The value of self-estimated scholastic standing in residency selection

The objective of this study was to determine the degree of association of self-estimated scholastic standing (self-rank) with an independent evaluation of the dean's letter (dean's letter score). Applicants to our emergency medicine residency program were asked to estimate their scholastic standing on the application form. A blinded independent review of the dean's letter for each applicant was performed, and the letter was scored. The final ranking of the applicant submitted to the National Resident Matching Program was also obtained. Analysis was carried out using the Spearman rank correlation procedure. One hundred forty-three medical students with self-rank, dean's letter, and final ranking from applications between 1991-1993 were analyzed. The association of self-rank with dean's letter score was highly significant. There was also an appreciable relationship between self-rank and final rank in the NRMP Match. Self-rank of scholastic standing by applicants to an emergency medicine residency is strongly associated with dean's letter information. Self-rank may be useful during early screening of applications before dean's letters are available.