The Standardized Letter of Evaluation (SLOE)

Instructions for Authors: Only Emergency Medicine Faculty may complete this form

For authors who are new to the process, we encourage you to seek mentorship from CORD, the SLOE Task Force or your program leadership (PD, APD, CD, etc.) before completing the eSLOE.

Before you write a SLOE, you will need to:

• Review the instructions (below), as they may change annually
• Obtain last year’s clerkship grades for question A5.
• Review the SLOEs you authored last year to report both the total # authored and the # recommended in each of the global assessment rankings. Remember that Question C1 requests the entire profile of global assessment rankings from the previous year for each applicant’s SLOE. (note: for future years the eSLOE website will track this for you automatically)

2024-2025: SLOE letters continue to be completed using the eSLOE website.

Click here to view the eSLOE FAQs

SLOE INSTRUCTIONS:

If this is your first SLOE of the year, please take a minute to review the instructions below.  Included in the instructions are tips for navigating the eSLOE website.  If you have already read the instructions, click here to enter the eSLOE website.

eSLOE Website

The SLOE has always been intended to be an evaluative tool and not necessarily a recommendation.  For this reason, the name SLOR has been replaced by SLOE.  This instrument was developed to provide a global perspective on an applicant’s candidacy for training by providing meaningful comparisons to peers applying for training in emergency medicine.  Please keep this in mind as you complete the SLOE.

The SLOE was developed to be:

• Standardized
• Concise
• Discerning/Discriminating

Keep comments succinct and relevant, and make every effort to avoid grade inflation in your comparisons so as not to detract from the effectiveness of your SLOE.

A well-written SLOE provides an overall perspective on what an individual candidate offers to a training program.  It is unique in its ability to provide comparative data to peers in addition to important information regarding the distinguishing non-cognitive characteristics (e.g. Maturity, professionalism, leadership, compassion, initiative, enthusiasm) that an applicant possesses.

Each year the pool of candidates applying to emergency medicine is very competitive. As such, applicants “at the level of peers (middle 1/3)” should be viewed as a positive evaluation, and “below the level of peers (lower 1/3)” also describes a candidate who will likely match. 

In addition to the applicant’s non-cognitive qualities, the written comments should highlight strengths and explain any areas of focus for the student.  Keep in mind that training programs vary in the attributes they value in a successful candidate.

Do’s:

1. Use the eSLOE (don’t create your own version of the SLOE!!!)
2. Please do answer every question
3. Do write a Group SLOE authored by program leadership e.g. PD, CD, APD if your institution has a moderate number of rotating students. When done appropriately, these letters provide a balanced perspective of the applicant.
4. Do keep in mind that most programs match out between #40-100 on their rank list.  As a result, middle 1/3 and lower 1/3 rank estimates should be viewed as competitive applicants who will likely match (Question C2b).
5. The “Written comments” section should be about the individual applicant only.
6. Do avoid reiterating information that can be found elsewhere in the ERAS application

Don’ts:

1. Don’t list random faculty comments from the rotation without context
2. Don’t write lengthy dissertations.  The comments should be concise and limited to 250 words.
3. Don’t use the comments section to describe your grading system or institution. 

If it is important to provide information regarding your institution’s demographics (e.g. grading, clinical experience, values) to better frame the applicant’s performance, please enter this information in the Institutional/Rotation Demographic Information Template on the SLOE template settings on the new eSLOE.

1. Go to the website for the eSLOE (listed below) and login.
2. You are then taken to your dashboard (a snapshot of your SLOEs written for the 2020-21 application cycle)
   • Click “Lifetime Evaluation” on the dashboard to
     • View and Edit prior SLOEs,
     • Save a PDF of a SLOE to upload to ERAS
     • Create a new evaluation.
   • Click “Update SLOE Template Settings” to update the settings
     • Written Comments Template – Information entered here will appear on every SLOE, this information in this field replaces the demographics form.
   • Click “View All My Evaluations” to view all previous evaluations written by you.
3. On the left column menu (if you are on a tablet or mobile device the menu button is at the top right corner):
   • Dashboard: will always take you back to the dashboard view
   • Evaluations: will take you to your list of completed SLOEs, or allow you to add a new evaluation
   • Users: lists your current users (and if you are the program director for your program, allows you to add additional users).
     • Click here for instructions to add a User to your program that can create and edit SLOEs
4. Once the letter is complete upload the PDF Letter to the Letter of Recommendation Portal on ERAS. 
   
   
5. If you have multiple rotations and have your grades different you will need a separate institution account for this rotation. Please contact the CORD office to set up an additional account.

Enter the eSLOE website

Also available is the document Bibliographic Citation Guidelines for EM Residency Applicants. Please copy and share these guidelines with anyone interested in applying to emergency medicine residencies. Applicants are requested to provide a signed copy of this form with their completed application.

As envisioned by the original SLOE Task Force, this instrument “remains flexible and reflective of membership opinion”.  Please contact the CORD office (cord@cordem.org) or any task force member with any suggestions you may have. Additional resources can be found at the ERAS/AAMC web site.

If you experience problems using the eSLOE, please contact the CORD office by phone at 888-444-2090 ext 3229 or email at cord@cordem.org.

For more information regarding the standardized letters:

• Keim SM, Rein JA, Chisholm C, Dyne PL, Hendey GW, Jouriles NJ et al.  A Standardized Letter of Recommendation for Residency Application.  Acad Emerg Med.  1999;6:1141-1146.
• Garmel GM.  Letters of Recommendation:  What Does Good Really Mean?  Acad Emerg Med.  1997:4:833-834.
• Harwood RC, Girzadas DV, Carlson A, Delis S, Stevison K, Tsonis G et a.  Characteristics of the Emergency Medicine Standardized Letter of Recommendation.  Acad Emerg Med.  2000;7:409-410.
• Girzadas DV, Harwood RC, Dearie J, Garrett S.  A Comparison of Standardized and Narrative Letters of Recommendation.  Acad Emerg Med.  1998;5:1101-1104.
• Girzadas DV, Harwood RC, Delis SN, Stevison K, Keng G, Cipparrone N et al.  Emergency Medicine Standardized Letter of Recommendation:  Predictors of Guaranteed Match.  Acad Emerg Med.  2001;8:648-653.
• Love JN, Deiorio NM, Ronan-Bentle S, Howell, JM, Doty C, Lane DR, Hegarty C.  Characterization of the CORD Standardized Letter of Recommendation in 2011-2012. Academic Emergency Medicine.  2013;20:926-932.
• Hegarty CB, Lane DR, Love JN, Doty C, Deiorio NM, Ronan-Bentle S, Howell JM.  Council of Emergency Medicine Residency Director’s Standardized Letter of Recommendation Writers’ Questionnaire.  Journal of Graduate Medical Education.  2014;6:301-306.  (PMID:  24949136)
• Love JN, Smith J, Weizberg M,  Doty C, Garra G, Avegno J, Howell JM.  The Council of Emergency Medicine Residency Directors Standardized Letter of Recommendation:  Program Directors Perspective.  Academic Emergency Medicine.  2014;21(6):680-687.  (PMID:  25039553)
• Jackson JS, Bond  M, Love JN, Hegarty C.  Emergency Medicine Standardized Letter of Evaluation (SLOE):  Data from 2016-2017 e SLOE Electronic Website. Journal of Graduate Medical Education  2019;11:182-186.  (PMID:31024650)