pass” a year in school requires the presentation of your portfolio to a group of faculty members known only as The Promotions Committee. No one really knows who sits on The Promotions Committee, only that they possess the ability to grant you sweet, sweet access to subsequent years of medical school. Or hold you back. Or do other unspeakable things to your career prospects. No one knows what these things are.

A part of me pictures The Committee like the Council from V for Vendetta, sitting in a darkened room and passing judgment on our worthiness to advance….

(Aside: It took me almost an hour to find this screenshot, so you better like it.)

A different part of me pictures them like Gandalf on the bridge, denying access to that demon-thingy.

Wait. This could be better. Nerd humor incoming…

Ahh. Home sweet home.

Realistically, The Promotions Committee (I refuse to refer to them without capitalization) is a group of faculty who already knows us fairly well and are just reviewing our files as just another administrative function.

Oh yeah. Portfolios. The “portfolio coach” is a faculty-person who reads all of your evaluations and sees all of your grades. They’re responsible for synthesizing a Portfolio Coach Evaluation (again, caps), a document basically designed to give an Emperor Commodus-style recommendation to The Promotions Committee about our fitness to advance.

Here is a table I made to explain this.

Now you all may understand. Thank you Microsoft Word for the crappiest Table money can buy.

Last week, I had my first real meeting with my Portfolio Coach. I’ve met her once before earlier in the year, but we hadn’t completed much yet in the way of tests, evaluations, or actual medical school. It thus wasn’t the most fruitful meeting, making this our first real one.

The goal of the meeting was to review my progress and see how I did on the “goals” I had created for myself last time.

I sat down in the booth across from her at a coffee shop near campus. She opened her computer as we made small talk; I had just come from clinic and was relating my first experience telling a concerned parent who wanted antibiotics for their kid’s stomach virus that they couldn’t have any. (That’s a story for another day).

She pulled up my file and began.

PC: “So, Nate, it looks like you’re doing really well. In fact, it looks like you’re killing medical school!”
Me: Um… really? [I know my grades, and I have a fair idea of where my classmates’ grades are. Mostly, higher than mine.]
PC: “Yeah! You’re definitely top half. Probably even top quartile. I’m really impressed with how far you’ve come since the first block.”

I was pretty sure how this was going to end.

Me: Uh, Portfolio Coach… are you sure you’re looking at the right file?

PC looked to her computer, perplexed. She looked back up at me, with my name prominently displayed on my ID badge attached to my lapel. She looked back to her computer, a red flush racing up her neck.

PC turned crimson.
PC: Oh my god. I’m so sorry. I have the wrong file!

Oops. I had a feeling she was Portfolio Coaching the wrong student.

[Aside: Because about 50% of my readers share my last name, with another 25% named Grandma, it’s worth noting that I am doing fine in medical school. I am in no danger of failing, and I am not at all upset that I am closer to bottom than top quartile. Pass/fail is a truly beautiful concept that enables you to give exactly zero consideration to where you fall within the class. Passing at all is well more than enough for me. Promise.]

My coach recovered well and the rest of our meeting went smoothly. It actually is a valuable tool for focusing on where you’d like to improve (read: everywhere). For example, anatomy:

PC: So you had a goal last time to get an 80% on the anatomy practical portion of the ex-
Me: HAHAHAHAHA!
PC: That appeared to be hard for you, it seems?
Me: I marked that goal as “discarded.”
PC: What’d you put as the reason?
Me: Unrealistic.
PC <checking my anatomy grade>: Oh. Yes. Yes, let’s revise that down for next time..

So it goes…