The MSPE is a letter of evaluation (not a letter of recommendation) intended to place a candidate's performance in relationship to his or her classmates. It consists of sections describing the candidate's unique characteristics, academic history (leaves, expected graduation date, joint or combined programs, etc.), a brief summary of the candidate's work in the preclinical curriculum (LOD's, Outstanding USMLE scores, etc.), narrative evaluations from the core clinical clerkships and elective rotations and a summative assessment of the student comparative performance in medical school.