'Tis the season.
Residency interview season, that is.
- Faculty are trying to sort out the piles of ERAS applications, trying not to zone-out while reading their 50th personal statement over the past 4 hours. Does it seem that medical students are getting more and more amazing every year?! I'm glad I got in when I did.
- Student forums are abuzz with residency program and interview etiquette questions.
- Students are second-guessing themselves about why they haven't heard from their first-choice program.
- Students are starting think about whether they still fit in their business suit from 4 years ago, when they interviewed to get into medical school.
I came upon this article in Academic Medicine, written by Emergency Medicine faculty like my friend Dr. Annie Sadosty (Mayo Clinic). The Dean's Letter, also known as Medical Student Performance Evaluation, is a summary evaluation of the graduating medical student. It is a key document that application-readers look at.
The authors conducted a retrospective, multicenter, chart review study at 3 residency programs. Two data abstractors independently looked at the 2007-08 Dean's Letters of all the applicants in the programs. They searched for the term "good" in the summary statement and appendices of each Dean's Letter, to find whether it correlated with the student's ranking.
Result
The adjective "good" was used in 34 of 122 (28%) institutions to classify the students into performance tiers. Of these 34 institutions, 25 (74%) used "good' to describe a student in the bottom quartile of the class (0%-25%). All 34 institutions used "good" to describe students performing in the bottom half of the class.
The authors concluded what some of us have learned through personal experience of reading hundreds of files. On the Dean's Letter, GOOD is a code word for BAD usually. This study illustrates the need for a more standardized tool or template for reporting student performance. Variability makes it really difficult for residency program directors to compare students from different medical schools.
The authors propose that that all medical schools should adopt a standardized approach to writing the summative portion of the Dean's Letter.
Tip
In the meantime, if you are writing letters of recommendations for anyone, try to avoid the term "good" for now. You never know if letter readers automatically interpret this as having a negative connotation.
Reference
Kiefer CS, Colletti JE, Bellolio MF, Hess EP, Woolridge DP, Thomas KB, Sadosty AT. The "good" dean's letter. Academic Medicine. 2005, 85 (11), 1705-8. PMID: 20881821
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