Clinical Guide
Section 6: Fourth Year & Residency Applications
Table of Contents
Residency application information:
Medical Student Performance Evaluation
The "Medical Student Performance Evaluation" (MSPE), formerly known as
the "dean's letter," is a traditional component of your residency application. It is a
written transcript of your performance in medical school. MSPEs are transmitted or mailed
to the residency programs you are applying to on November 1 of your fourth year.
We begin working on your MSPE just as you begin your fourth year. The first
part of the letter is a description of your undergraduate and pre-UCSF career,
and what particular qualities led to your selection by our Admissions Committee.
In order to capture your individual accomplishments and perspective, you draft
the personal sections of your MSPE. For more details, see "Phase III"
of the UCSF Careers in Medicine web site.
Next follows a paragraph detailing your pre-clerkship years. We ask you to draft
a description of activities you were involved with during medical school,
including research, community service, extracurricular activities, extended programs,
other significant projects, etc. We will also discuss your path towards successful completion
of these courses, and detail the longitudinal work you did in FPC.
We add the grades and summative comments from your clerkship evaluations
taken through Summer Block II of your fourth year. The evaluations are listed
chronologically to give a consistent presentation of your clinical performance and to show your
progress over the clinical years. The summative comments from your clerkship evaluations
are scanned verbatim into your letter. However, we may exercise limited editorial
license, e.g: if the comments contain errors or are redundant. We may also add
administrative annotations in italics as needed. If you do not satisfactorily complete (receive an I or
E grade) or if you fail (F) a clerkship and have to repeat it, the MSPE will note the
specific deficiency, and comments from the passing rotation are included.
The next-to-last section of the letter describes any additional activities
you participated in during the clerkship years. Again, in order to prioritize your
own individual experience, you are responsible for drafting this paragraph.
The final paragraph is a summative overview by Dr. Helen Loeser, the Associate
Dean for Curricular Affairs, commenting on your individual strengths and qualities
as a graduate of the UCSF School of Medicine. The "adjective" is included
in this paragraph. The five adjectives are: outstanding, superior, excellent,
very good, and good. Clinical honors are used to guide determinations
of overall performance designations of outstanding and superior: Students eligible
for "outstanding" have earned honors in more than half of the weeks
of required core clerkships, and students eligible for "superior"
have earned honors in more than one third of the weeks of required core clerkships.
All other students are eligible for the "excellent," "very good,"
and "good" designations. The 110 series clerkships are weighted according
to the length of the clerkship (i.e. medicine is eight weeks long and therefore
"heavier" than pediatrics at six weeks). The UCSF "Medical School
Information Page," attached to the back of every students' MSPE, specifies
the percentage of students receiving each "adjective," as well as
a bar graph detailing comparative performance in the core clerkships.
Neither the adjective nor your final paragraph are directed by your
specialty choice, i.e., we do not say "This student is an excellent candidate for surgical
training." This is not the point of the letter, which is a summary of your medical
school performance. Such labeling may actually limit you. For this reason, we edit out
faculty comments that refer to your suitability for or interest in a particular specialty.
In September of your fourth year, you will be sent a draft of your MSPE for
review. You need to read it carefully for accuracy, correct any errors, and return the draft copy
to Curricular Affairs. You may make an appointment with Dr. Loeser to discuss any part
of your letter or the residency process. On November 1, all MSPEs are transmitted
or mailed to the residency programs you've selected.
Remember that your MSPE is only one component of your residency
application. Letters of recommendation, your personal statement, and interviews are
equally important in obtaining a residency position. Your MSPE offers a useful perspective
on your skills by providing a composite of many observers' viewpoints.
Kristen Fitzhenry coordinates the preparation of the MSPE, the ERAS (Electronic
Residency Application Service) application procedure, and the listserv used
to disseminate MSPE and residency information. He will work with you to prepare
a draft of your letter, and will oversee the process to ensure that your letters
of recommendation, photographs, and transcripts are scanned and transmitted
to the programs you select. For more information, please contact Kristen at kristen.fitzhenry@ucsf.edu
or at 514-2059, and also review "Phase III" at http://medschool.ucsf.edu/careermed/
Letters of Recommendation
Letters of recommendation (LORs) for residency programs are written by
the faculty with whom you have worked closely. Therefore, it makes sense that if you
want to go into surgery, you would like to show your surgery attending what a
stellar individual you are. However, LORs are not contingent upon receiving Honors. Ask
the attending if s/he feels capable of writing you a strong letter. LORs for your
residency applications are more valuable when written by someone who knows you well as
an individual, rather than by someone who knows you superficially, but gave you
Honors. You can get a good sense of who can speak to your strongest attributes by reading
the individual E*Value comments. Faculty are used to writing LORs; don't hesitate to ask!
You can request as many LORs as you like, but you can send no more than four
to each program. Once the residency process begins, you register your list of
LOR writers in ERAS, and you will then be able to generate explanatory cover
sheets for each writer.
The NRMP "Match"
After applying to residency programs, and interviewing during the winter months,
fourth-year students will narrow down their choices of residency programs and
submit a Rank Order List through the NRMP (National Resident Matching Program).
For complete details of this process, policies, fees, and timeline, visit http://www.nrmp.org
Corrie Silva coordinates the Match process, certifying students' status with
the NRMP, working with students who will be absent when results are released,
and coordinating Scramble and Match Days. She can be reached at csilva@medsch.ucsf.edu
or at 476-8081. Students are also encouraged to meet with Dr. Maxine Papadakis,
the Associate Dean for Student Affairs, to review choice of careers, advisors,
and programs.
Alpha Omega Alpha (AOA)
A nominating committee of the UCSF chapter of Alpha Omega Alpha
elects qualified students to its membership in the fall of the fourth year. Approximately
thirty UCSF faculty members (mostly from clinical departments, but also some basic
science and preclinical teachers), all of whom have had extensive contact with students,
serve on this nominating committee. Faculty representatives from the
UCSF/UC-Berkeley Joint Medical Program are also included. The number of students elected to AOA
is limited to one-sixth of a school's graduating class.
Eligibility for membership is limited to those students whose scholastic qualifications place them in the
upper twenty-five percent of their class. At UCSF, eligibility on the basis of
scholastic achievement is based on student performance in the third-year core clerkships.
AOA is a national organization, founded in 1902, which recognizes and perpetuates
excellence in the medical profession. Scholastic achievement, however,
is not the only criterion for election. The bylaws and constitution
stipulate "integrity, capacity for leadership, compassion, and fairness
in dealing with colleagues" to be of equal significance. You can
get a copy of the AOA constitution from the Office of Curricular Affairs, or
on the Web at http://www.alphaomegaalpha.org
New AOA members are informed of their election in October, and
membership status is included in their MSPE. During the following month, our new student
AOA members meet with the chapter councillor, Dr. Steven Pantilat, to plan the
annual visiting professorship program and banquet in the spring, and to elect a
designated number of house staff, faculty, and alumni to the chapter.
AOA sponsors a research fellowship program and a student essay contest,
which are open to all UCSF students. The national organization publishes a
quarterly journal, The Pharos, which contains a wide spectrum of articles and news from
AOA chapters across the country.
If you have additional questions about AOA or the election process, please
contact Kathy Healy at khealy@medsch.ucsf.edu
or at 476-8085.
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