An important part of the residency application process is obtaining letters of recommendations (LORs). These letters are an opportunity for interviewers to gain insight into your character and who you are as an individual from a 3rd-party perspective. In this article, we will delve into some common questions applicants ask about ERAS letters of recommendation and provide insight on how to navigate the process of successfully obtaining letters of recommendation
There are several considerations when figuring out who to ask for a letter of recommendation. Of course, it is most important to ask people who know you best – think attendings you connected with throughout a rotation, mentors/advisors, faculty you have done research with, physicians you have worked on volunteer projects with, etc. These writers would ideally not only speak about your merits in medicine, but also who you are as a person and what it is like to work with you. These are characteristics that are challenging to glean from other areas of your application.
Generally, we recommend your letter writers be physicians. If you are targeting more academic residency programs, the academic rank of your letter writer does matter (i.e. professor/department chair carries more weight than an assistant professor). This is not a major factor when applying to community programs. It will be in your favor to have at least 2 letter writers who have worked with you in a clinical setting and can speak to your interactions/demeanor with patients and the team as a whole.
Bonus tip: It is absolutely okay to ask for MORE letters than you need (ie you can ask 5 to 6 people for a letter). As discussed below, sometimes letter writers are not able to complete the letter by the submission time so having backup letters can be helpful.
Perhaps the most stressful aspect of LORs is that you are entirely dependent on someone else completing this task! It goes without saying that asking your letter writers for a LOR early on is better. A general rule of thumb is 6 to 8 weeks to write a letter but even a few months is preferred.
Bonus tip: Do not be afraid to drop the hint or directly ask for a LOR during or immediately after a rotation. Asking during this time period will give the letter writer a chance to reflect on details of your character and merit and specific examples of admirable things you did – details they might not remember if you ask 6 months later.
There are a couple ways to go about this. It is generally favorable to ask in-person, as this is the most personal and can open up a conversation reflecting on your performance on the rotation. If this is not possible, an email is perfectly sufficient. It is recommended to err on the side of formality, even if you are close with your letter writer. Ensure you include your CV and clearly write the due date of the letter, whether that be the “hard” date (ie when the application is due) or a week prior to give a buffer period.
Bonus tip: After asking for a LOR in-person, be prepared to send your letter writer an email with details including “due date” for the letter, your CV, etc., in addition to another note of appreciation for their time. This will help solidify the request and provide important details they might not have remembered from a verbal request.
Be prepared to send (gentle) reminder emails! Physicians tend to be extremely busy not only with clinical duties, but administrative and research responsibilities. It is unlikely they are intentionally ignoring the letter and may actually appreciate a gentle reminder. A simple example would look something like:
Hello [blank],
Thank you again for agreeing to write me a letter of recommendation for residency. Since the application due date is nearing [insert date], I just wanted to check in to see how the letter is going and if you need anything from my end? Thank you so much.
Bonus tip: Avoid sending your first reminder close to the application due date (ie the day before). Generally, 1-2 weeks is a reasonable timeframe to give a gentle reminder.
It is fine to ask your letter writers to include specific details, but this should be worded carefully! Rather than demand they include something in the letter, you can request they “highlight” a certain thing (for example: a meaningful patient interaction they noticed, success with a research project, award you were given, etc). The letter writer then has the right to decide a) if they want to include it at all, and b) how it would be worded.
Bonus tip: Although it is not uncommon for letter writers to send you the letter copy or even ask you to write the letter yourself, be aware this is against AAMC policy. As discussed above, it is perfectly fine to help writers by giving them your CV, reminding them of specific examples of things you did during the rotation, etc.
Preparing your application is a stressful but exciting time! You have worked so hard and now the fruits of your labor are paying off/coming together. LORs are an important way to show off your character and most physicians are happy to write one for you. Support your letter writer by having your CV prepared, giving them plenty of time to write the letter, and sending gentle reminder(s) as needed. If you follow these recommendations, you will be off to a great start!
