A Program Director's Guide to the Medical Student Performance Evaluation (Former Dean's Letter) With a Database

Purpose To examine the variability among medical schools in ranking systems used in medical student performance evaluations (MSPEs). Method The authors reviewed MSPEs from U.S. MD-granting medical schools received by the University of California, Irvine emergency medicine and internal medicine residency programs during 2012–2013 and 2014–2015. They recorded whether the school used a ranking system, the type of ranking system used, the size and description of student categories, the location of the ranking statement and category legend, and whether nonranking schools used language suggestive of rank. Results Of the 134 medical schools in the study sample, the majority (n = 101; 75%) provided ranks for students in the MSPE. Most of the ranking schools (n = 63; 62%) placed students into named category groups, but the number and size of groups varied. The most common descriptors used for these 63 schools’ top, second, third, and lowest groups were “outstanding,” “excellent,” “very good,” and “good,” respectively, but each of these terms was used across a broad range of percentile ranks. Student ranks and school category legends were found in various locations. Many of the 33 schools that did not rank students included language suggestive of rank. Conclusions There is extensive variation in ranking systems used in MSPEs. Program directors may find it difficult to use MSPEs to compare applicants, which may diminish the MSPE’s value in the residency application process and negatively affect high-achieving students. A consistent approach to ranking students would benefit program directors, students, and student affairs officers.

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“…2,4 Our study clearly demonstrates inconsistency in the student ranking systems used in MSPEs among U.S. MD-granting medical schools.…”

Section: Discussionmentioning

confidence: 79%

Ranking Practice Variability in the Medical Student Performance Evaluation: So Bad, It’s “Good”

et al. 2016

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“…The movement away from meaningful grades for medical school courses also has led to an increasingly elaborate subjective evaluation in “dean’s letters” [77, 78]. The AAMC has introduced the Medical Student Performance Evaluation (MSPE) as a refinement of the “dean’s letter.” Approaches to evaluation of student performance generally involve formative and summative exams in the pre-clinical years, and subject exams coupled with faculty assessment of performance, in the clinical clerkships.…”

Section: Discussionmentioning

confidence: 99%

“…are integrated into lengthy MSPEs or dean’s letters that provide commentary and largely subjective impressions. In spite of the AAMC guidelines of comparative information about applicants be included, dean’s letters or MSPEs often continue to lack specificity regarding student performance [77, 78]. Major emphasis continues to rest on USMLE scores for the granting of interviews and ranking of applicants by residency program selection committees [74].…”

Section: Discussionmentioning

confidence: 99%

Medical education today: all that glitters is not gold

2019

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Background The medical education system based on principles advocated by Flexner and Osler has produced generations of scientifically grounded and clinically skilled physicians whose collective experiences and contributions have served medicine and patients well. Yet sweeping changes launched around the turn of the millennium have constituted a revolution in medical education. In this article, a critique is presented of the new undergraduate medical education (UME) curricula in relationship to graduate medical education (GME) and clinical practice. Discussion Medical education has changed and will continue to change in response to scientific advances and societal needs. However, enthusiasm for reform needs to be tempered by a more measured approach to avoid unintended consequences. Movement from novice to master in medicine cannot be rushed. An argument is made for a shoring up of biomedical science in revised curricula with the beneficiaries being nascent practitioners, developing physician-scientists --and the public. Conclusion Unless there is further modification, the new integrated curricula are at risk of produce graduates deficient in the characteristics that have set physicians apart from other healthcare professionals, namely high-level clinical expertise based on a deep grounding in biomedical science and understanding of the pathologic basis of disease. The challenges for education of the best possible physicians are great but the benefits to medicine and society are enormous.

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“…We excluded class rank and clerkship grades because of the extreme variability in the way these are determined among medical schools (including some schools that use pass-fail for these measures), making direct comparison difficult. 29 We also chose not to include medical school strength as we did not have a standardized way of determining this.…”

Section: Methodsmentioning

confidence: 99%

USMLE Step 2 CK: Best Predictor of Multimodal Performance in an Internal Medicine Residency

Sharma

Schauer

Kelleher

et al. 2019

Journal of Graduate Medical Education

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Background Internal medicine (IM) residency programs receive information about applicants via academic transcripts, but studies demonstrate wide variability in satisfaction with and usefulness of this information. In addition, many studies compare application materials to only 1 or 2 assessment metrics, usually standardized test scores and work-based observational faculty assessments.Objective We sought to determine which application materials best predict performance across a broad array of residency assessment outcomes generated by standardized testing and a yearlong IM residency ambulatory long block.Methods In 2019, we analyzed available Electronic Residency Application Service data for 167 categorical IM residents, including advanced degree status, research experience, failures during medical school, undergraduate medical education award status, and United States Medical Licensing Examination (USMLE) scores. We compared these with post-match residency multimodal performance, including standardized test scores and faculty member, peer, allied health professional, and patientlevel assessment measures. ResultsIn multivariate analyses, USMLE Step 2 Clinical Knowledge (CK) scores were most predictive of performance across all residency performance domains measured. Having an advanced degree was associated with higher patient-level assessments (eg, physician listens, physician explains, etc). USMLE Step 1 scores were associated with in-training examination scores only. None of the other measured application materials predicted performance. Conclusions USMLEStep 2 CK scores were the highest predictors of residency performance across a broad array of performance measurements generated by standardized testing and an IM residency ambulatory long block.

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A Program Director's Guide to the Medical Student Performance Evaluation (Former Dean's Letter) With a Database

Cited by 15 publications

References 7 publications

Ranking Practice Variability in the Medical Student Performance Evaluation: So Bad, It’s “Good”

Ranking Practice Variability in the Medical Student Performance Evaluation: So Bad, It’s “Good”

Medical education today: all that glitters is not gold

USMLE Step 2 CK: Best Predictor of Multimodal Performance in an Internal Medicine Residency

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