Objective measures and the standardized letter of recommendation in the otolaryngology residency match

The objective of this study were to determine if any of the 10 attributes of the standardized letter of recommendation (SLOR) correlate significantly with objective measures of each applicant and to determine whether professor characteristics were associated with reported SLOR attributes.

Retrospective cohort study.

We reviewed 339 SLORs from 187 otolaryngology residency applicants. The 10 SLOR attributes were converted into a percentile score and statistically analyzed.

All 10 SLOR attributes had a mean ± standard deviation above the 80th percentile (0.82-0.93 ± 0.08-0.52) and negative skewness. United States Medical Licensing Examination step 1 and 2 scores correlated most strongly with match potential (B = 93.1,P < .001 and B = 96.3, P = .002, respectively). Students from top 40 National Institutes of Health-funded institutions had a significant difference in length of relationship with their letter writer (B = -0.51, P = .02) and interpersonal communication skills (B = -12.9, P = .011). Alpha Omega Alpha (AOA) and non-AOA members differed in medical knowledge (B = 21.0, P = .007), research (B = -8.80, P = .036), and commitment to otolaryngology (B = -25.89, P = .020). Total number of research experiences correlated most strongly with medical knowledge (B = -16.55, P = .011). There was a significant difference in means between length of relationship and professorial rank (F[4, 339] = 3.61, P = .023), administrative position (F[5, 339] = 5.43, P = .002), and institution of the letter writer (P < .001).

Overall, the lack of correlation between SLOR attributes and objective measures suggests that the SLOR adds little to the residency application. Professor characteristics were similarly not associated with any of the 10 SLOR attributes; however, there were significant differences in the length of relationship between the professor and students with respect to professor rank, administrative rank, and institution of the letter writer.

NA Laryngoscope, 130:603-608, 2020.