The SLOR has been revamped to emphasize its true utility as a letter of evaluation. The new SLOE, retains many of the previous features to define each candidates fit, commitment and abilities in EM, while striving to be both standardized and accurate.
Departmental SLOEs are often composed by the clerkship director, with input from the program director, and faculty that worked with you. Personal SLOEs can be written by any faculty member with whom you have had extended clinical contact. You should strive to have two departmental SLOEs done by October. A personal SLOE can act as an additional letter of evaluation.
The SLOE continues to relate the author's credentials, provides a global assessment of each candidate, allows for peer to peer comparison, and for personal written comments about each student.
The SLOE begins with background information including the type of SLOE, author, length of your and the author’s relationship, nature of your contact, the grade during your rotation, how many EM rotations you’ve completed, and last years grade distribution for the clerkship. In the new SLOE there is an added space to distinguish required and elective rotations. This will allow programs to view the grade scale in context of the rotators, and continue to discourage grade inflation.
The new SLOE also defines the author's relationship to the residency program. Since SLOE's are not solely used by the program administrators, this better defines how closely the author influences and understands the ranking process.
Next the SLOE establishes the students qualifications for EM, in comparison to other applicants. Your commitment to EM, work ethic, differentials and treatment plans are each compared with your peers, and categorized as “Above Peers,” “At level of peers,” and “Below Peers.” In the new SLOE the descriptors of candidates now emphasizes team work, and ability to communicate a caring nature to patients. These two essential characteristics of the EM candidate have replaced the personality questions on the previous SLOR, to shift focus from personality traits to skills.
The predicted amount of guidance each student will need is now defined in comparison to peers. Students are ranked as needing, “Less than peers,” “The same amount as peers,” or “More than peers.” Given this guidance the author predicts your success as “Outstanding,” “Excellent,” or “Good.”
Next the Global Assessment of each candidate with ranking compared to other EM candidates recommended in the last academic year, as “Top 10%,” “Top 1/3,” “Middle 1/3,” and “Lower 1/3.” The number of applicants recommended in each category last year, and the number of letters written last year are listed, to allow for both context and comparison. Finally the expected placement of each student on the programs rank list as “Top 10%,” “Top 1/3,” “Middle 1/3,” and “Lower 1/3,” or “Unlikely to be on our rank list.”
After each applicant is compared to peers there is a comments section with the emphasis clearly on addressing areas of concern and strength. Detailed information about the rotation itself, the residency program and grading system, are now separated onto the program demographics form easily accessed at the cord website, or it can be attached to each letter. This allows all programs to define their theory and unique approach, without adding bulk to the evaluation itself.
This new streamlined SLOE's name may be quirky but it's aim is true: to create concise accurate and useful evaluations, to maximize students matching at the program best suited to their abilities and needs.