The dishonest dean's letter: an analysis of 532 dean's letters from 99 U.S. medical schools.
OBJECTIVE
To quantify the censure of potentially negative information in dean's letters.


METHODS
Concordance between 532 dean's letters and the corresponding transcripts was determined for six variables (failing grade in a preclinical course, marginal preclinical course grade, failing grade for a clinical rotation, 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% to 50% of the time that they were present on the transcripts. In three of nine 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 noted in only two cases. In toto, 35 of 104 (34%) of the variables identified on the transcripts were not reported. In addition, deans were significantly less likely to report a student's USMLE 1 score if the score was at or below the 20th percentile (p = .03).


CONCLUSIONS
Some deans suppress negative information in their letters and potentially obfuscate the residency selection process.
Edmond
M
M
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0509, USA. medmond@hsc.vcu.edu
Roberson
M
M
Hasan
N
N
D000124:Achievement; D000288:Administrative Personnel; D002982:Clinical Clerkship; D015709:Correspondence as Topic; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D012577:Schools, Medical; D014342:Truth Disclosure