Are You Buying What We Are SEL-ling? How to Write and Interpret the IM SEL (Structured Evaluative Letter) for Holistic Applicant Review

The residency recruitment process is complex, challenging, and resource-intensive for all stakeholders. Historically, most categorical internal medicine residency programs require a departmental letter, typically written by a faculty designee of the department. Programs view this letter as a representation of the candidate's attributes.

With challenges including lack of standardization across institutions and implicit bias, this letter's format has evolved towards a structured evaluative letter (SEL) focused on the candidate's clinical competencies and professional skills, which provides programs with a more holistic view of an applicant's possible strengths and areas for improvement.

On review of the 2021 Coalition for Physician Accountability recommendations, AAIM charged a task force to review and make recommendations for SELs. The presenters from the task force include a residency program director, a clerkship director who writes SELs, an osteopathic program core faculty member with insight into the unique challenges that osteopathic students face in obtaining a SEL, and a director of clinical education.

We will use breakout groups to identify and discuss common challenges faced in the preparation of SELs as well as features of SELs that residency programs found most helpful in providing a holistic applicant review. We will present the methods of some institutions that were identified by residency program representatives as having produced especially helpful SELs to support a shared understanding of the SEL as a tool in residency recruitment.