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J Emerg Med. 2011 Jan;40(1):72-5. doi: 10.1016/j.jemermed.2009.09.017. Epub 2010 Oct 20.

The Family Education Rights and Privacy Act's impact on residency applicant behavior and recommendations: a pilot study.

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Department of Emergency Medicine, Michigan State University, Kalamazoo, MI, USA.



The Family Education Rights and Privacy Act (FERPA) provides residency applicants the right to view letters of recommendation. Applicants must indicate whether they waive this right.


We determined how frequently applicants to an emergency medicine residency program waived the right to view letters of recommendation and whether such decisions impacted the letters' contents.


A retrospective, observational review of all letters of recommendation submitted to an emergency medicine residency program in 2005-2006 determined applicants' FERPA declaration, use of the Standardized Letter of Recommendation (SLOR), and the SLOR Global Assessment ranking. The percentage of applicants waiving FERPA rights was determined. Chi-squared tests of independence assessed whether applicants' decisions influenced the SLOR Global Assessment. All statistical analysis used a 5% level of significance.


There were 367 applications received; 1120 letters of recommendation accompanied 264 US medical school applications, 449 (40%) using the SLOR format. Of the SLORs, only 6% stated that the applicant did not waive his FERPA right; 426 SLORs included a Global Assessment. Of those waiving FERPA rights, 30% were ranked "Outstanding," 50% "Excellent," 17% "Very Good," and 3% "Good." For those not waiving FERPA rights, 35% were ranked as "Outstanding," 46% "Excellent," 15% "Very Good," and 4% "Good." There was no statistical difference in Global Assessment ranking between applicants who waived FERPA rights and those who did not (p = 0.934).


In this pilot study, the vast majority of applicants waived FERPA rights to view letters of recommendation. The applicants' decisions did not influence their SLOR Global Assessment ranking.

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