MSPE: Guide to Make You Stand Out

What is the purpose of the MSPE?

If you’re in medical school then you probably already have an idea of what the MSPE is and that you’ll need this document to apply for residency. However, you’ll need more than a basic understanding in order to ensure that yours stands out to residency programs.  

The MSPE or Medical Student Performance Evaluation is the current version of what used to be called a Dean’s Letter. It allows a panel of faculty and/or administrators, usually one or more deans or assistant deans of your medical school, to standardize and present your performance as a medical student up to that point to both help you contextualize your achievements and help residency programs determine if you’re a good fit. Think of it as a cumulative snapshot of not only your quantitative performance indicators (test scores, grades, class standing, etc.) but also the more nuanced aspects of how you’ve executed your rotations, clerkships, preceptorships, and extracurricular activities. 

In contrast to the ERAS letters of recommendation, the MSPE attempts to be as objective as possible. Your letters of recommendation are meant to offer convincing narratives and detailed analysis from your writers, but the MSPE is a concise and systematic presentation of your accomplishments and abilities. While the MSPE (and Dean’s Letter even more so) used to be a more subjective evaluation—often using inexact terms like “good” or “bad” in relation to a student’s skills or performance—the AAMC has since offered significant updates to its MSPE Guidelines to improve both standardization and impartiality. Because of this, those writing your MSPE are asked to conform as closely as possible to the AAMC’s recommended format. 

What is the content of the MSPE?

Following the AAMC guidelines, the MSPE is comprised of 6 sections. They include:

What is the format of the MSPE?

The AAMC’s guideline for length states that the MSPE can be a maximum of 7 pages in 12-point font, but for the most part this maximum is simply the default length. That is, it cannot be more than 7 pages long, but it’s almost never fewer than 7 pages as well. Additionally, it is prepared and sent digitally, so once it has been finalized you cannot change any of its information. 

How and when do I request my MSPE?

Given that the MSPE is a vital and wholly necessary part of your ERAS application, your medical school should provide specific information in your student handbook or other official guides to your program on how and when to begin the process.

Each school structures the preparation of the MSPE slightly differently, both in terms of timing and level of student participation. Some schools effectively take care of it entirely without student input and only offer the student an opportunity to view it and voice any concerns just before finalization. Other schools invite the student to participate in multiple planning meetings with their evaluators to steer the content somewhat and offer suggestions for criteria like MSPE Noteworthy Characteristics. It is in your best interest as a student to find out the intricacies of your school’s MSPE process as early as possible so that you can plan accordingly. All those caveats in mind, a general timeline for your MSPE will look something like this:

Fall of Third year

1. Determine your school’s MSPE policies and schedule, and make sure you’re able to attend any preparatory meetings or info sessions relating to them and residency . Most medical schools won’t have official MSPE appointments this early, but you may be able to meet with the dean(s) responsible for writing the MSPEs and discuss any preliminary questions or concerns you have. Given that you’ll be working on your residency CV and residency personal statement during this time, any work toward the MSPE will be mostly relegated to information-gathering, but it’s important nonetheless.
2. Begin narrowing down what residencies/specialties you’re interested in and research them as thoroughly as possible and check out our tips for choosing a medical specialty. Knowing where you want to end up will help you plan for any input you may eventually have in your MSPE. 

Spring of Third Year

1. Your school should, if they haven’t already, offer you a concrete timetable and plan for drafting your MSPE. If you’re going into an early matching field like Neurology, Neurosurgery, Ophthalmology, or Urology, then you’ll want to let your administrators and/or MSPE evaluators know as soon as possible, as you’ll be able to schedule meetings earlier than other students.
2. Attend any official meetings offered or schedule them yourself if possible to discuss the MSPE and its construction with your evaluators or deans. Some schools, such as Harvard Medical School, don’t hold MSPE meetings until late Spring or even during the Summer, but there will almost assuredly be a preliminary meeting of some kind during the latter part of your Spring semester.
3. If your school allows you to draft any part of your MSPE, such as the Noteworthy Characteristics section, you’ll want to begin doing this now, before any finalizing meetings during the summer. 

Summer Before Fourth Year

• Meet with your evaluators and finalize your MSPE. Discuss any concerns you have, offer any edits you feel are necessary, and get ready to sign off on your MSPE and your ERAS application overall. You’re almost there!

Early to Mid September of Fourth Year

• ERAS begins accepting applications for residency programs, so finalize and submit yours. It is crucial to remember that nothing can be changed once it’s submitted into ERAS, so make sure you’re okay with your MSPE before it’s submitted. In almost every case, your Designated Dean’s Office directly uploads your MSPE into the ERAS system for you, but if you’re an International Medical Graduate (IMG), you may be required to submit it yourself along with your other application materials. As always, check with your school to determine how MSPEs are handled. 

October 1st of Fourth Year

• MSPEs are released to residency programs, after being held in the “ERAS Post Office” until 12am on this date. It’s all out of your hands now, so focus on your final year of medical school and start preparing for interviews!

Check out our complete ERAS Timeline for more information on how to organize this busy transitional period in your journey to becoming a doctor.

Check out our video to learn how to stand out in your ERAS application:

What if I’m an IMG?

You still definitely need an MSPE if you’re an IMG applying for residency in the United States. Even if your school isn’t connected to ERAS, you’ll still need an MSPE or equivalent, such as the MSPR in Canada (more on that in a moment). If your school doesn’t normally produce the MSPE or a document similar to the MSPE, you should get in touch with the administrators of your current school sometime in your third year to determine if they can provide an MSPE in the correct AAMC format.  

MSPE vs MSPR

Medical schools in Canada do things a little differently, but fortunately this isn’t much of a problem. Canadian students apply for residency using CaRMS, and submit an MSPR (Medical Student Performance Review) as part of their application.

The big question here is whether or not you can use an MSPR in place of an MSPE in AAMC format. Although residency programs may have their own regulations, students coming from Canadian medical schools and who are using CaRMS to submit their ERAS materials are indeed allowed to submit an MSPR rather than an MSPE. The MSPR is ultimately so close in format to the MSPE that it's typically viewed as interchangeable. Moreover, McGill and a few other Canadian medical schools seem to be adopting most of the MSPE task force's guidelines for the MSPR, making it a nearly identical document. It is extremely important to note that most schools’ deadlines for CaRMS materials and the MSPR specifically are a bit later than for ERAS/MSPE in the United States. Unlike the MSPE, which is usually finalized in the summer before fourth year, the MSPRs are usually produced in October, and in some cases as late as November, of a student’s fourth year. As such, if you’re using an MSPR for ERAS instead of an MSPE, make sure it will be made available by the October 1st release date for MSPEs. Additionally, if you’re using an MSPR you’ll need to make sure it’s uploaded into CaRMS at least a week prior to the ERAS due date.

In contrast to the MSPE, most Canadian schools treat the MSPR as a more automated document. That is, the student is usually given an opportunity to offer feedback on the document once it’s generated, but there usually isn’t as much involvement in steering its contents. This varies by school, though, so do check with your program’s specific timetable to see what opportunities you may have to influence your MSPR’s various sections as they’re compiled. The MSPR is comprised of four sections:

Notice anything missing? That’s right, the MSPR does not have a “Noteworthy Characteristics” section. This is in large part the reason why the MSPR is typically auto-generated for the student’s CaRMS or ERAS application materials, as its contents are culled from comments already made in your rotation evaluations. As such, it’s incredibly important to make sure that these comments are filled out appropriately at the end of each of your rotations and clerkships. Again, your school may allow you more opportunities for input as it compiles this information, but for the most part, you should treat the MSPR as something that’s building as you progress through your coursework and activities, and not as something crafted from scratch at the end of them. 

Tips for a strong MSPE

1. Find out if and how you can participate in your MSPE — Each medical program is different in this way, but many schools will invite you to not only meet with your evaluators but also offer input regarding the various information and metrics included in your MSPE. This can be a fantastic opportunity to help clear up any ambiguities in your performance, as well as help improve the way your strengths are described or reported. 
2. Start early — As mentioned above, the earlier you get in touch with your program’s administrators/evaluators in your third year the better, especially if you have any significant concerns on which you’d like to offer input. 
3. When meeting with your MSPE writer(s), discuss the ACGME competencies — The ACGME Milestones are comprised of 6 core competencies that serve as indexes of your professional ability. They are: patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and system-based practice. Although professionalism is a core part of section 4 of the MSPE, you’ll want to make sure your evaluators provide information on the other 5 when applicable.
4. Write a draft MSPE yourself — If your school allows or requires this option, you can draft your own MSPE and send it to your Dead and MSPE evaluators. This will allow you to determine the “Noteworthy Characteristics” section, as well as more fully influence discussions of your strengths and weaknesses. Even if your school doesn’t invite you to do this or allow you to send it to your assessors, it may be a helpful exercise in reifying what points you feel are important or requiring of further explanation when you go into your planning meetings prior to the MSPE’s finalization.
5. Ensure good evaluations during clerkships and electives — In both the case of the MSPE and the MSPR, the comments and evaluations of your preceptors, supervisors, and other faculty are crucial in populating the various metrics and narratives in your MSPE. Make sure to be an active participant both in the classroom and in rotation, be punctual and avoid tardiness, and exceed, to the best of your abilities, the expectations of your clerkships’ preceptors and teachers. Additionally, if you aren’t given time to do so by default, make time to speak with your preceptors after each rotation in order to get their feedback and then act on it going forward. They might be your evaluators later on!

Conclusion

Although the MSPE itself may seem like a simple thing, it carries huge weight to residency programs when considering candidates. In fact, according to an NRMP survey, only your letters of recommendation and USMLE scores are weighted more heavily. Starting early and understanding what the MSPE will cover can help you not only ensure that it’s a positive representation of your time in medical school, but also help you build confidence in your chosen path in medicine. 

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To your success,

Your friends at BeMo

BeMo Academic Consulting

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