AAMC Annual Meeting San Antonio, Texas November 1, 2008

1. GSA Transition Forum:Is the MSPE Dead? AAMC Annual Meeting San Antonio, Texas November 1, 2008

2. Chair • Molly Osborne, M.D., Ph.D. • Associate Dean for Student Affairs • Oregon Health & Science University • Chair-Elect, AAMC Group on Student Affairs

3. Speakers • Richard P. Wheeler, M.D. • Executive Associate Dean for Academic Affairs, College of Medicine • University of Arkansas for Medical Sciences • Lanny Garth Close, M.D. • Professor and Chair, Department of Otolaryngology • Columbia University College of Physicians & Surgeons

4. Speakers • Neil H. Parker, M.D. • Senior Associate Dean, Student Affairs & GME • University of California Los Angeles Geffen SOM • Angela Nuzzarello, M.D., MHPE • Associate Dean, Student Programs & Professional Development • Northwestern University Feinberg School of Medicine

5. Speakers • Maria C. Savoia, M.D. • Vice Dean for Medical Education • Professor of Medicine • University of California San Diego School of Medicine

6. Question # 1 • Which of the choices below is your primary affiliation? • 1. Student Affairs (GSA) • 2. Undergraduate Medical Education (GEA) • Graduate Medical Education (Program Directors) • Student (OSR) • Resident (ORR) • Other

7. Question # 2 • If you are involved with GSA what part are you primarily involved with? • 1. MAS • 2. COSR • 3. COSA • 4. COSFA • OSR • All

8. Question # 3 • How long have you worked in this position? • 1. < 1 year • 2. 1-5 years • 3. 5-10 years • 4. >10 years

9. Question # 4 • Are you the sender, recipient or subject of the MSPE? • 1. Sender • Recipient • Subject • None of the Above

10. Richard P. Wheeler, M.D. • Executive Associate Dean for Academic Affairs, College of Medicine • University of Arkansas for Medical Sciences

11. History of the Dean’s Letter • AKA – MSPE • AKA – MISSPEEEEEEEE • AKA – “It’s not time yet to do those darn things again this year, is it?”

12. National Library of Medicine 4th or 5th Century AD

13. National Library of Medicine 4th or 5th Century AD

14. National Library of Medicine 4th or 5th Century AD

15. This was too damn hard. Have the Associate Dean do it from now on!!

16. National Library of Medicine 4th or 5th Century AD

17. National Library of Medicine 4th or 5th Century AD

18. National Library of Medicine 4th or 5th Century AD

19. Henry M. Sondheimer, M.D.November 1, 300

20. No rules or standardization. Personal letters written to individual program directors. Many times a real letter of recommendation rather than reference.

22. UAMS Dean’s Letters = 1 to 2 pages

23. 1989

24. UAMS Dean’s Letters = 2 to 3 pages

25. November 1 release date approved through a complex process. Intended to slow down the process - and it worked. Few interviews before November.

26. ERAS 1995 September 1 release established by ERAS Committee but not through complex approval process like the November 1 release date

28. Camel

29. 2002

30. UAMS Dean’s Letters = 8 to 9 pages

31. TODAY

32. OR

33. Lanny Garth Close, M.D. • Professor and Chair, Department of Otolaryngology • Columbia University College of Physicians & Surgeons

34. THE PROGRAM DIRECTOR’S POINT OF VIEW The Medical Student Performance Evaluation

35. MSPE 2004 Survey of Oto/HNS PD’s Rank Order of ERAS Candidate Information USMLE step 1 score Performance as sub-I LOR from fellow Chairs/PD’s AOA status Candidate’s Personal statement Dean’s Letter (MSPE)

36. MSPE The PD’s dream MSPE……… “ Josephine Smith’s class rank at the completion of the third year of medical school is **/***.”

37. MSPE The PD’s nightmare MSPE……….. “Although the Dean’s Letter Advisory Committee of the AAMC recommends that the MSPE contain comparative performance statements, ………..’s evaluation system was not designed to provide information comparing one student to another. For that reason, we encourage review of this evaluation in it’s entirety.”

38. MSPE Why is the non-revealing “stealth” MSPE a problem for the PD in a highly competitive specialty for which large numbers of highly qualified candidates are applying? 450 applicants 4 positions 40 interview slots One PD

39. MSPE What does the PD want from the MSPE Earlier release Clearly stated, uniform performance scoring Clearly stated and illustrated performance comparisons for All subjects (rotations) for all 3 years An overall ranking of performance at the end of the third year (at least by quartiles) As few adjectives and adverbs as possible

40. MSPE Where does the PD turn when the MSPE does not provide a meaningful comparison of performance for the candidate? Other schools USMLE scores AOA status (when available) LOR from colleagues College transcript

41. MSPE Example of scored/illustrated performance by course Number of Students

42. MSPE Example of scored/illustrated overall performance at completion of third year % Students

43. MSPE A Review of 2007 MSPEs from 62 U.S. Medical Schools

44. MSPE SCORING CRITERIA 3 CATAGORIES MS performance scored MS performance compared MS performance comparison illustrated

45. MSPE MS Performance Scored 0- not done 1- poorly/incompletely done 2- average (acceptable) 3- well done 4- uniformly done (excellent)

46. MSPE MS Performance Compared 0- not done 1- poorly/incompletely done 2- average (acceptable) 3- well done 4- uniformly done (excellent)

47. MSPE MS Performance Comparison Illustrated 0- not done 1- poorly/incompletely done 2- average (acceptable) 3- well done 4- uniformly done (excellent)

48. MSPE Overall Score for Institution 0- No attempt to follow AAMC guidelines 6- Acceptable presentation of MS performance 12- Outstanding (Gold Standard)

49. MSPE # of Institutions SCORES

50. MSPE Study Results 20/62 (32%) U.S. Medical Schools failed to present MS Performance in acceptable format 42/62 (68%) U.S. Medical Schools present MS Performance in acceptable format 6/62 (10%) U.S. Medical Schools present MS Performance in outstanding format