Emergency medicine (EM) program directors have expressed a desire for more
evaluative data to be included in application materials. This is consistent
with frustrations expressed by program directors of multiple specialties,
but mostly by those in specialties with more competitive matches. Some of t
he concerns about traditional narrative letters of recommendation included
lack of uniform information, lack of relative value given for interval grad
ing, and a perception of ambiguity with regard to terminology. The Council
of Emergency Medicine Residency Directors established a task force in 1995
that created a standardized letter of recommendation form. This form, to be
completed by EM faculty, requests that objective, comparative, and narrati
ve information be reported regarding the residency applicant.