title: Relationship between dean's letter rankings and later evaluations by residency program directors.
abstract: BACKGROUND
  It is not known how well dean's letter rankings predict later performance in residency.
  
  
  OBJECTIVE
  To assess the accuracy of dean's letter rankings to predict clinical performance in internship.
  
  
  METHODS
  Participants were medical students who graduated from the University of Rochester School of Medicine and Dentistry in the classes of 2003 and 2004. In their Dean's Letter, each student was ranked as either "Outstanding" (upper quartile), "Excellent" (second quartile), "Very good" (lower 2 quartiles), or "Good" (lowest few percentile). We compared these dean's letter rankings against results of questionnaires sent to program directors 9 months after graduation.
  
  
  RESULTS
  Response rate to the questionnaire was 58.9% (109 of 185 eligible graduates). There were no differences in response rate across the four dean's letter ranking categories. Program directors rated students in the top two categories of dean's letter rankings significantly higher than those in the very good group. Students in all three groups were rated significantly higher than those in the good group, F (3, 105) = 13.37, p < .001. Students in the very good group were most variable in their ratings by program directors, with many receiving similarly high ratings as students in the upper 2 groups. There were no differences by gender or specialty.
  
  
  CONCLUSIONS
  Dean's letter rankings are a significant predictor of later performance in internship among graduates of our medical school. Students in the bottom half of the class are most likely either to underperform or overperform in internship.
authors.affiliation: Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. Stephe_lurie@urmc.rochester.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lurie
authors.forename: David R
authors.initials: DR
authors.lastname: Lambert
authors.forename: Tana A
authors.initials: TA
authors.lastname: Grady-Weliky
mesh_terms: D004521:Educational Measurement; D005180:Faculty, Medical; D005544:Forecasting; D006801:Humans; D007396:Internship and Residency; D009518:New York; D011361:Professional Competence; D012577:Schools, Medical; D013337:Students, Medical / Q000145:classification*; D011795:Surveys and Questionnaires