Improving the Medical Student Performance Evaluation to Facilitate Resident Selection

Abstract

The Medical Student Performance Evaluation (MSPE) was introduced as a refinement of the prior "dean's letter" to provide residency program directors with a standardized comprehensive assessment of a medical student's performance throughout medical school. The author argues that, although the MSPE was created with good intentions, many have questioned its efficacy in predicting performance during residency. The author asserts that, despite decades of use and some acknowledged improvement, the MSPE remains a suboptimal tool for informing program directors' decisions about which applicants to interview and rank. In the current approach to MSPEs, there may even be some inherent conflicts of interest that cannot be overcome. In January 2015, an MSPE Task Force was created to review the MSPE over three years and recommend changes to its next iteration. The author believes, however, that expanding this collaborative effort between undergraduate and graduate medical education and other stakeholders could optimize the MSPE's standardization and transparency. The author offers six recommendations for achieving this goal: developing a truly standardized MSPE template; improving faculty accountability in student assessment; enhancing transparency in the MSPE; reconsidering the authorship responsibility of the MSPE; including assessment of compliance with administrative tasks and peer assessments in student evaluations; and embracing milestones for evaluation of medical student performance.

What Do Program Directors Look for in an Applicant?

“…The MSPE was criticized for being used as an LOE when in fact it is an LOE, as well as for the lack of standardization and inclusion of comparative information (15,16). Accordingly, an MSPE Task Force was launched in January 2015 and released new recommendations to be adopted while writing MSPEs (15,17). Take time when you meet with the Dean or Associate Dean who will write your evaluation to go over the strengths of your application and specific evidence of your commitment to EM.…”

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

“…[1][2][3][4][5] The MSPE, despite recent efforts at improvement, often lacks transparency and standardization, making it difficult to interpret during the selection process. 6,7 Evidence is mixed about LOR predictive value. One small study showed successful residents had more LOR comments about excellence in the Accreditation Council for Graduate Medical Education core competency areas of patient care, medical knowledge, and interpersonal and communication skills, 8 but other studies found little value of LOR altogether for residency selection or resident performance.…”

Mexican ENARM: performance comparison of public vs. private medical schools, geographic and socioeconomic regions

“…6 The ENARM and the percentages of selection of their graduates are indicators of efficiency and reason of prestige and even of propaganda among the aspirants to study medicine. 7 Residency program directors want to predict which students will be most successful in their program as efficiently and cost-effectively as possible; 8 however, there is a paucity of consistent predictors of residency performance that have been well documented in the literature. 9 Although there are tools able to perform a standardised, comprehensive, summative assessment of a medical student's performance such as the Medical Student Performance Evaluation (MSPE); 8 to the best of our knowledge, there is no consensus of the best statistical methods to compare medical schools performance worldwide.…”