Medical Student Performance Evaluation (MSPE)

The Medical Student Performance Evaluation is an important part of a student’s application for a postgraduate internship/residency position.  In accordance with guidelines drafted by the AAMC, the letter is primarily descriptive rather than a personal letter of recommendation.

In addition to the student’s grades (which are also contained in the student’s transcript), the MSPE includes paragraphs describing some of the student’s achievements prior to coming to Medical School, selected research, school and community service activities during Medical School, and descriptions of clinical performance excerpted from narratives written by clinical clerkship and elective coordinators.  The letter concludes with an endorsement at a level decided by a faculty committee.

The faculty of the University of Massachusetts Medical School have established these guidelines for the level of endorsement of their graduates for the Medical Student Performance Evaluation.  These ranks may be considered as overall appraisals of student performance by a committee of the faculty, but they should not be considered as representing “quartiles” of performance.  As these are criterion-based rather than competitive norm-based rankings of students, it is theoretically possibly for all students to be considered as “outstanding” or as “good.”  We consider this endorsement to represent the student’s performance as it will reflect functioning in a clinical position; therefore significantly more emphasis is placed on clinical than on preclinical academic performance.  Because qualities other than purely academic average are also considered, the difference in academic averages of students between continuous ranks is small and may even overlap.  Factors other than academic performance that may be considered at all levels of endorsement include special interpersonal skills and characteristics considered necessary for effective functioning as a physician, outstanding research or social service participation, or unusual strengths in the student’s chosen clinical field.

Summaries of these criteria:

Outstanding: Reserved for those students who have earned ratings of “Outstanding Performance” in all of the required core clerkships and whose clinical performance has been consistently above the expected level. These students’ preclinical knowledge is also strong, as represented by a Step 1 score usually in the top 50 percent nationally.

Excellent/Outstanding: Those students who have done quite well and generally earned grades of “Outstanding” in the majority of required core clerkships. This student has successfully completed all preclinical coursework and has passed USMLE Step 1 with a score of at least 200. For students admitted before 2010, when we moved to P/F for preclinical years, many have also earned “Honors” grades in preclinical courses. Often this student shows increasingly strong performance as third year clerkships are completed and fourth year status is attained. When available, fourth year courses are also considered.

Excellent: These students have done very well academically, generally receiving grades of “Outstanding” or “Above Expected” grades in the majority of required core clerkships. This student has successfully completed all preclinical coursework and has passed USMLE Step 1. This student is considered highly competent. When available, fourth year courses are also considered.

Very Good/Excellent: The student has received a mixture of “Out- standing, Above Expected Performance and “Expected Performance” grades in core clerkships or electives and has successfully completed all preclinical coursework as well as passed Step 1 of USMLE.  This student has achieved a solid academic performance.

Very Good: The student has successfully completed all coursework, generally at an “Expected” or “Credit” level. This student may have received ratings of “Outstanding” or “Above Expected Performance” in electives, but generally has not received them in core clerkships. When available, fourth year courses are also considered.

Good: The student has met all requirements. Additional support time may have been required to master basic science or clinical skills.  The student’s performance is considered acceptable at the current time. When available, fourth year courses are also considered.

Recommended: The student is considered competent to progress to postgraduate training but has needed significant additional support or has required a longer time to master both basic science and clinical skills.  When available, fourth year courses are also considered.

(N.B.: Any grade of “No Credit” (preclinical) or “Fail” (clinical) must be remediated. A successful remediation from these grades will be noted on the transcript. In addition, any grade of “Below Expected Performance” in a clerkship must be remediated. All clinical remediations from any previous grades are discussed in the body of the Medical Student Performance Evaluation.

When an MSPE has been written for a student who has graduated, and after graduation that person chooses to apply to a program in a subsequent year, the Student Affairs Office will submit the original MSPE as requested.  This means that an updated MSPE will not be written for the former student.

The Medical School utilizes the AAMC guidelines for composition of the MSPE. In addition, the following guidelines were approved by the Executive Council of the Faculty in April, 1987 and amended subsequently:

1. Each student will be given the opportunity to read his/her letter before it is sent out and discuss it with the Associate Dean for Student Affairs or the Associate Dean for the Office of Undergraduate Medical Education.

2. Students will not be placed in categories of endorsement through any predetermined percentages, statistical curves, or class rankings.

3. Scores on Steps I and II of the United States Medical Licensing Examination will be mentioned in the letter only at the student’s request.

4. The letter will attempt to describe those themes which characterize and typify the student’s overall academic performance.  Thus, negative comments will not necessarily be mentioned unless they are part of a pattern of performance.