Requesting Letters of Recommendation

Overview

Letters of Recommendation (LOR’s) are an important part of your application.  Residency programs hope to learn several things from a LOR.  They are interested in your fund of knowledge, clinical judgment, interpersonal skills and personal qualities.  Equally important is what type of student you are and your potential as a resident.  Essentially, will you be a “good fit”.  Along with clerkship grades and the interview, your LOR’s are one of the most important factors programs use when selecting candidates for interviews and in ranking candidates.

You can and should be asking for LOR’s early on, even before you have decided on a specialty or picked programs.  It is very important throughout this process to keep in mind that programs and specialties may have different requirements. LOR requirements are program specific. It is your responsibility to research requirements prior to applying.

LOR’s submitted for your residency (Electronic Residency Application Service –ERAS or SF-CAS) application must follow specific guidelines.  Please review the links below for more details.

Who to Ask

• The most important factor is to ask someone who knows you well and can describe your fund of knowledge, clinical judgment, interpersonal skills and personal qualities.  
• Letters should be from faculty who have observed your clinical work.
  • The exception is a letter from a faculty research advisor, especially if research is important to your program or specialty
• 3rd year vs. 4th year rotations
  • The majority of your letters should come from 4th year
    • As a 4th year student you are more experienced and mature, and your work is likely to be a better basis for a strong LOR.
    • Your most important letter will likely come from your Sub-I in your specialty. It is very important to ask early in this rotation for a letter and to work closely with this attending.
  • LOR’s 3rd year are also valuable, especially if
    • You performed well
    • It is from a relevant specialty
    • It is from later in the year
    • You are offered a letter
    • Scheduling and timing of specialty choice can prohibit you from getting enough 4th year LOR’s.
  • Do not ask 1st or 2nd year faculty, no matter how well you did or how much they love you.  Programs want to know about your clinical performance.
• Specialty vs. non-Specialty Faculty?
  • Usually the majority of your LOR’s will come from your 4th year work in the specialty you are pursing.
  • However, not all LOR’s need to be from your specialty.  Other valuable LOR’s may come from:
    • Other relevant specialties, i.e. Pediatrics for Family or vice versa
    • Where you performed very well.
  • Again, programs have different requirements. For example,
    • A surgical program may require one non-surgical LOR. 
    • EM programs often require all EM LOR’s or a standardized SLOR
• “Famous” vs. “non-Famous” Faculty
  • “Famous” faculty are those physicians who are well known, in their field or region, or who hold important positions, such as department chair.
  • A LOR from a “famous” faculty member can be extremely helpful, but only if they know you well.  If not, it will be obvious and the LOR will carry little weight.
• Senior vs. Junior Faculty
  • Both are perfectly acceptable however, a letter from a senior faculty member who knows you well can carry more weight. However, having worked with your letter writer personally is the most important factor
  • No residents! There are rare exceptions, i.e.  some Ortho programs require a letter from a chief resident.
• LOR from an Away rotation?
  • Faculty from away rotations, especially in your specialty can be helpful.
  • This letter can illustrate how well you perform outside your home institution and is an unbiased evaluation and comparison to other students.
  • A letter from a faculty member in the program or region a student is applying can be helpful.
  • Remember, you do not have to send this letter to all programs.  You can send it just to that away site or to the region of the country where you did the rotation.
• Other important issues and exceptions…
  • Never family members!

When to Ask

• The earlier the better.  Be sure to give your letter writers adequate time, about 4-6 weeks, to write your LOR.
  • Depending on your programs, you should aim to have your LOR’s submitted to the Career Development Center by mid-September.
• During 3rd and 4th year?
  • Majority of LOR’s come from 4th year work; however LOR’s from the work of your 3rd year are also fine.
• When during a rotation?
  • It is best to ask at the start of the rotation, especially for 4th years. You can let the attending know you will be requesting a LOR as early as the first day.
  • You can also wait to get to know the faculty and let them get to know you before asking.  You would then ask in the middle or towards the end.
  • If you decide to wait, ask faculty soon after the rotation ends.  They will have your performance fresh in their mind and can write a stronger LOR.  Do this even if you will not need the letter right away.
  • If needed, you can go back and ask a 3rd year attending, but the longer you wait after you have finished the rotation, the more difficult it will be for them to write the letter
  • Always remind your letter writer at the end of the rotation.

How to Ask

• Ask directly and in person (see “how do I ensure a strong LoR?” section).
• We recommend meeting with your letter writer, in person, to discuss your career goals, strengths and interests. It will help him/her compose a more personal LOR.
  • Address generic versus specialty specific LOR’s
  • Discuss career goals & strengths
• Make appointment – meet face-to-face if possible, or over the phone if not
• Give adequate time – suggested advance notice is 4-6 weeks
  • Provide a deadline to submit LOR by (mid-September)
• Some may offer you a LOR.  Respond to this offer ASAP.
• Say thank you!

How Do I Ensure a Strong LOR?

• It is extremely important when requesting a LOR to ask your letter writer if they can write you a strong letter. There are a couple ways to ask:
  • “Can you write me a strong letter of recommendation?”
  • “Do you know me well enough to write a strong letter?”
  • “Would you feel comfortable writing a strong letter?”
• Know yourself.  Did you do well on this rotation? Did you perform your best for this attending?
• Read body language and be aware of any discomfort
• If faculty makes any excuse, look elsewhere for a LOR

What information should I provide to my letter writer?

• A “Request for Letter of Recommendation/Coversheet” (ERAS only)
  • The coversheet can be found on the Career Development Center Website at: eras_2011_lorcover_us.pdf
  • The LOR coversheet requires your AAMC ID number. This is the same AAMC ID number you used with AMCAS. If you do not have it, you will receive it again when you register for ERAS. In the meantime, it is not necessary.  You can submit the coversheet without it.
• Guidelines for Writing Letters of Recommendation; A Guide for Faculty
• It is strongly recommended that you waive your right to see the LOR.
  • This makes your letter confidential and the letter is then considered more strongly by residency programs.
  • This must be indicated on the coversheet before sending it to your letter writer.
• Your CV (Link to CV site)
• Additional documents may be requested
  • Personal Statement (Link to P.S. site)
  • Copies of Evaluations
  • Transcripts if requested
• Provide and discuss a list of experiences and qualities you would like highlighted
• Tell your letter writer if you would like the letter to be specialty specific (you will be an excellent Ob/Gyn) or general (you will make an excellent resident)
  • This is very important if you are undecided, applying to more than one specialty or to prelims/transitional years.
• LOR’s should focus on your direct clinical interactions with the faculty member, not your whole medical school career or life story.  So only give what is relevant.
• Give a reasonable deadline (usually mid-September) and adequate advanced notice (4-6 weeks)
• Follow up with email summarizing meeting. This also serves as a good reminder.
• Thank you note & follow up.

How many letters will I need?

The number of LOR’s that you will need will vary by student and program.  While most will only need three, you may need more depending on your specialty, if you are applying to more than one specialty or prelims/transitional years, etc.  This information is program specific. It is extremely important to check with the programs directly.

• Most residency programs will ask for 3 to 4 LOR’s.
  • A maximum of four (4) LOR’s can be sent to any given program via ERAS
  • The exact number is program specific.
  • If you send more than the requested number, the program may indiscriminately discard one LOR.
  • So check with each individual program!
• Some specialties will request a chairman’s letter (in the specialty to which you are applying). The Chair letter counts as one of your LOR’s.
• The majority of your LOR’s should be from faculty within your chosen specialty (2 of 3)
• Request extra LOR’s...
  • In case some faculty members end up not being able to write the letter
  • For applying to different specialties or prelims
  • For specific programs (i.e. where you did an away rotation)
  • For specific regions of the country
• You will be able to assign different LOR to different programs, so you may have or need 5 or more letters on ERAS, even though you are only sending 3 to each program.

Chairman Letter

• A letter from the Chair of the department is required for some specialties. Most common are medicine and surgery. Check with your programs.
• Only request a Chair letter if it is required or if you have worked with the Chair.

MSPE (formerly known as the Dean’s Letter)

• Known as the Medical Student Performance Evaluation (MSPE)
• Everyone will receive an MSPE either from Dr. Parrish or Dr. Rodriguez
  • They DO NOT need your CV
• MSPE’s DO NOT count as LOR’s
• All MSPE’s will be uploaded together on Nov 1.
• Fill out the MSPE form on time!
• You can and are expected to review this letter.  Make sure you do this as soon as your letter is ready for review!

Where do LOR’s get sent and how?

• LOR’s can be mailed, sent electronically via email or fax.  All must be on letterhead and signed (electronic signatures are acceptable)
  • Mail: Marie Hartman
    Career Development Center
    
    2900 Queen Lane
    Philadelphia PA 19129
  • Fax: 215-991-8132 Attn: Marie Hartman
  • Email (in a .pdf format): mhartman@drexelmed.edu

Tracking your LOR’s? (How do I check to see if my LOR’s have been received?)

• To find out if your LOR has been received by the Career Development Center, email Veronica Bosier (vbosier@drexelmed.edu) or Marie Hartman (mhartman@drexelmed.edu).
• Beginning July 15th, you can use the Electronic Residency Application Service (ERAS) to track your letters
• To track letters in ERAS you must enter your letter writers name’s and titles in ERAS, then “finalize” them
  • Format: Name (Howard Miller, M.D.), Title (Professor), Department (Dept. of Medicine)
  • “Finalizing” does not send the LOR’s to your programs, it just allows you to track and later assign.
  • Do this as soon as possible to expedite the application process
• Once this is done, the Career Development Center will scan your letters into the system, and the LOR’s will be sent to the ERAS Post Office, along with other documents. Document remain here until you assign them and apply.
• You then must assign LOR’s to each program
  • Once you apply and assign LOR’s to each program,  the LOR’s will automatically be sent.
  • You can then use ERAS ADTS to track if programs have downloaded your application and LOR’s
  • Programs can only view LOR’s assigned to them.
  • Additional information about tracking will be covered in future ERAS sessions.

Early Match (SF Match-Central Application Service-CAS)

• You must submit three (3) ORIGINAL letters of reference for review by the programs. No more,No less. It is recommended that residency applicants provide one letter from a core rotation. If you have requested a confidential letter, please indicate so on your CAS application and ask the author to return the letter to you in a sealed envelope. DO NOT open the sealed envelopes.
• Nonconfidential letters can be included in your application open faced.
• NOTE: Letter writers can address their letters to either “Dear Program Director” or “Dear Review Committee”.
• SF/CAS procedure makes you (the applicant) responsible for assembling ALL support documents. Once the necessary documents have been gathered (except the Dean’s Letter if you are currently a US Senior), you will send all documents to CAS in ONE PACKAGE.
• Please refer to the Early Match Guide for more information or visit www.sfmatch.org

How do I choose which ones to use?

• Based on performance in rotation
  • Better Performance usually results in a stronger LOR
• Based on Specialty Choice
  • At least 2 of 3-4 LOR’s should be from your specialty
• Student Underground…Beware!
  • Other students are probably where you will get much of your information, but that is not always reliable!
  • Most students waive their right to see their LOR so they may not be the most reliable source.
  • Other students can certainly be helpful in identifying supportive faculty.

Career Development Center Rules

• We do not review LOR’s
• We do not select LOR’s
• If an error is seen while scanning the LOR, the letter writer will be contacted.
• ERAS LOR’s CANNOT be used for any other purpose, i.e. recommendation for electives
• If you have waived your right to see your LOR, you will not be able to see it at any time
• If you have not waived your right to see your LOR, you will NOT be able to review it in our office. Contact your letter writer.

TIPS

• Ask early
• Follow up, send reminders
• Send Thank You Notes!