Contents of Dean's Letter

[FatPigeon]

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[NotAProgDirector]

Each school is different. However, the MSPE is not designed to describe you "in the best light". It is supposed to be a fair and balanced description of your performance. The best MSPE's include all comments from all rotations, without cherry picking. If the dean feels that this evaluator is truly unfair, then 1) all comments positive and negative from all evaluations should be removed and 2) they should be removed from the teaching staff. The dean is welcome to include a comment on the specific circumstances regarding this evaluation comment.

Not all MSPE's work this way. Some selectivly choose their comments, but then I worry that important information (for me) is edited out.

 

[GreatSaphenous]

I agree with the Progdirect that the Dean's letter is intended to be a fair representation of your medical school career. However including an abberrant bad evaluation is not a true representation.

I had a similar experience with a medicine attending who torched me in my evaluation. Thankfully no one else on that or any other rotation agreed with her so I wasn't concerned until I received my copy of the Dean's letter and found direct quotes from her evaluation. I immediately contacted the writer of my Dean's letter, explained that her comments were not consistent with every other evaluation that I had received, and requested their removal. He thankfully agreed and my final Dean's letter was much more favorable.

I honestly think that many writers of the dean's letter leave much of their writing to their secretaries who just incorporate a variety of comments without considering their effect. It is definitely legitimate to bring your concerns to the writer of your dean's letter. You should have a fiar chance of having these comments stricken from the letter.

Hope this helps.

All for now, go back to your bean and rice burrito.
I am the Great Saphenous!!!!

 

[smq123]

So it's my understanding that the Dean's Letter is generally meant to say the best things possible about a given student, to portray them in the best light.

Is my dean required to include this awfulness, or are they typically selective about what they mention for the sake of the student?

I think it depends on the school and on the letter writer.

My MSPE writer told me, flat out, that she was not going to include comments from the one bad eval (which was slightly histrionic) in my letter. It was the only negative eval I had received all year, and she felt there was no need to include it.

Other students at other schools have told me, though, that they HAVE had negative comments included, even if they were outliers.

Hopefully, they allow you to talk one-on-one with your MSPE writer.

 

[mercaptovizadeh]

This is a real shame. It sounds like some random policy of the dean's office can be the difference between having bad comments discarded vs. kept in the letter. I assume this can have a significant impact in program evaluations of applicants.

Then again, comments are like bad apples - a few nasty comments can easily neutralize a plethora of excellent comments. Deans should look at the overall picture. ONE nasty letter in a pile of excellent letters is an aberration and SHOULD be ignored. If 1/4 or 1/3 or 1/2 the letters are bad, that's clearly not an aberration and should be recorded in the letter. I hope program directors look at it in the same light. They must be aware of how one bad letter amidst many good ones could speak as much (or more) about the letter writer as the applicant being evaluated.

 

[medsRus]

This is a real shame. It sounds like some random policy of the dean's office can be the difference between having bad comments discarded vs. kept in the letter. I assume this can have a significant impact in program evaluations of applicants.

Then again, comments are like bad apples - a few nasty comments can easily neutralize a plethora of excellent comments. Deans should look at the overall picture. ONE nasty letter in a pile of excellent letters is an aberration and SHOULD be ignored. If 1/4 or 1/3 or 1/2 the letters are bad, that's clearly not an aberration and should be recorded in the letter. I hope program directors look at it in the same light. They must be aware of how one bad letter amidst many good ones could speak as much (or more) about the letter writer as the applicant being evaluated.

The recent published survey demonstrated that the MSPE was in 16th place out of 16 fields for most specialties.

 

[dragonfly99]

medsRus
that may be true
but just because PD's ranked it 16th doesn't mean they don't look at it

residency programs look for evidence of personality disorders or any inability to get along with people, and such negative comments could be seen as a potential sign of that (fairly or unfairly)

dean's letter likely ranked 16th because it varies from program to program, and an excellent eval. at one school likely requires more effort than at many other schools, etc. It may be hard for PD's to compare one vs. another, and in general they have the transcript which may be easier to use for overall evaluation purposes, at least if they are in a hurry. However, any overtly negative evaluation in a dean's letter could definitely raise a red flag, and might get a student screened out, depending on what rotation it is from. IM programs may not care if an isolated surgical attending hated you, but if you want to do peds or psych and someone in your dean's letter said you don't care about your patients, are not sympathetic, etc. you can bet it's going to hurt.

 

[ShyFly]

My school let us write our own MSPE. It was really nice of them but it showed that I wrote it in the disclaimer, didn't seem to hurt though.

 

[gluon999]

My school let us write our own MSPE. It was really nice of them but it showed that I wrote it in the disclaimer, didn't seem to hurt though.

That is just ridiculous...and makes your MSPE totally useless.

 

[Pinkertinkle]

My school let us write our own MSPE. It was really nice of them but it showed that I wrote it in the disclaimer, didn't seem to hurt though.

wat clown college of a school lets you do that?

 

[WholeLottaGame7]

medsRus
that may be true
but just because PD's ranked it 16th doesn't mean they don't look at it

residency programs look for evidence of personality disorders or any inability to get along with people, and such negative comments could be seen as a potential sign of that (fairly or unfairly)

dean's letter likely ranked 16th because it varies from program to program, and an excellent eval. at one school likely requires more effort than at many other schools, etc. It may be hard for PD's to compare one vs. another, and in general they have the transcript which may be easier to use for overall evaluation purposes, at least if they are in a hurry. However, any overtly negative evaluation in a dean's letter could definitely raise a red flag, and might get a student screened out, depending on what rotation it is from. IM programs may not care if an isolated surgical attending hated you, but if you want to do peds or psych and someone in your dean's letter said you don't care about your patients, are not sympathetic, etc. you can bet it's going to hurt.

I think it's 16th out of 16 because they're 99.99% positive. What that boils down to is, a good MSPE won't help you, but a negative one can sink you fast. Schools want their graduates to get into residency programs to protect their reputation, so they're not likely to torpedo their own students. I think most programs at least give you the option to read it over beforehand.

 

[NotAProgDirector]

The recent published survey demonstrated that the MSPE was in 16th place out of 16 fields for most specialties.

What survey are we discussing? In the NRMP survey, MSPE ranked near the top in importance.

 

[medsRus]

What survey are we discussing? In the NRMP survey, MSPE ranked near the top in importance.

aProgDirector, here is the study that we are discussing. Your fellow PDs find the MSPE pretty much dead last in selection criteria across the medical fields:

Green M, Jones P, Thomas JX Jr. Selection criteria for residency: results of a national program directors survey. Acad Med. 2009 Mar;84(3):362-7.

Look at Table 3, last criteria...

 

[NotAProgDirector]

Interesting, but the NRMP survey recently published suggests otherwise. Hard to know. Regardless, I think it can be said that the better you do in medical school, the better all of these metrics will be...

 

[medsRus]

Interesting, but the NRMP survey recently published suggests otherwise. Hard to know. Regardless, I think it can be said that the better you do in medical school, the better all of these metrics will be...

From the peer-reviewed published article in the respected Academic Medicine:

The MSPE was ranked lowest of all criteria by the program directors. In theory, MSPEs should provide most of the information that program directors value. However, MSPE usefulness may be limited by variability in content and quality across institutions. Additionally, information included in the MSPE can be acquired through the transcript, USMLE score report, ERAS application, or letters of recommendation. Finally, the MSPE release date of November 1 may be too late to be useful to program directors, particularly for early match specialties. Given the enormous effort that goes into the creation of the MSPE, it may be worth further study to assess why program directors do not find it useful and to judge whether the resources required to create it are justified.
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[NotAProgDirector]

What is it that you find useful about the letter? I always thought it was kind of redundant. Is it just that all the information from other sources is summarized in one paper, cutting down the time you have to spend on each app?

The useful part of the MSPE is the review of performance in the 3rd year clerkships. The best MSPE's include all comments (good and bad), the shelf score (if available), and a histogram showing the student's performance compared with the rest of their class. This allows me to accurately assess their performance within their class. Although the grades might be on the transcript, it's impossible to know what they mean. Some programs give 5-10% honors and 90% pass. Some give 85% honors and 15% pass. Pass in the first is probably fine. Pass in the second is potentially trouble.