The Medical Student Performance Evaluation (MSPE) is a letter from the Dean’s office that will include a summary of academic performance and professional attributes. These are derived from student evaluations during medical school, including classroom, clinical, and other relevant settings. The MSPE is not a letter of recommendation but a letter of evaluation and is prepared early in the student’s fourth year. This letter of evaluation becomes part of the Electronic Residency Application Service (ERAS) application.