Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;17(2):211-216.
doi: 10.4300/JGME-D-24-00501.1. Epub 2025 Apr 15.

eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

Sharon Bord  1 , Erin Karl  2 , Doug Franzen  3 , Cullen B Hegarty  4 , Joseph B House  5 , Katherine M Hiller  6 , Kevin Hamilton  7 , Alexis Pelletier-Bui  8
Affiliations

eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

Sharon Bord et al. J Grad Med Educ. 2025 Apr.

Abstract

Background The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) was created to provide a standardized, concise, and differentiated evaluation of EM residency applicants. It was revised in 2022 (eSLOE 2.0) to better align with the shift toward competency-based evaluations in undergraduate and graduate medical education. Objective To investigate how applicants were rated by evaluators on the new competency-based component and revised normative-based components of the eSLOE 2.0 and to establish preliminary validity for the new letter format. Methods Data from the first 2 application cycles utilizing the eSLOE 2.0 (2022-2023, 2023-2024) were accessed via a national EM database. The data specifically from parts A (core EM clinical skills), B (professionalism and interpersonal skills), and C (anticipated guidance during residency and rank list placement) were examined. Results Data from the 11 789 letters, representing 6543 unique applicants, revealed that 44.8% to 71.7% of applicants were designated as fully entrustable, and 27% to 50.7% as mostly entrustable on part A skills. Most applicants (81.7% to 85.7%) were placed as either 4 or 5 (1-5 Likert scale) in each part B skill. Nearly fifty-two percent (n=6076) were anticipated to need standard guidance in residency, while 32.8% (n=3872) were anticipated to need minimal guidance and 15.6% (n=1841) to need moderate or most guidance. In part C, 20.5% (n=2414) were designated as being in the top 10% on the rank list, 37.2% (n=4381) in the top third, 31.6% (n=3727) in the middle third, and 10.0% (n=1178) in the lower third. Conclusions The findings from the first 2 years of utilizing the eSLOE 2.0 format offer preliminary validity data on this new letter format.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part A Category Distribution (2022-2024)
Figure 2
Figure 2
Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part B Likert Scale Distribution (2022-2024)
Figure 3
Figure 3
Emergency Medicine Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part C Anticipated Guidance Needed During Residency (2022-2024)
Figure 4
Figure 4
Emergency Medicine Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Estimated Position on the Rank List (2022-2024)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Humphrey HJ, Woodruff JN. The pass/fail decision for USMLE Step 1—next steps. JAMA . 2020;323((20)):2022–2023. doi: 10.1001/jama.2020.3938. doi: - DOI - PubMed
    1. Wang A, Karunungan KL, Story JD, et al. Reimagining a pass/fail clinical core clerkship: a US residency program director survey and meta-analysis. BMC Med Educ . 2023;23:788. doi: 10.1186/s12909-023-04770-8. doi: - DOI - PMC - PubMed
    1. Keim SM, Rein JA, Chisholm C, et al. A standardized letter of recommendation for residency application. Acad Emerg Med . 1999;6((11)):1141–1146. doi: 10.1111/j.1553-2712.1999.tb00117.x. doi: - DOI - PubMed
    1. Coalition for Physician Accountability. The Coalition for Physician Accountability’s Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC). Recommendations for Comprehensive Improvement of the UME-GME Transition. Published 2021. Accessed February 3, 2025. https://physicianaccountability.org/wp-content/uploads/2021/08/UGRC-Coal....
    1. Jackson JS, Bond M, Love JN, Hegarty C. Emergency Medicine Standardized Letter of Evaluation (SLOE): findings from the new electronic SLOE format. J Grad Med Educ . 2019;11((2)):182–186. doi: 10.4300/JGME-D-18-00344.1. doi: - DOI - PMC - PubMed

MeSH terms

LinkOut - more resources