Content of a Feed-Forward Letter from Medical Schools to Surgery Residency Programs

Background: At present, the only information on medical student performance provided by medical schools to residency programs is the medical student performance evaluation (MSPE) which is heavily biased in favor of students. This leaves residency programs to discover the strengths and areas in need of development of their new trainees. Purpose: An educational handover letter has been proposed as a means to bridge this gap. The letter, sent from medical schools to residency programs after the Match, provides information residency programs can use to capitalize on the strengths and address the deficiencies of new trainees. Although piloted at several institutions, the appropriate content for such a letter is unclear. This study is deigned to determine the optimal content for such a letter based on expert consensus of key stakeholders. Methods: A 3 round Delphi study was conducted consistent with previously published guidelines. Thirty-two experts were included with eight from each stakeholder group: Program Directors, Prep-Course Directors, MSPE letter-writers and residents. Results: Of the 285 items recommended for inclusion in the first round, 23 met the a priori definition for consensus at the end of the third round. 31/32 participants concurred with the results. From the 395 comments received, four themes were identified to guide the implementation of a feed-forward letter. Conclusions: The optimal content for an educational handover letter from undergraduate to graduate education is described. The next step will be optimizing data collection and assessing the impact on trainees and programs.