Medical Student Performance Evaluation for Residency Applicants 

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Medical Student Performance Evaluation
for Residency Applicants 

Medical Student Performance Evaluation for Residency Applicants 

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Greetings everyone! The 2025 ERAS Match season is soon hitting the calendars, which means it’s time to compile all the relevant documents, review them thoroughly, and submit them within the deadline. Seems like a lot of work, right? When applying for a U.S. residency position through ERAS, every applicant strives to gain a competitive edge that distinguishes them.

One crucial document not to be underestimated in this regard is the Medical Student Performance Evaluation (MSPE), the revised version of what was formerly known as the Dean’s Letter. This essential document offers program directors a comprehensive, impartial assessment of each candidate, highlighting their strengths, achievements, and potential.

In this blog, we’ll discuss the intricacies of the MSPE and share practical insights that will address all your questions and help you make the most of this document.

Before we start, if you are looking for MATCH® 2025 All-in-One Application Resources, including MSPE samples, personal statement examples, ERAS application template, and much more, click here.

Table of Contents:

What exactly is the Medical Student Performance Evaluation (MSPE)?

The Medical Student Performance Evaluation (MSPE) assesses a medical student’s performance throughout their academic career in comparison to their peers. The term “Dean’s letter” has been replaced with MSPE to more accurately reflect the document’s purpose. Although ERAS Support Services will accept a “Dean’s letter” from your medical school, it is strongly recommended that medical schools provide an MSPE that adheres to the guidelines set forth by the Association of American Medical Colleges (AAMC).

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Why is the MSPE Important for the Application?

  • Initial Screening: Program directors often use the MSPE, along with USMLE scores and other application materials, to decide which candidates to select for interviews.

  • Insight into Clinical Skills: The detailed feedback from clinical rotations provides insight into the applicant’s practical skills and ability to work in a clinical environment.

  • Professionalism and Conduct: The MSPE highlights any professionalism issues or commendations, which are crucial for residency selection committees.

How is MSPE different from the LOR?

Although both MSPE and LOR assess an individual’s performance, the MSPE provides an objective overview of a student’s accomplishments and abilities. On the other hand, “ERAS letters of recommendation”, or LORs, are designed to present detailed, opinionated analyses from the recommenders, providing a more personal perspective.

In the past, the MSPE used to have more indefinite evaluations, often using vague terms like “good” or “bad” to evaluate a student’s performance. However, the AAMC has made crucial revisions to its MSPE Guidelines to improve standardization and objectivity. As a result, those making your MSPE are encouraged to closely follow the AAMC’s recommended structure/format.

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What content should I add to my MSPE?

Under the AAMC guidelines, the content of MSPE is divided into six sections, each signifying different aspects of the applicant.

1. Identifying Information

This section contains fundamental information such as your legal (full) name, current year of study, and the name of your medical school and its location.

Example:
Jessica White is a fourth-year medical student at [Medical School] in [City], [State].

2. Noteworthy Characteristics

Everyone has certain, unique abilities that represent their individuality. In this section, your evaluators/writers highlight three characteristics that perfectly describe you.

This may include hobbies or passions, previous work experience, roles not specific to academics, and pertinent research. However, this section is not intended for lengthy narratives; the AAMC guidelines, practiced by medical schools, recommend not to exceed these bulleted points by more than 40 words.

You will likely have significant input in this section. While each school has its own process for drafting MSPEs, you will typically be asked to provide feedback on these characteristics. Many schools will request that you submit a list of 3-4 traits for your evaluators to choose from and edit into the final MSPE.

Examples:

  • “Ms. Tania Jacobs has demonstrated exceptional leadership as president of the student medical association, coordinating many successful events and initiatives during her tenure.”

  • “Mr. Omar is deeply committed to community service, volunteering regularly at local health clinics and organizing health camps in underprivileged societies.”

  • “Mr. James Brown has contributed significantly to medical research, with his work about microbial resistance published in reputable journals and presented at national conferences.”

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3. Academic History

Your academic history section provides a straightforward account of your educational journey, including key details such as your matriculation dates and expected graduation date. It also covers any additional degrees you’ve participated in and notes if you repeated or redid any coursework.

According to the AAMC guidelines, this section can also explain leaves, breaks, or gaps in your education journey. While the basic overview of your academics is definite, there is space to briefly describe any circumstances that might exhibit concerns.

For example, suppose, unfortunately, you took a semester off due to COVID-19. In that case, this section will note the break and provide a plausible explanation for why you took it and how it affected your studies. Finally, this section will record any disciplinary or adverse actions taken by your medical school.

Example:

“Date of Initial Matriculation in Medical School:”
January 15, 2016

“Date of Expected Graduation from Medical School:”
May 30, 2023

“Please explain any extensions, leave(s), gap(s), or break(s) in the student’s educational program below:”
Ms. Sarah Carson took a one-year leave of absence during her second year of medical school due to family reasons. Upon her return, she successfully resumed and completed all required coursework and clinical rotations with dedication.

“Information about the student’s prior, current, or expected enrollment in, and the month and year of the student’s expected graduation from dual, joint or combined degree programs.”
Ms. Sara Carson is enrolled in a joint MD/MPH program and expects to graduate on May 30, 2023.

“Was the student required to repeat or otherwise remediate any course during their medical education? If yes, please explain.”
Yes, Sarah was required to remediate an introductory sciences course during her first year of medical school due to personal health issues. This was successfully completed, and the student has since progressed without any further academic issues.

“Was the student the recipient of any adverse action(s) by the medical school or its parent institution? If yes, please explain.”
No, Sarah has not received any adverse actions by the medical school or its parent institution.

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4. Academic Progress

This is another contextual section that provides definite performance/ evaluation metrics in three key areas:

  • Professional Performance: Evaluators assess your professionalism based on a criteria set by your school. This includes feedback from preceptors, faculty, officials, and administrators regarding your clinical rotations, scholarly activities, and personal conduct.

Example:

“During his academic tenure, Mr. Max consistently demonstrated exceptional professionalism, marked by a proactive approach and meticulous attention to detail. He actively engaged in collaborative settings, consistently fostering a positive and respectful environment among peers and faculty. His dedication to ethical standards and commitment to patient care exemplify the core values expected in the medical profession.”

“During her third year, Ms. Danny received a professionalism citation for consistently arriving late to morning rounds. She promptly addressed the issue by giving extra hours and improving her punctuality for the remaining days at the rotation. Since then, she has maintained an excellent attendance record and no further incidents have occurred.”

  • Preclinical Coursework: Notes your completion (pass/fail) of preclinical curriculum, including strengths and weaknesses demonstrated in each course.

Example: “Mr. Thompson has successfully completed the preclinical anatomy coursework, graded on a pass/fail basis. In his Anatomy course, instructors note Mr. Thompson’s exceptional grasp of anatomical concepts. He demonstrated keen attention to detail during dissections and effectively collaborated with peers in group study sessions, contributing to a deeper understanding of complex anatomical structures.”

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  • Clerkships (in Chronological Order): This section provides a breakdown of clerkship grades, their grading weight, and comparative student performance. Evaluations within each clerkship highlight strengths and weaknesses, which can play an important role in residency program director decisions regarding interview invitations.

Example: “Internal Medicine Rotation (Feb-April 2023), “Ms. Smith excelled during her rotation and was a pleasure to work with. She consistently demonstrated a strong work ethic and management skills that helped her gain respect from the staff and evaluators around her.”

In case you fail a clerkship, you can mention the reason and subsequent measures in details as follows:

“Pediatrics Rotation (Feb- April 2024), Ms. Maria received a passing grade after an additional four weeks to fulfill competencies. She embraced feedback, showing initiative in skill improvement. Her presentation, medical knowledge, and differential diagnosis skills notably progressed. Evaluators affirm she achieved all required competencies.”

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5. Summary

To conclude your MSPE, evaluators will summarize your performance, both individually and comparatively. What does that mean? Essentially, this section not only presents your overall GPA and test scores but also illustrates them in direct comparison to your peers.

The AAMC’s revised guidelines require schools to clarify how their class ranking methodology works to avoid confusion. This transparency aids residency program directors in comparing candidates effectively.

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6. School Information

Lastly, this section contains your school’s pertinent details: name, contact information, location and the school’s core programs. It may include average student timelines and enrollment length. Your school’s facilitators and officials handle this section, ensuring accuracy and relevance to your application.

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How and when should you issue the MSPE from your Medical School?

It is recommended to begin preparing your MSPE in the early to mid-final year of medical school.

Requesting the MSPE from your medical school typically involves submitting a written petition or meeting with a school official. The ease of this process depends on your medical school’s experience in issuing such letters.

If your school has a history of providing MSPEs, a simple written request may suffice. However, if your school is less familiar with the process, it’s advisable to provide them with the guidelines outlined above to ensure they understand the instructions and objectives of the MSPE.

Moreover, collaborating with school personnel can be beneficial, especially if this is the first time they are tasked with writing such an important letter. It is recommended to meet with your medical school officials to discuss constructing your MSPE specially the “noteworthy characteristics” section.

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Is there a specific format I need to follow for the MSPE?

Following the recommendations outlined earlier, your MSPE should be suitable for submission to ECFMG or ERAS. However, before uploading the MSPE, I’d like to mention some important tips to consider:

  • The MSPE typically spans a maximum of 7 pages in 12-point font, although it’s rarely shorter than this limit. While it cannot exceed 7 pages, it’s usually at least 7 pages long.

  • The document type must be in Portable Document Format (PDF) and unlocked.

  • The MSPE should be formatted in 12-point Times New Roman font, single-spaced, with one-inch margins on all sides.

  • Scan all pages of the document into one file. Do not upload pages separately, and refrain from including any additional documents besides the MSPE letter, such as your medical diploma or CV.
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What should I do if my medical school doesn't issue an MSPE?

If your medical school doesn’t provide an MSPE, it’s essential to indicate this on the Additional Documents page in your MyERAS application. In such instances, a neutral placeholder letter will substitute for the MSPE. This ensures your application appears complete for programs that mandate an MSPE before reviewing your application.

How do I upload my Medical Student Performance Evaluation?

For International Medical Graduates (IMGs):

  1. Visit the ECFMG website.
  2. Navigate to “Online Services” in the menu bar and select “OASIS.”
  3. In the ECFMG/OASIS dashboard, choose “ERAS Support Services” from the left column.
  4. Click on “Upload” and then select “Upload MSPE.”
  5. Carefully read the instructions provided before proceeding with the upload.
  6. Click on “Choose file” to locate the document on your computer or system.
  7. Finally, click “Upload File” to complete the process.

ECFMG typically verifies your MSPE within approximately five business days. Once verified, the MSPE will appear in your ERAS application, eliminating the need for further action.

Note: MSPE rejections may occur, often due to issues such as copyright infringement or plagiarism. Ensure that your letter follows a template but is not a direct copy of someone else’s MSPE.

For U.S. Medical Graduates:

U.S. medical graduates have their MSPEs submitted by their respective medical schools. The schools prepare and upload the MSPE directly to ERAS on behalf of the students.

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I'm an IMG. Do I still need to submit the MSPE?

If you’re an international medical graduate (IMG) applying for a residency program in the United States, securing an MSPE is essential. Even if your school is not linked to ERAS, obtaining an MSPE or its equivalent, such as the MSPR in Canada, is crucial. It’s important to proactively contact your school administrators to ensure they can provide an MSPE in the AAMC format.

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What is MSPR and how is it different from the MSPE?

Canadian medical schools use a slightly different process, but it aligns closely with the MSPE. Canadian students applying for residency through CaRMS submit an MSPR (Medical Student Performance Review) as part of their application.

You might wonder if you can use an MSPR instead of an MSPE in AAMC format. Generally, yes. Students from Canadian medical schools applying through CaRMS can submit an MSPR rather than an MSPE. The MSPR’s format is so similar to the MSPE that it is usually considered interchangeable. Additionally, some Canadian medical schools, like McGill, have adopted most of the MSPE task force’s guidelines for the MSPR, making it almost identical.

It’s crucial to note that the deadlines for CaRMS materials, including the MSPR, are usually later than those for ERAS/MSPE in the United States. While the MSPE is typically finalized in the summer before the fourth year, MSPRs are often produced in October or even November of the fourth year. If you plan to use an MSPR for ERAS, ensure it is available by the October 1st release date for MSPEs. Also, make sure your MSPR is uploaded into CaRMS at least a week before the ERAS deadline.

Unlike the MSPE, most Canadian schools treat the MSPR as a more automated document. Students usually have an opportunity to provide feedback once the MSPR is generated, but there is typically less involvement in shaping its content. This can vary by school, so check your program’s specific timetable to understand what opportunities you have to influence your MSPR’s sections as they are compiled.

Looking for MATCH® 2025 All-in-One Application Resources, including MSPE samples, personal statement examples, ERAS application template, and much more?

What should I do if my MSPE is not in English?

If your MSPE is not in English, you need to obtain a certified English translation. The translation must be certified by one of the following:

  • A government official (such as a Consular Officer)
  • A medical school official (such as a Dean or Registrar)
  • A professional translation service (ECFMG recommends Straker Translations)

Make sure you submit only the English translation to ERAS Support Services at ECFMG.

Is the Dean's LOR and MSPE the same?

Understandably, the terminology can be confusing, so here’s a simplified explanation:

A ‘Dean’s Letter’ is now referred to as the MSPE. It is a mandatory part of your ERAS CV and is separate from the LOR section. On the other hand, if you obtain a ‘Dean of Medicine’s Letter of Recommendation’ which is an LOR obtained from the Dean at your institute, this LOR will go in the LOR section and is just like any other LOR.

Can I update or change my MSPE?

For current students and graduates who are re-applying: Once the MSPE is submitted to ERAS, any new information should be added via an addendum (an additional document or section added to the original MSPE after it has been initially submitted). The original MSPE should only be altered to correct factual errors and should only include details up to the student’s graduation.

For re-applicants who delayed graduation: The school can produce a new MSPE, incorporating a revised Academic History section and updated student performance evaluations

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What are some tips for a good MSPE?

  • Your preceptors’ and faculty’s comments and evaluations play a vital role in shaping your MSPE. Active participation, punctuality, and striving to exceed expectations are key. Seek feedback from your preceptors and take action on it.

  • Check with your program early to see if you can have a say in your MSPE. Meeting with evaluators can ensure that your accomplishments are presented accurately and positively.

  • Reach out to your program’s administrators and evaluators early, especially if you have concerns, particularly in your third year.

  • Draft your own MSPE, especially the “Noteworthy Characteristics” section. Even if your school doesn’t allow this, drafting it yourself can help you identify key points to discuss in planning meetings.

  • Make sure the language in your MSPE is strong and positive, clearly highlighting your strengths and accomplishments.

  • Lastly, ensure that your MSPE reflects your professionalism and ability to work effectively in a team. These traits should shine through in your MSPE.

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Final Thoughts

Remember, your MSPE is your chance to shine and make a lasting impression. Ensure it thoroughly and accurately showcases your academic performance and experiences. Presenting yourself as a well-rounded and committed candidate can significantly boost your chances of securing your desired residency program in the United States.

We hope this blog helps you grasp the importance of a well-crafted and comprehensive MSPE, enhancing your ability to stand out amongst the competitive applicants.

For those gearing up for the Match, be sure not to miss our all-inclusive Match package! It includes personal statement editing, ERAS application editing, residency advising, and interview preparation, all in one package! All by expert physician advisors! Learn more here!

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Good Luck with your residency application and don’t hesitate to reach out to us for any questions.

Safa Sohail, Malke Asaad

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