Top Tips for Residency Letters of Recommendation

A quality letter of recommendation incorporates how well the writer knows the medical student, what specialty the candidate is applying to, the qualities of that person that make them an exceptional choice for the specialty in the Match SM, the activities the candidate has engaged in (research/community service) that make the student well-rounded, and the kinds of feelings the student evoked in the letter writer. For example: “On a personal note, it was wonderful to work with him because of his great sense of humor and positive approach to everything!”

The key is to start forming relationships early, so asking for a letter of recommendation will seem natural and sincere. First, arrange a mid-clerkship meeting with the attending you’d like to get to know. This attending can give feedback on how you’re doing in that rotation. Come equipped with an H&P you’ve done, or be prepared to talk intelligently about the patient who made the biggest impression on you.
Next, give that attending some personal information about you—how you came to the decision of being a doctor and what your hopes are for the future. Then, incorporate their feedback into your work, and let the attending know that you’ve done so. At the end of the rotation, ask that attending if she’d be willing to write a strong letter of recommendation for you. Don’t be shy! Teachers love helping students who have worked hard.

Do you have the right to read your letter of recommendation? Yes. Should you waive that right? Yes—in all instances! Admissions officers view it as a red flag when they see that a candidate for residency has not waived his or her right to read the letter. It may cause them to wonder what the applicant may have omitted from the letter.

This may seem obvious, but a letter from a specialist in the area you’d like to Match is going to carry a lot more weight than someone in a different specialty. Make sure you do your due diligence and seek out an experience within your chosen field. A letter of recommendation from a program director or vice chair of education is a testament to the candidate’s characteristics and strengths. A letter from an ambulatory clinician educator and clerkship directors who has worked closely with the candidate carries as much weight.

Do not ask friends to write a letter of recommendation attesting to your character, unless that person knows you professionally or knows someone with admissions authority at a program you’re interested in. If you do have a friend who knows a decision-maker, I recommend that person sends a letter or e-mail outside of ERAS.

When it’s time to ask for your letter of recommendation, it’s probably best to ask for the letter in mid-July or so. Be sure to have your CV and personal statement in reasonable shape by that time.  Stay in touch to make sure your letters are in by the time the ERAS mailbox opens for the programs.

After you match, send a note of gratitude letting your letter writers know where you ended up matching. It’s a nice touch, and you never know if you’ll cross paths again. It makes for a memorable professional relationship.

Though you may not get a chance to review your letters, having a good relationship with the writer helps you avoid receiving a lackluster and unusually short letter of recommendation like “He was nice and always was punctual.” This kind of letter indicates that the letter writer didn’t get to know the candidate very well. Remember the letters of recommendation are a critical aspect of your application. You want to prepare early and attend to them with care.
In other words, you don’t want to start your application for residency wondering who your letter of recommendation writers will be. Start your clinical rotations or clinical experiences knowing that one of your objectives is to identify and impress a clinician-educator enough to be able to write an outstanding letter for you.