MSPE vs Letter of Recommendation: What Differs
The MSPE is not a letter of recommendation. Who writes each, how each reaches residency programs, and what a letter writer should not repeat.
MSPE vs Letter of Recommendation: What Differs
The MSPE is not a letter of recommendation. The dean's office writes it from the school's records and it goes to every program the student applies to. A letter of recommendation is written by one faculty member, about what that person saw.
That difference sets your job as a letter writer. An MSPE built on the AAMC's recommended sections, as New York Medical College describes its own, already gives programs the student's summative evaluations and standing in the class, so a letter that repeats them spends one of the student's letters on information the reader already has. The orthopaedic letter form says so in one line, quoted below. If you are writing the letter now, the residency letter of recommendation sample shows the full structure.
Every page quoted below was checked on November 7, 2026. AAMC's own MSPE chapter and its ERAS letters chapter refused our automated retrieval that day (HTTP 403), so this page leaves out what only those pages state: the national MSPE release date for the 2026-27 cycle, how ERAS assigns letters to programs, and the AAMC's MSPE template guidance. What remains comes from ResidencyCAS, one medical school's MSPE policy and two specialty letter forms.
Side by side
| MSPE (dean's letter) | Letter of recommendation | |
|---|---|---|
| Who writes it | The school. At New York Medical College, "the Office of Student Affairs (OSA) will generate the MSPE letters" and they are "signed by the Dean of Students" | A faculty member or physician who worked with the student |
| What it holds | The student's record across medical school, compared with the class | What the writer observed, and the writer's endorsement |
| Who sends it | The school uploads it. In ResidencyCAS, "Your medical school will then upload the performance evaluation" | The writer submits it through the letter portal |
| Who receives it | In ResidencyCAS, it "will automatically be attached to your ResidencyCAS application and shared with all programs you apply to" | Set by each service; ERAS assignment rules were not verified for this page |
| Can the student see it first? | At NYMC, students are emailed "a locked PDF copy of the MSPE" to review, for factual errors only | Only if the student did not waive access and you share a copy (waiver rules) |
The NYMC rows are one school's policy. Other schools set their own drafting and review steps.
What the MSPE already tells programs
The clearest description we could retrieve is New York Medical College's MSPE policy, issued July 28, 2026:
"The MSPE is not a letter of recommendation letter [sic] but a comprehensive letter of evaluation and summary of the student’s academic record and performance through the first three years of medical school."
The policy says its MSPE is organized on AAMC recommendations "to include seven sections" and then lists six: identifying information, noteworthy characteristics, academic progress, professional performance, a summary, and medical school information. Two of them matter to you:
- Academic progress carries "information from the student’s summative evaluations." Clerkship comments are already in the file.
- Summary "compares the student's performance in medical school relative to their medical school cohort." The class comparison is already in the file too.
The same policy says students draft the noteworthy characteristics section "in consultation with an advisor", and that it covers leaves of absence, remediation and adverse actions where they apply. The school explains those events. Your letter does not need to.
Where standardized letters fit
Standardized letters sit between the two documents. APGO's OB/GYN SLOE guide (May 1, 2025, written for the 2025-26 cycle) says: "The SLOE is intended to augment the Medical Student Performance Evaluation (MSPE) with an OBGYN-focused assessment." The MSPE compares the student with their own class; the SLOE adds a specialty-specific rating from people in the field.
For the rank-list question itself, see filling out the EM SLOE.
The specialty forms and their rules are compared in standardized letters of recommendation by specialty.
What a letter writer should not repeat
The AOA eSLOR page for orthopaedic surgery gives the rule in its list for authors:
For residents, the PD letter plays the summary role; see the program director letter for a fellowship applicant.
"Don’t reiterate information found elsewhere in a student’s ERAS application (i.e. on the applicant’s transcript or in a Dean’s Letter)."
and the positive version: "Do provide comments and perspectives not easily found in other parts of the ERAS application packet." The page also lists the MSPE among the supporting documents applicants are expected to have in place when programs begin review.
Our view: the rule applies to every residency letter, not only the eSLOR. Cut anything the reader can find in the MSPE or transcript, and spend the space on what only you saw.
The countercase: a letter may mention a grade or an honor in one clause when it explains your own observation ("she earned the clerkship's top grade, and on my service I saw why"). And where the student's file has a gap the MSPE explains, a writer who supervised the student after it can say what they saw since. Neither is a restatement.
Constructed example: the paragraph to cut and the one to keep
Constructed example, written by us, not a real letter. Context (invented): Dr. H. Novak supervised Daniela Ortiz on a medicine sub-internship.
Duplicates the MSPE (43 words):
Ms. Ortiz received honors in internal medicine, surgery and pediatrics. Her clerkship evaluations describe her as "an excellent team member" and "knowledgeable beyond her level." She ranks in the top quartile of her class and passed all licensing exams on her first attempt.
Adds what only the writer saw (53 words):
On my service Ms. Ortiz carried four patients by her second week. When one became confused overnight, she reviewed his medication list, found a newly started sedating drug, and brought it to the team at rounds with a plan to stop it. That is the judgment I expect in July from an intern.
The first paragraph repeats grades, clerkship comments and class standing, which the reader already has. The second gives one patient-care incident with the student's own action and a comparison only the writer can make.
A four-line check before you submit
- Delete every grade, honor or exam result unless it sets up something you saw.
- Delete quoted clerkship comments. They are in the MSPE.
- Do not explain a leave, a repeat or a remediation the school's MSPE already covers.
- Keep at least one incident you observed and your own comparison of the student.
Questions about the MSPE and letters
Is the MSPE a letter of recommendation?
No. NYMC's policy calls it "a comprehensive letter of evaluation and summary of the student’s academic record." It is written by the school, not by a recommender.
Is the dean's letter the same as the MSPE?
Yes. The ResidencyCAS help page uses both names: "Medical School Performance Evaluation (MSPE) (i.e., Dean's Letter)."
Does the student choose which programs get the MSPE?
Not in ResidencyCAS: once the school uploads it, it is "shared with all programs you apply to." NYMC's policy says its MSPE is released through ERAS "to all residency programs to which the student applies."
Can a recommender read the student's MSPE?
Nothing we retrieved says. NYMC's policy describes the student receiving a locked review copy. Ask the student what they want you to know, not for the document.
Get a free review of the letter
Get a free Quick Review of your recommendation letter against GradPilot's residency letter of recommendation rubric. Its patient-care evidence check flags paragraphs built from grades and quoted evaluation comments, the material the MSPE already carries, and looks for incidents you saw yourself.
Writing for an ERAS file? The ERAS letters of recommendation guide covers how programs read the letter set, and more residency pages are in the medical school and residency essays hub.
Sources
Retrieved November 7, 2026, except where noted.
- New York Medical College, Medical Student Performance Evaluation (MSPE) Policy (issued July 28, 2026; one school's policy): MSPE definition, sections, author, student review.
- Liaison, ResidencyCAS: Medical School Performance Evaluation (no year stated): school uploads; shared with all programs.
- APGO, OB/GYN SLOE Writing Guide (May 1, 2025; 2025-26 cycle): the SLOE augments the MSPE.
- American Orthopaedic Association, eSLOR (updated April 2024): do not reiterate the transcript or Dean's Letter.
- Not retrieved (HTTP 403): AAMC, Medical Student Performance Evaluation (MSPE or Dean's Letter) and Letters of Recommendation chapters of the ERAS publication.
Review the Letter Before It Is Submitted
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