Medical student self-assessment as emergency medicine residency applicants

Emergency medicine (EM) applicants are encouraged to consider their own "competitiveness" when deciding on the number of applications to submit. Program directors rank the Standardized Letter of Evaluation (SLOE) as the most important factor when reviewing an applicant. Accurate insight into how clinical performance is reflected on the SLOE could improve medical students' ability to gauge their own competitiveness.

This study aims to determine the accuracy of students' self-assessment by SLOE evaluation measures when compared to the SLOE completed by faculty after their EM clerkship.

Participants of this multicenter study included fourth-year medical students who had completed their EM clerkship and were applying to EM residency. Students completed a modified SLOE to reflect rankings they believed they would receive on their official SLOE. Additionally, students completed a survey assessing their knowledge of the SLOE, their perception of feedback during the clerkship, and their self-perceived competitiveness as an EM applicant. Correlation between the rankings on the student-completed SLOE and the official SLOE was analyzed using the Kendall correlation.

Of the 49 eligible students, 42 (85.7%) completed the study. The correlation between scores on the student-completed and official SLOE were significantly low (r < 0.68) for each item. The majority of students agreed that they were satisfied by the quantity and quality of feedback they received (31/42, 73.8%). Few students agreed that they knew how many applications to submit to ensure a match in EM (7/42, 16.7%).

This study demonstrates that students did not accurately predict their rankings on the official SLOE at the end of an EM rotation and had little insight into their competitiveness as an applicant. These findings highlight opportunities to mitigate the burden on students and programs caused by the increasing number of applications per applicant. Further research is needed as to whether strategies to increase insight into competitiveness are effective.