The Dreaded MSPE Letter

[ChemEngMD]

Thanks Yall

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[Amygdarya]

A couple of things:

1) Given that schools are interested in their graduates matching well (and your school specifically, based on what I've heard of the grading structure), it is highly unlikely for negative comments to end up in MSPE. As you can see, these comments didn't even make it into your final clerkship narrative. However, if one is *consistently* perceived as unprofessional, disagreeable etc, this will result in potentially harmful lukewarm clerkship evals/MSPE comments.

2) Regardless of the first point, we work with people in medicine - and some forget that "people" include not only patients, but our colleagues, staff etc. Playing well with others is necessary to get the job done, plain and simple. This is why being seen as disagreeable may raise the dreaded "professionalism" issues. I hear ya, I'm also the kind of person who hates to pretend to be someone I'm not - thus, I was *appalled* when an attending who disliked my kind of quiet and reserved personality suggested that I should "perform" i.e. to act in an artificial way to comply with his view of how doctors in training should behave. However, there is a difference between just being yourself and offending other people. You don't have to change your whole personality, but you may want to consider which aspects of it may be tuned down.
It is possible that that resident (and, by extension, attending) was the only person who you rubbed the wrong way, an issue of individual incompatibility (which was the case with me and the attending I mentioned above), in which case you may just shrug your shoulders and move on. However, if several people have issues with you, especially people on different teams/services/rotations, you may want to consider the way you behave.

 

[ChemEngMD]

A couple of things:

1) Given that schools are interested in their graduates matching well (and your school specifically, based on what I've heard of the grading structure), it is highly unlikely for negative comments to end up in MSPE. As you can see, these comments didn't even make it into your final clerkship narrative. However, if one is *consistently* perceived as unprofessional, disagreeable etc, this will result in potentially harmful lukewarm clerkship evals/MSPE comments.

2) Regardless of the first point, we work with people in medicine - and some forget that "people" include not only patients, but our colleagues, staff etc. Playing well with others is necessary to get the job done, plain and simple. This is why being seen as disagreeable may raise the dreaded "professionalism" issues. I hear ya, I'm also the kind of person who hates to pretend to be someone I'm not - thus, I was *appalled* when an attending who disliked my kind of quiet and reserved personality suggested that I should "perform" i.e. to act in an artificial way to comply with his view of how doctors in training should behave. However, there is a difference between just being yourself and offending other people. You don't have to change your whole personality, but you may want to consider which aspects of it may be tuned down.
It is possible that that resident (and, by extension, attending) was the only person who you rubbed the wrong way, an issue of individual incompatibility (which was the case with me and the attending I mentioned above), in which case you may just shrug your shoulders and move on. However, if several people have issues with you, especially people on different teams/services/rotations, you may want to consider the way you behave.

Thanks for the feedback. BTW, my final clerkship narrative hasn't been released yet so idk if it will end up on that or not. It was a short rotation and thus I only had 1 attending unfortunately so I could end up royally screwed here.

You bring up fair points. I had one other attending who is very straight laced and traditional who thought I was too casual and felt it may come off as unprofessional. I think with the patient population I work with and the one I plan to work with in the future it actually tends to be an asset (and I've had more than one attending give me this feedback). Perhaps I have one of those polarizing personalities that some people respond really well to and others are not receptive of lol.

I will try and take your attendings advice and do a bit more "performing."

 

[Frazier]

MSPE is usually polished up by administration. As said above, best interest for a school to have its students match.

NOW, if administration doesn't like you... you're in trouble.

 

[MilkIsGood]

..

 

[justin1390]

MSPE is usually polished up by administration. As said above, best interest for a school to have its students match.

NOW, if administration doesn't like you... you're in trouble.

Don't get me wrong, this is generally true, but I'm with MilkIsGood, this really boils down to the clerkship director comments. Unless it was glaringly evident an attending did not like a student or gives poor evals, the MSPE was a cut/paste. That said, the school would try to provide reason in their summary assessment from what I heard from students who were perceived poorly. It's all a terrible game, but unfortunately you have to roll the dice.

I would address this head on in interviews if you get asked. Highlight the other good reviews, and I would note that this was unobserved by the attending, and if true, note that you had not received any negative feedback up until this assessment. Best of luck! Really sucks when that happens. My friend who has a stutter and is introvert got the same thing on a surgery rotation. Guy is my best friend, one of the nicest and most upstanding guys, but he got slammed by a surgery attending. Still matched to #2 spot.

 

[Redpancreas]

EDIT: deleted the quote since you deleted your post.

While I have nothing to say about your MSPE and hope things work out for you, I want to comment on your sarcastic humor and what you describe as a lack of desire to be "phony".

I personally have been told that I came off as a bit blank-faced/lost even while I do my tasks well. Regardless of how well I do things though, this still affects people around and and I have had to change who I actually am during this time to always appear like I'm actively listening, etc. This is something that comes unconsciously yet I still have to own it and change it.

You on the other hand are actively saying stupid things and I feel your attending is perfectly in line to say you're being unprofessional. Keeping your mouth shut and being polite is the very least that's expected of you as a medical student. It's not unreasonable for you to have to be what you think is phony. Most medical students have to do far more to appear professional. Just look at the poster above me with a friend who gets slammed because of his stutter.

 

[Mass Effect]

Don't assume that the school always has all the students' best interests at heart. My school made it clear that the MSPE would include ALL comments, unedited, from our evaluations. Both positive and negative. They even had a line in the MSPE so that program directors knew that all comments were unedited.

 

[Psai]

Don't assume that the school always has all the students' best interests at heart. My school made it clear that the MSPE would include ALL comments, unedited, from our evaluations. Both positive and negative. They even had a line in the MSPE so that program directors knew that all comments were unedited.

That is having your best interests at heart. Residency directors know that what's said is legit and unedited instead of having all glowing crap about someone who isn't actually that great.

 

[Mass Effect]

That is having your best interests at heart. Residency directors know that what's said is legit and unedited instead of having all glowing crap about someone who isn't actually that great.

You should join a political spin team. If the goal of a med school is to have their student match, then a version of the MSPE that don't include negative things is appropriate. Some negative comments aren't even relevant. They're just annoying. Unless there are serious red flags that programs need to be aware of, there is no need to include any old thing an attending chooses to write. For example, I applied psychiatry. My surgery attending put on my eval my eye site must be poor because I cut a lot of his knots. WTF is that in the MSPE for? A classmate's neurology eval mentioned that he did not have sufficient experience in neurology because he was "not available for rounds at least once a week every week." Mind you, this is because of mandatory didactics which the attending was well aware of and told by the school, not because he was off somewhere chilling out. But because the comments are unedited, these things were not explained. They stood as is. So, no, you'll forgive me if I'm not feeling that they had our best interests at heart.