The MSPE and Residency Process

1. The MSPE and Residency Process January 17, 2008 Class of 2009 Meredith, Buck, and Dr. Parker

2. Who Writes the MSPE? Dean Parker Supplemental information provided by SAO, Colleges Chairs, and YOU!

3. What goes into the MSPE? • 1-2 Paragraphs about your performance in Years 1 and 2. • Does NOT include exam scores • All of Year 3 evaluation comments (verbatim) • Summary of academic progress (including gaps or leaves of absence) • Summary paragraph • Unique characteristics

4. What does an MSPE Look Like? • All Medical Schools follow the AAMC guidelines to format and submit their MSPE. • All have the same headings and content. For review of the guidelines: http://www.aamc.org/members/gsa/mspeguide.pdf

5. Identifying Information MEDICAL STUDENT PERFORMANCE EVALUATION FOR JOE BRUIN NOVEMBER 1, 2008 IDENTIFYING INFORMATION Joe Bruin is a fourth-year student at the Joe Geffen School of Medicine at UCLA in Los Angeles, California.

6. Unique Characteristics UNIQUE CHARACTERISTICS Joe Bruin was born in New York to immigrant parents. His mother is a nurse, and his father is a dentist. At age three, the family moved to downtown Los Angeles while his father completed dentistry licensure, then to Orange County and finally to Palos Verdes. In elementary and high school, Joe developed an interest in science and excelled in his studies. He also competed in Tae-Kwan Do and held an international junior ranking. Seeking to broaden horizons, Joe did his undergraduate work at Rutgers University, where he received a Bachelor of Arts degree in Genetics and Human Biology. He made the Dean’s List for two years. In the summer following his freshman year, he became an Emergency Medical Technician in a ten-week program at UCLA, and this led to a two-year stint as a live-in volunteer firefighter and EMT at the Cayuga Heights Fire Department in Ithaca. He assumed leadership roles as company secretary and then president. After graduation, Joe decided to take a research year with Dr. Buchanan in the Department of Orthopedic Surgery at UCLA. He was involved in a number of basic projects concerning bone repair. This work has continued and expanded to include a project on imaging of experimental metastatic lesions. As a result of his research, Joe is co-author of seven manuscripts in print or in press. During the dedicated research year, Joe supported himself by teaching at the Kaplan Learning Center and an independent learning center in Torrance and by private tutoring. Joe has done very well at the School of Medicine. He maintains a wide scope of interests outside of medicine, including athletics, travel, cooking, auto restoration, and music. His interest in orthopedics has been strengthened by his clinical experiences and his ongoing research. He enjoys the technical challenges that orthopedics provides, the camaraderie among physicians in the discipline, and the nature of the clinical problems.

7. Academic History ACADEMIC HISTORY Date of expected graduation from Medical School: June 2, 2009 Date of initial matriculation in Medical School: August 4, 2005 Please explain any extensions, leave(s) of absence, gap(s) or breaks in the student’s educational program: N/A Transfer student: N/A. UCLA does not accept transfer students. For dual/joint/combined degree students: N/A Date of Initial Matriculation in Other Degree Program: Date of Expected Graduation from Other Degree Program: Type (degree and major) of Other Degree Program: Was this student required to repeat any coursework during his/her medical education?(if yes, please explain): No Was this student the recipient of any adverse actions by the medical school or its parent institution? (if yes, please explain): No

8. Academic Progress ACADEMIC PROGRESS The Joe Geffen School of Medicine at UCLA adopted a pure pass/fail grading system without the ability to obtain honors with the 1993 entering class. However, a Letter of Distinction can be awarded. A Letter of Distinction is based on the extraordinary quality of a student’s performance, irrespectivof the performance of other students in the course. These letters are not awarded on any type of quota system. An assessment of Joe’s academic abilities both in the basic sciences as well as in the clinical sciences can be readily ascertained from the narratives below. These are taken directly from the evaluations submitted by the course chairs and the faculty of the basic sciences, small group discussion sections, and clinical clerkships: Years One and Two Joe successfully completed the curriculum of the first two years. Comments from his evaluations include: “Joe uses his good knowledge of basic science and his own hands-on experience and applies them very well. He had excellent problem solving and critical thinking skills. Often made astute comments. He had the most outstanding patient interviewing skills in the group. Joe will make an incredibly observant, thoughtful and effective physician.”

9. Academic Progress Required Clinical Clerkships and Elective Rotations Narratives are edited for length, grammar and redundancy only. Doctoring 3 (Required) For the duration of the 3rd year Center for Health Sciences Joe Bruin is an active, enthusiastic and valuable member of our doctoring group. Joe combines his naturally personable, open demeanor with a fine capacity to articulate and present well reasoned opinions and knowledge on pertinent issues. He demonstrated a highly skillful patient interview and appeared to easily understand the need to subordinate his own rapid, decisive pace and opinions to the needs and pace of the patient. Joe has been a thoughtful participant on all issues and his written and verbal participation have been outstanding in every session. Longitudinal Preceptorship (Required) For the duration of the 3rd year Center for Health Sciences Cardiology: Joe is a star! He is one of the most delightful, insightful, engaging students I have interacted with. During his preceptorship he displayed abilities and talents comparable to a fourth year medical student. He is clearly at the head of the class. During the preceptorship he used the time to practice and hone his physical diagnosis skills, interviewing skills and fund of knowledge. Joe also has a very large interest in scientific investigation. He was always on the lookout for interesting scientific questions and he saw each case as a new opportunity to ask insightful and probing questions. Joe will undoubtedly succeed in any field he chooses. I thoroughly enjoyed my interactions with him and give him my very highest and most enthusiastic evaluation.

10. Academic Progress Ambulatory Internal Medicine (Required) 7/25/2006 (4 weeks) Kaiser Foundation Hospital Joe rotated through Kaiser Foundation Hospital for his ambulatory medicine rotation 8/8-9/4/05. History taking was superior, very thorough and included most all important details. PEs were high-satisfactory and were complete and appropriately targeted and demonstrated good technique. Oral case presentations were superior, demonstrating good organization and clarity and were of appropriate length. Write-ups were superior demonstrating good DDX and problem lists and a thorough TX plan. Fund of knowledge was superior and above the level for a third year student. His clinical judgment was high-satisfactory; he was able to frequently integrate clinical information, medical facts and TX options applying an evidence-based approach. Joe's humanism was Superior. He demonstrated great empathy for his patients and was clearly interested in his patient's emotional as well as physical problems. He was enthusiastic and hardworking. His Attending wrote "Joe demonstrated an outstanding medical knowledge base during this rotation". Overall Joe performed at a superior level during his ambulatory medicine rotation at Kaiser Foundation Hospital.

11. Academic Progress Inpatient Internal Medicine (Required) 9/1/2006 (8 weeks) West Los Angeles VA Joe did and outstanding job on the first month of his medical clerkship at the West LA VA. He is a pleasure to work with and displayed a strong interest in learning and a deep commitment to patient care. He has outstanding interpersonal skills. His ability to care for and communicate with his patients is perhaps best illustrated by the several occasions when he was able to translate complex medical information into language that his patients could understand, resulting in improved patient adherence and a strong bond between him and his patients. Several observers observed his constant effort to improve his medical knowledge and his presentations. His depth of interest in learning medicine is beyond the typical medical student leading one house officer to judge him at the level of a sub-intern or intern. In summary, Joe is a "wonderful personality" who "always did more than what was needed to make sure his patients received the best medical care.Joe will make an outstanding house officer and physician. Joe rotated at Harbor-UCLA Medical Center. This student's evaluation is a composite of scores and evaluations from attending physicians and residents. History taking was excellent, with consistent precision and focus on relevant problems. Nearly all pertinent positive and negative findings were elucidated skillfully and with appropriate attention to details. The student performed satisfactory physical examinations that were, on occasion, very good. The student demonstrated current knowledge, including information from journal articles, that was at a high level for 3rd year students. The student regularly demonstrated excellent judgment, including the ability to integrate data and facts, balance risks and benefits, and make justifiable decisions. "Good fund of knowledge. Good team player, willing to help out and always interested in learning. Strong foundations of skills that will serve him well in the future." The overall performance of this student on the Harbor-UCLA portion of the Inpatient Medicine clerkship was excellent.

12. Academic Progress Neurology (Required) 12/1/2006 (3 weeks) Harbor-UCLA Medical Center Joe was outstanding on this rotation. He mastered the neurologic exam rather quickly, and was very good at drawing out important details from patient's exams to guide differential diagnosis. He was inquisitive and extremely conscientious, and his organized presentations were top-notch. He was very easy to work with, and was very reliable. He essentially functioned at the level of an intern for our team, and this bodes very well for his future residency of choice. Obstetrics and Gynecology (Required) 2/12/2007 (6 weeks) Harbor-UCLA Medical Center Joe did an outstanding job during his 3rd year clerkship on Ob/Gyn at Harbor-UCLA. He learned rapidly, read widely, became very involved in patient care and sought out clinical and learning experiences. The faculty noted that "Joe was an enthusiastic, capable, hard working, pleasant student. Joe is a very interesting young man who brings a wide breadth of experiences to his medical career. He should make a very good physician/surgeon.” A second faculty noted "He has great potential and I believe he will be an asset to whatever specialty he chooses.” A third on said "This is a stellar student. Very responsible, great fund of knowledge.” The residents were also impressed, the comment "Great Job" sums up their assessment. Joe received a Letter of Distinction in Obstetrics/Gynecology

13. Academic Progress Pediatrics (Required) 4/1/2007 (6 weeks) Center for Health Sciences Excellent medical student. I am sure he'll be an outstanding resident in whatever field he selects. Nice to work with. Calm and composed. Integrated clinical information extremely well. Always professional and appropriate with coworkers and patients. Efficient and took charge of his own independent learning as well. Joe did a very good job on his Nursery rotation, and it was nice to work with him. Although he is not interested in a Pediatrics career, Joe was always willing to learn new things and experience new patients. He related well with the patients' families, he was always on time, and did a very good job with his history taking and physical exams. I wish him well in his future as a Cardiologist or surgeon. Very professional among patients. Interacted very well with children. In the nursery Joe demonstrated himself to be an eager pleasant student who worked well with the nursery staff. Psychiatry (Required) 5/28/2007 (6 weeks) Harbor-UCLA Medical Center Joe was one of the best medical students that particular psychiatric service has seen. He is self-motivated, knowledgeable, hard-working, professional, caring conscientious and well-organized. He will be a truly outstanding resident. Orthopaedic Surgery (Elective) 8/24/2007 (4 weeks) Center for Health Sciences Truly an outstanding job by this exemplary student. Joe embodies what I look for in an exceptional future houseofficer: extremely bright, asks provocative questions, hard working, and has an easy going calm demeanor.

14. Summary SUMMARY Joe Bruin has performed admirably throughout his education. He is bright, friendly, dedicated, and well-rounded. His clerkship evaluations have been particularly strong and seem to predict that he will be a very effective clinician, as well as a good teacher. He has tested his interest in orthopedics with an extended exposure to research and close relationships with a number of faculty members. He has a sophisticated understanding of the field and the intellect and personality to succeed through training and beyond. Sincerely, Neil H. Parker, M.D. Senior Associate Dean for Student Affairs

15. Appendix Appendix A – Graphic Representations of Comparative Performance in Preclinical/Basic Science Coursework The grading system for all four years is Pass/Fail without the possibility to obtain Honors. Thus a class ranking or placement into quartiles cannot be calculated. Appendix B – Graphic Representations of Comparative Performance in Core Clinical Clerkships The grading system for all four years is Pass/Fail without the possibility to obtain Honors. Thus a class ranking or placement into quartiles cannot be calculated. Appendix C – Graphic Representations of Comparative Performance in Professional Attributes The grading system for all four years is Pass/Fail without the possibility to obtain Honors. Thus a class ranking or placement into quartiles cannot be calculated. Appendix D – Graphic Representations of Overall Comparative Performance in Medical School The grading system for all four years is Pass/Fail without the possibility to obtain Honors. Thus a class ranking or placement into quartiles cannot be calculated. Appendix E – Medical School Information Page – Class of 2006 Joe Geffen School of Medicine at UCLA – Los Angeles, California Special programmatic emphasis, strengths, mission/goal(s) of UCLA: The mission of the Joe Geffen School of Medicine at UCLA is to prepare graduates for distinguished careers in medicine. Students are selected from an applicant pool of over 6,000 and are chosen for demonstrated excellence in academics, community service, research, and teaching. Over their four years at UCLA, students participate in a wide range of activities that continue to emphasize our selection criteria. Over 80% of the students will have had meaningful experiences in community service, teaching, or research. In the middle of the third year, students choose to belong to a College which has special emphasis on advising and mentoring. Special characteristics of the UCLA educational program: The curriculum for the class of 2006 was a discipline-based coursework for the first two years with emphasis on small groups and problem-based learning. The third year is taken in two blocks of 24 weeks each of surgery, obstetrics & gynecology, and pediatrics or inpatient and ambulatory medicine, family medicine, and psychiatry & neurology. Half of all the clinical coursework is in the ambulatory arena where students learn to do focused histories and physicals and are exposed to system-based practices and real life issues in a highly managed care environment. Over the first three years, students participate in Doctoring, which focuses on learning and improving their skills in communication, history taking and integrating psychosocial issues into patient care. The program uses standardized patients, direct observation of students’ interviews, and trigger tapes of common problems and situations to stimulate small group discussion. Students join a College in the middle of their third year organized around specialties sharing common perspectives: Applied Anatomy, Acute Care, Primary Care, M.B.A./M.P.H., Medical Scientist, and Urban Underserved. The colleges start with a week long Foundation course to prepare students for the fourth year, have a set of defined selectives, include evening seminars and preparation sessions for residency, and focus on advising and mentoring for career selection and preparation. There are both the MSTP program, which accepts students for their M.D. and Ph.D. from the initial application, and the Access program, which accepts students during their second year for their Ph.D. Most students spend 3-5 years between their second and third years. Additionally, students are increasingly electing to obtain their M.B.A. or M.P.H. Students are selected in their third year and do joint courses over the subsequent two years, obtaining both degrees at graduation in a total of five years. Average length of enrollment (initial matriculation to graduation) at UCLA: Seventy percent of the Class of 2006 will have spent three years and ten months in our four year program. Thirty percent elected to take additional training for research, community service, or an advanced degree. Only the summer between the first and second years is non structured time.

16. Appendix (cont.) Description of the evaluation system used at UCLA: The grading system for all four years is Pass/Fail without the possibility to obtain Honors. Thus a class ranking or placement into quartiles cannot be calculated. A student may be awarded a Letter of Distinction (LOD) based on extraordinary quality of his/her performance in all segments of the course and irrespective of the performance of the other students. LOD’s can only be awarded for first and second year courses which have small group and problem-based components. All required clerkships of the third year (except Radiology and Preceptorship) may award LOD’s. They are, however, not awarded for any fourth year coursework (elective clerkships). Requirements for completion of USMLE Steps 1, 2: USMLE Step 1 – passage required for promotion into senior year and for graduation USMLE Step 2 – Both CK and CS must be taken to graduate and CK passed Requirement for completion of OSCE: An OSCE is required for completion of the Second Year Physical Diagnosis course. The Clinical Performance Examination by the California Consortium for assessing clinical competence is required of all students at the end of their third year. Utilization of course, clerkship or elective directors’ narrative comments: Narratives are edited for length, grammar, and redundancy. Utilization of AAMC’s “Guidelines for Academic Transcripts”: Partially in compliance with guideline recommendations. Student review MSPE prior to transmission for accuracy: Yes

17. The Evaluation Section of MSPE • Evaluations go in verbatim-remember this is an evaluation not a recommendation • The only way to have the comments revised on your MSPE is to have the Clerkship Director submit new comments on ESS. Revised comments must be submitted to the SAO on ESS by September 1, 2008. • Buck and Meredith will not be able to make revisions or alter your evaluations in any way during the MSPE review process • Questions or concerns about evaluations should be discussed with Dr. Parker, Buck, or Meredith before approaching Clerkship Director.

18. Sample Evaluation Reformat Before Edit: Comments from faculty: "Excellent job getting clinical information efficiently and presenting cases in clear logical format. Good rapport with patients." "Joanne Bruin is bright and enthusiastic, and did an excellent job on this rotation. She developed instant rapport with patients, putting them at ease. Her histories were detailed and systematic. She evaluated patients carefully, and formulated excellent differential diagnoses and management plans. Her case presentations were complete and focused. It was a pleasure to work with her!" On her case presentation project she received a score of 20/20 and on her written final examination she received 70%. After Edit: "Excellent job getting clinical information efficiently and presenting cases in a clear logical format. Good rapport with patients." "Joanne is bright and enthusiastic, and did an excellent job on this rotation. She developed instant rapport with patients, putting them at ease. Her histories were detailed and systematic. She evaluated patients carefully, and formulated excellent differential diagnoses and management plans. Her case presentations were complete and focused. It was a pleasure to work with her!"

19. What Is Removed from the Evaluation? • PDA logs • Attendance (Unless it is an issue noted within the narrative of the evaluation.) • Nomination for a LOD (If you received one, it will be noted in bold at the end of the evaluation.) • Exam scores or percentiles • References to graded presentations • Physician/evaluator names • Websites and journal citations • Dates of Clerkships (the MSPE is written in chronological order)

20. What edits does the SAO make? • Correction of name: You will be referred to by your given first name throughout the MSPE • Gender: Pronouns will be changed to reflect your gender • Spelling and punctuation: All spelling will be corrected, but the nature of composite evaluations is that punctuation may not be 100% accurate. Sentence fragments may be left in. • Redundant comments may be removed

21. What do I edit on the MSPE? • “Unique Characteristics” Section • Errors, omissions, and chronology • Reference to specialty choice (this is up to you whether or not you want your specialty included in the MSPE) • Personal information you do not want included in your application • “Summary” Section • Errors, omissions, and chronology • Reference to specialty choice (this is up to you whether or not you want your specialty included in the MSPE) • Ensure LOD’s and AOA are included if applicable

22. How does the MSPE process work? Spring 2008: Complete online MSPE Personal Information Form-turn in to SAO by April 1st June 5, 2008: Mandatory Application Process Meeting • Handbooks distributed (Application and Interview) June-September: Meet with Dean Parker (appointments will be scheduled by SAO) July 1: Issued ERAS token by SAO to BOL account-make sure there are no junk mail filters set • All students (early match too) register on ERAS July-September: Schedule CV/PS meeting with Buck or Meredith August 1-October 1: MSPE Editing Begins • You are notified by SAO when your MSPE is ready for review October 10: Last day for Evaluations to be received by SAO to be included in MSPE November 1: MSPEs released automatically to all programs (National Deadline)

23. MSPE Editing Timeline • Each student allotted 1 opportunity to make edits-”Unique Characteristics” and “Summary” only • Edits will be made by SAO and you will be contacted to sign-off on your MSPE when completed • MSPE must be reviewed in SAO (allow30 minutes to review) • You will not be allowed to make copies of your MPSE nor remove it from the SAO • Content of each MSPE is confidential and should not be shared with other classmates • Until you have signed-off on your MSPE it will not be released NOTE: Revised comments must be received by SAO before you begin the editing process-you will not be allowed to contest comments during the MSPE review.

24. Letters of Recommendation • Download ERAS Recommendation form from “Forms Index” on website • You do not need to include your AAMC ID on the form • You do need to waive your right to see the letter by signing this form • Requests for LORs should begin this spring. All requests should be made by September 1 to allow letter writers time to complete them • LORs are submitted to the SAO and uploaded onto ERAS as received as PDFs

25. Suggested types of Letters Early Match (Ophthalmology and Urology) • LOR from either Medicine or Surgery (Yr 3) • Can be used for Preliminary Programs in ERAS Match • 1-2 LORs in specialty of choice (Yr 4) • At least one LOR should be from UCLA, the others can be from Away Electives • LOR from research mentor (if applicable)

26. Suggested types of Letters • Regular/ERAS Match • LOR from either Medicine or Surgery (Yr 3) • Can be used for Preliminary Programs if applicable • At least one LOR in specialty • One should be from UCLA • Should be from Faculty Only (no residents) • 1-2 LORs in Sub-Is or Electives taken in the summer • Good to have a variety of specialties NOTE for Orthopaedics Applicants: 2-3 LORs should be in specialty and should include Away Electives

27. Chairs Letters For applicants applying in: • Internal Medicine • Pediatrics • Orthopaedics • OB/Gyn • Preliminary Medical programs You may be required to submit a Chair’s Letter. Requests for Chair’s Letters happen in June.

28. Residency Application Includes • The MSPE (sent out nationally on November 1) • Personal Statement(s) • CV • Letters of recommendation • Medical School Transcript • Photograph • USMLE Score Report (automatically released by ERAS)

29. Advising in the Third and Fourth Year • College Introduction Meetings (Mandatory) • First Week in January • Scheduling 4th Year Clerkships Meeting (Mandatory) • January 30, 2007 • Residency/Match Timeline Meeting (Mandatory) • June 5, 2008 • Open Advising Office Hours for Personal Statements, CV’s, and application preparation July 1-September 1

30. How Should I Structure my Time? Year 3 • Continue to excel on Clerkships—earning an LOD is one of the strongest things you can do to increase your competitiveness • Attend Doctoring Lunches with Dean Parker and Meredith throughout 3rd Year • Think about obtaining LORs from required clerkships. You may officially begin to ask for these letters January of Year 3. • Continue to attend career specialty luncheons and lectures • Focus on career exploration and choice • Scheduling for Year 4 and the College selection process begins in January • Meet with Meredith or Buck after Match Day (early April) to assess status of your application, confirm Year 4 schedule-etc June of Year 3 Residency process officially begins

31. What do I until June of Year 3? • Continue to explore career choices • Establish faculty mentor through College • Hang-out with the people in the specialties you are considering—see if you fit in. • Plan away electives and sub-internships “Your future career should fit like a glove!” -Dean Parker