Medical Student Performance Evaluation (MSPE) Resources

Medical Student Performance Evaluation (MSPE) was the 5th highest ranked factor (equivalent to USMLE and COMLEX scores) cited by 924 medical residency program directors when selecting applicants to interview.

2020 NRMP Program Director Survey Results. (2020). NRMP, 3-3. Retrieve here

What is the Medical Student Performance Evaluation (MSPE)?

The Medical Student Performance Evaluation (MSPE) evaluates a medical student’s performance during their academic career among their medical school class. According to AAMC: “MSPE is a summary letter of evaluation, not a letter of recommendation. Information presented in the MSPE must be standardized, clear, and concise and presented in such a way that allows information to be easily located within the document.”

What’s new with MSPE for the 2021 Match & COVID-19?

  1. Take a look at the AAMC Task Force on MSPE’s “2016/2017 Recommendations for Revising the Medical Student Performance Evaluation (MSPE)“. The most important changes are that MSPE’s must now be more objective and ACGME core competency-based than ever before. Also, they’ve done away with “Appendix A to E”, which was quite a challenge to adhere to by non-U.S. medical schools. A well-written MSPE can help medical residency selection committees predict the future performance of incoming applicants; as such, AmeriClerkships Members and their medical schools are highly encouraged to follow the 2017 AAMC MSPE Task Force’s new recommended guidelines, so their evaluation is crystal-clear.
  2. The GSA Committee on Student Affairs (COSA) MSPE Effective Practices Working Group has released new guidance and an adapted template for addressing COVID-19 related curricular, evaluative, and other changes in the MSPE. The new COVID-19-specific guidance emphasizes clarity over uniformity in describing the impact(s) of the pandemic on the applicant’s academic experience, using the 2016 MSPE Task Force recommendations as the foundation.

Is the MSPE really that important for an international medical graduate?

Absolutely! MSPE was cited by medical residency programs to be as important as USMLE Step 2 CK score when ranking applicants who interviewed at their program (N=1,275; NRMP Program Director Survey Results. (2016). NRMP, 4-4. Retrieve here)To put things in perspective, residency candidates typically spend months, if not years preparing for Step 2 CK, but nearly zero effort or time in ensuring that their MSPE stacks up against their formidable competitors (namely, other U.S. medical graduates).

Is an MSPE the same as a Dean’s Letter?

Not really; however a “Dean’s Letters”, the precursors to MSPE’s from the early 1990’s, is still being accepted by ECFMG and ERAS, giving the impression that it is still acceptable to use it when it shouldn’t be. A Dean’s Letter typically recommends a candidate to residency, which is the exact opposite of what an MSPE should be doing, deviating from the 2017 MSPE recommendations by AAMC. Any deviation from the MSPE guidelines has a higher risk of confusing residency programs and hurting your interview chances.

I am a medical student at a non-U.S. medical school; should I worry about the quality of my MSPE?

Unfortunately, yes! Of 283 MSPEs analyzed by AmeriClerkships (benefit of Certified Membership), 82% (231) failed to meet the minimum requirements to be recommended for use in ERAS. Of note, these 231 problematic MSPEs were exclusively issued by non-U.S. medical schools and not LCME (U.S.) accredited medical schools, which is to be expected. MSPE is not a standard document produced by the majority of 2800+ medical schools across the globe; it is only commonly issued by U.S., Canadian, Caribbean and offshore medical schools. For all other medical schools, compiling a strong MSPE often takes upwards of 10 hours to complete, which has typically not been worked into a foreign medical school Dean’s daily activities or training.

What are the most common MSPE red flags?

The following red flags are what have been noted by AmeriClerkships in MSPE’s generated by non-LCME medical schools (including Caribbean and offshore; U.S. and Canadian medical school MSPE’s are rarely found to not follow the most current guidelines) in order of prevalence, and mainly for MSPE’s being prepared for submission to the 2018 Match:

  1. Not following at least 2 of the 10 recommendations made by the AAMC Task Force on MSPE’s “2017 Recommendations for Revising the Medical Student Performance Evaluation (MSPE) (still following the 2002 MSPE guidelines, or worst, the 1989 Dean’s Letter format”);
  2. Resembles a letter of recommendation (often evidenced by being able to predict exactly what the ending “Summary” paragraph will say after the first couple of paragraphs on page 1 of an MSPE);
  3. Minimal (if any) reference to ACGME core competencies;
  4. ‘Noteworthy Characteristics’ section often provides no objective evidence for the statements made (i.e. “xxxxx showed a great deal of academic excellence during his school years and often finished amongst the top students.“)
  5. Academic Progress does not go the extra mile to draw parallels with U.S. medical education (4 years in the U.S. and the inability to practice medicine immediately upon graduation, versus 5 to 7 years and the ability to practice as a GP in nearly every other country, forcing the reader to make his own assumptions and conclusions);
  6. At least 2 inconsistencies (or unexplained gaps in medical education) found in the timelines provided.

Should there be any differences in content of an MSPE prior to graduation, versus when a medical graduate asks his/her medical school to write an MSPE years after graduation?

Technically no, but preferably yes. A well-written MSPE should be simple to read, and provide certain objective evidence (i.e. if the Dean is going to talk about your U.S. clinical experiences after your medical school graduation, he/she should support that statement after having reviewed objective proof that these experiences actually took place – either through clinical evaluations or letters recommendations by the attending physician who supervised you).

How can I improve my MSPE?

If your school allows input while they are drafting your MSPE, it is essential that they conform to the AAMC’s guidelines as much as possible to help programs understand your performance. A medical school’s ability to understand and work with these guidelines comes dow to how much experience they have had with drafting such MSPE’s before, so make sure your school knows what to do. If you already have your MSPE and want to know whether or not your school’s MSPE is strong or not, AmeriClerkships Certified members can have their MSPE analyzed as a part of their membership benefits.

My medical school does not typically write MSPEs; what should I watch out for, and how do I deal with this?

Entrusting your residency application future to a medical school that may or may not be familiar with AAMC’s guidelines for drafting an MSPE is a risky proposition. If your medical school is unsure or inexperienced with the 2017 guidelines for writing an MSPE, or if you want an original MSPE and wish to accelerate the signing process of an MSPE by your school, then the AmeriClerkships ‘Medical School Performance Summary Draft’ Writing Service may be right for you.

Can I draft my own MSPE?

Some schools allow you to assist your Dean by having you draft a part or most of your MSPE, and if they do, you should absolutely take advantage of this opportunity by:

  1. Drafting your MSPE using the new recommended format implemented in 2017, THEN
  2. Upload for AmeriClerkships to analyze (Certified Membership required), THEN
  3. If it scores 75 or above, then send the MSPE you helped draft to your Dean for review, fact-checking and finalizing.

Can AmeriClerkships help my Dean draft a 2017 recommendations compliant MSPE?

Yes; click here for details.

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