The NRMP has updated its requirements for the MSPE, one of the application requirements for residency. The MSPE, Medical Student Performance Evaluation, is a document submitted by the university that outlines your performance during medical school. It’s divided into numerous sections including:
Noteworthy Characteristics (any achievements you’ve done during medical school)
Academic History (any gaps in education, repeated courses, adverse actions towards the university, etc.)
Academic Progress, which is divided into Preclinical and Clinical Course outlines, with the majority of this section devoted to your clerkship evaluations.
The updated part which we students have to take into consideration is the clerkship evaluation. Usually, the university would fill it up for the applicant and send it to the NRMP. But now, the clerkship directors have to personally fill it out for each individual student. They will have to write their impression about you, which quartile you lie in for that specific course only (honors, high pass, pass, or fail), and your detailed assessment (MCQ score, OSCE score, and clinical performance).
Why is this important for us? Usually, in the good old days, your clerkship grades were of little importance, except for the specialty you were aiming at of course. For instance, if a student was aiming at surgery for residency, then the program directors would look at surgery more than the others on their transcript. This allowed you some free room to mess up in the other specialties. Now program directors will be able to see your individual performance across all clerkships. So if you worked hard in only one specialty and didn’t care for the others, program directors will be able to see this. And you can’t make up for this by studying the last week and getting a great score on your MCQ and OSCE, that won’t work anymore. A huge portion of the evaluation is dedicated to the clerkship director’s impression of you and it can be quite detailed sometimes. These remarks could entail various comments from different teaching staff, their overall impression of you and what they advise you to do in order to improve.
I know what most of you are thinking: the clerkship director doesn’t know me or remember me. Don’t worry, this the case for the majority of the students and it’ll probably stay that way for the foreseeable future. In the US, these impressions are collected at the end of the rotation for the purpose of putting them in the MSPE. For us unfortunately, we either don’t have that information or we don’t have enough information regarding it (some clerkships will make doctors write feedback, but most doctors just write: “good” or “enthusiastic”). Currently, the administration in the COM is doing its best to make sure that this is a smooth process for all.
So what I advise for the upcoming batches is that you make sure to do your best in ALL your clerkships. Getting an A in the exam won’t cut it anymore. The MSPE is taken very seriously (usually it’s in the top 5 criteria for picking an applicant for an interview for residency programs). Also, clerkship directors remember one category of students above all else, the bad ones. I am not talking about those who failed or got a low mark, I am talking about the ones who had disciplinary problems. This could range anywhere from attendance problems, failing to follow instructions, disruptive behavior, etc. Clerkship directors will remember you and may mention this in your MSPE, which is a total show stopper in most cases.
My final advice for everyone is to make sure to preserve the unity of your batch. These new regulations may cause some students to develop the urge to get ahead at the expense of other students. There is a difference between showing that you are the best and showing that you are better than others. As a former batch leader of the 4th year, I can tell you the one thing that clerkship directors hate above all else is “gunners” (a person who will compromise their relationship with their peers to get ahead). Don’t be a gunner. Clerkship directors absolutely despise this and will think less of you. This doesn't mean you shouldn't try to impress your seniors, you should always strive to be at your best. But when you do that on the expense of your colleagues, you show that you are the lowest of the low. In my batch, the rule was: "All for one and one for all". We had the overachievers, but they did that with their own hard work, not by hurting others. If the clerkship director writes in the MSPE that he/she was too competitive or that he/she purposefully went out of their way to undermine or hurt their peers for their own benefit, that is a fatal blow in your application. Program directors look for candidates who work best in teams, they'd never allow a "gunner" to join their ranks. So my final message is that don't let this undermine your values, don't let it drive you to sever relations with your friends and peers. Be the best towards yourself and towards others.