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To the Editor: The dean's letter is important to residency programs in assessing an applicant's performance during medical school. In 1989, the Association of American Medical Colleges (AAMC) issued guidelines recommending a uniform format for all deans' letters.¹ The guidelines suggested the inclusion of a bottom-line statement of comparative performance, such as class rank or descriptive words, along with a key for interpreting such statements. However, controversy persists over the honesty² and variability^3-4 of deans' letters.

Methods

I reviewed of all deans' letters received by a large pediatric residency program between 1998 and 2001. Using a standardized data abstraction instrument, the letters were assessed for the presence or absence of a summary statement on comparative performance and a key for interpreting the summary statement.

Results
I reviewed 1130 deans' letters from 116 (91%) of 128 US allopathic medical schools. Overall, 70% of schools provided a bottom line summary of comparative performance. . . . [Full Text of this Article]

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