Letters of Recommendation (LOR) and Your Residency Application

Strong letters of recommendation are considered one of the most important aspects of your residency application, yet many students feel that they have little to no control over this piece of their application.  You have more control than you think and it is important to ensure that your letters of recommendation achieve their intended purpose, which according to the authors from The Successful Match is “to demonstrate to programs that you have both the professional and personal qualities to succeed as a resident and, later, as a practicing physician.”  Choosing your letter writers wisely is the most important factor that should result in a strong letter of recommendation.

Who should I ask to write a letter of recommendation?

Anyone can write you a letter of recommendation, however you want to choose individuals that will write you an EXCELLENT letter of recommendation that will strongly support your candidacy for a residency program!  According to The Successful Match, the authors mention that if you can answer “Yes” to the following questions than this is a potential letter writer:

• Did I do well on their rotation?
• Do they think highly of me?
• Did I work closely with them?
• Do they have time?
• Do they care about my future?
• Do they have good communication skills?
• Do they have specific examples they can use to reflect my strengths?

Do all the letters need to come from people in my specialty?

Strong letters from clinical faculty in your field could be weighted more heavily than a strong letter from clinical faculty in another specialty.   However, at least two letters of recommendation from faculty within your specialty will suffice for most programs and a majority of specialties.  The exception would be surgical specialties where letters of recommendation from those in the field are much more strongly preferred.

How many letters of recommendation do I need for my residency application?

You will need a minimum of three LORs in order for your application to be complete.  Most residency programs ask for and will ONLY review three letters of recommendation. You can submit up to four letters of recommendation via the Electronic Residency Application Service (ERAS), programs will choose three letters and read them and the TCOM Medical Student Success office encourages students to request at least 4 letters of recommendation to ensure they are meeting any request by residency programs during application season.  You submit the appropriate number of letters based on the individual program requirements.

Will I need a Department Chair Letter?

This is VERY PROGRAM SPECIFIC and you will need to check the program’s website you plan on applying to see if there is a specific request made for a Department Chair Letter. At TCOM each department has a specified protocol for requesting chair letters, this information will be provided during your residency counseling meeting OR you can contact the respective departments.

• Any student pursuing Internal Medicine will require a department chair letter for their residency application. For those pursuing General Surgery, Obstetrics and Gynecology, Orthopedic Surgery or Pediatrics, obtaining a Chair Letter is strongly recommended.

What is the most appropriate way to ask for a letter of recommendation?

You want to ALWAYS ask in person, preferably after you have developed a relationship with the letter writer that allows them to write you a strong and favorable letter of recommendation.  Also if you feel that you potentially could have a great letter writer, but do not feel comfortable asking them after interacting with them for two to four weeks, then continue to build the relationship beyond your rotation.  Ask your potential letter writer if they would be ok with you following up with them to gain information from them about their knowledge and insight about the field. When requesting a letter of recommendation, request an appointment or time to meet one on one.

What documents should I provide when I request a letter of recommendation?

• Cover Letter (should include deadline)
• CV / CIRRICULUM Vitae (should include Board Scores & Rank)
• Letter of Recommendation Request Form (You need to create this in ERAS)
• Personal Statement: Please note your personal statement for your letter writer will be slightly different than your personal statement for residency. Should be one page or less on a Word Doc with reasonable margins, font and formatting.  Consider touching on the following topics in your personal statement:
  • Information pertaining to what led you to what your specialty choice.
  • A recap/summary of a significant case or memorable patient encounters during your rotation with the letter writer.
  • A reminder of any presentation, research, handouts/write-ups you did during your rotation
  • A brief overview of a personal experience that helps to distinguish you from your classmates (leadership role, organizer of significant event or community initiative, non-traditional student, prior or unique/relevant work history, distinctive awards or recognitions received)
  • A sentence or two highlighting what you feel your top two-three strengths are

Regardless of if the letter writer is known to request these things or not, you should be proactive in providing this information as it will show your level of preparation.  It also makes it more convenient for your letter writer to recall favorable information about their interactions with you.

I really want to see my letter of recommendation!

Although you have the right to see your letter of recommendation along with other educational records, waiving your right to view your letter is highly recommended for your residency application.  We advise students, based on feedback from the graduate medical education community, that letters where a student’s viewing right are waived, are considered more “credible” than those where the student did not waive their rights.  Choose your letter writers carefully!  Building a strong relationship with your letter writer can help to alleviate any concerns you have about the content in the letter.