The quality of deans' letters from medical schools.

Residency training directors have noted considerable variability in the quality of deans' letters sent by medical schools on behalf of graduating students. A total of 212 deans' letters from 103 U.S. medical schools received by a large psychiatric residency program were rated by two of the authors. Of these, 26.9 percent were judged excellent, 49.5 percent average, and 23.6 percent poor. Excellent letters were characterized by detailed personal and academic comments; verbatim statements for each clinical clerkship; tactful , yet explicit, remarks about problems; and internal consistency. Poor letters were generally short regardless of content, offered global impressions about clerkship performance by fusing remarks from several different clerkships without identifying sources, or omitted important information that was quickly evident to the discriminating interviewer. Recommendations are offered for authors and readers of deans' letters and to medical students.