The dishonest dean's letter: An analysis of 532 dean's letters hom 99 US medical schools

Purpose. To quantify the censure of potentially negative information in dea n's letters, Method. Concordance between 532 dean's letters and the corresponding transc ripts was determined for six variables (failing grade in a preclinical cour se, marginal preclinical course grade, failing grade for a clinical rotatio n, marginal: clinical rotation grade, leave of absence, and requirement to repeat an entire year of medical school). Results. The evaluated variables were not found in the dean's letters 27% t o 50% of the time that they were present on the transcripts. In three of ni ne instances (33%), a failing grade in a clinical rotation was not included . Four students had been required to repeat an entire year, but this was no ted in only two cases. In toro, 35 of 104 (34%) of the variables identified on the transcripts were not reported. In addition, deans were significantl y less likely to report a student's USMLE 1 score if the score was at or be low the 20th percentile (p = .03). Conclusion. Some deans suppress negative information in their letters and p otentially obfuscate the residency selection process.