Residency Letters Of Recommendation (With Samples)

Letters of recommendation are one of the most important components of a residency application. Program directors value the opinion and assessments of people with whom you have worked during medical school, and, especially those letters from people within the specialty to which you are applying.

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When To Ask For Letters Of Recommendation

At any time during your medical education, when you identify someone with whom you have rapport and who thinks highly of you ask that person if she would be willing to write you a strong letter of reference in the future. Then be sure to keep in touch with that individual from time to time. Keep the attending updated on your progress and achievements so when it comes time to write your letter she won’t have to play catch up, which will make the letter more sincere. Assuming you are applying for residency in September, you should request letters by May or June, if possible. 

How To Ask For Letters Of Recommendation

How you go about asking someone to write a letter depends in part on your relationship with the individual. If an attending offers to write a letter on your behalf and you have had an open dialogue about his doing so, then simply ask him if he would like any supporting documentation. 

Otherwise, it is best to schedule an appointment to meet with the attending. I suggest first requesting this meeting via email. If the email isn’t answered in three to four business day, follow up with a phone call.

We suggest you try and personalize your request as much as possible.

Here is a sample email letter request:

Dear Dr. Murray,

I will be applying for residency in otolaryngology this fall and I am writing to ask if you would be willing to write me a letter of reference. I really enjoyed my rotation with you where I learned so much about the practice of ENT both in the OR and in the outpatient setting. This rotation is what really solidified my desire to practice ENT. Since then, I have written one case report and started a research project with Dr. Katz. As we talked about during the rotation, I hope to return to Texas for residency so I can be closer to family. I would be happy to meet or speak with you, whatever is easiest for you. I have attached my CV to this email for your reference.

Thank you for your time and consideration.

Krystal Khan, MS IV

During the meeting, it is fair to ask this person openly if he would be willing to write a strong letter on your behalf. You must hope that you will get an honest reply. If you sense any hesitation, walk away. You don’t want any mediocre or poor letters in your profile.

Your job is to make the letter writer’s job as easy as possible. Arrive at the meeting with a folder in hand that has a copy of your CV, your personal statement (if you have already written it), and any information he may need, such as your AAMC number and where the letters should be sent.  Some attendings may refer you to their administrative assistants, who will let you know what materials are needed for the attending to compose your letter. 

Who Should Write Letters Of Recommendation?

Which letters have the most impact when it comes to residency? It depends. If you are applying for orthopaedic surgery, for example, you don’t want to have three letters from non-orthopaedic faculty. When applying to residency, titles matter; a letter from a community doctor will carry less weight than a letter from the chair at a major academic center. By the same token, a letter from someone with a “big name” with whom you have never worked won’t be strong either. The best letters come from people who know you well and have worked with you directly.

Across all specialties, program directors surveyed indicated that letters of reference in the specialty were one of the most important factors in deciding whom to interview.

Most influential are letters from clerkship directors, program or associate program directors and chairs within the specialty to which you are applying. Strong letters from department faculty, while they might have less weighty titles, are still valuable.

How Many Letters Of Recommendation Should You Have?

ERAS allows you to select four letters to be sent to each program and we recommend having at least two of these letters from attendings within the specialty to which you are applying.  Since ERAS allows you to upload multiple letters of reference which you can then assign to programs, it never hurts to ask for more letters than you need in case someone doesn’t come through. 

Sample Letter Of Recommendation

To whom it may concern:

It is with pleasure that I write this letter on behalf of Excellent Student who is applying for residency in surgery. I worked directly with ES for two weeks in March while he was on his core general surgery rotation at the University. During this time, I was an Associate Professor of General Surgery and Clerkship Director for General Surgery. 

ES was always an outstanding student clinically and was well above the expectations of a third year medical student. In our time together, ES cared for numerous patients on the service. Each morning, she would arrive at 5:30 AM, even before the residents and diligently gather information on overnight events, speak with nurses, record laboratory values, and interview patients on her own. Because she was often done with her work before the residents, she then assisted them with any time remaining. During morning rounds, ES always presented her patients in an organized and succinct manner. She paid close attention to details and would often question why his patients had abnormal patterns of laboratory values. She demonstrated an exceptional fund of knowledge that she applied to complex clinical situations. Furthermore, her ability to prioritize problems and create her own plan to address those issues was impressive. ES cared for each of her patients with a rare blend of compassion and sensitivity that is rare for a student her age. She also considered a patient’s family and loved ones when they were present. ES took her role seriously and patients and families often viewed him as “the doctor” rather than a medical student.

In the operating room, I was impressed with ES’s technical skills, ability to know when to step in an assist and when to stay in the background at the ready. Her level of stamina paralleled her curiosity about general surgical techniques. I remember one fairly complex cholecystectomy when the cystic artery was severed and we had to covert to an open procedure. ES expertly assisted during this procedure, staying calm, and the patient did very well. 

Residents on ES’s team remarked at how independent and hard working she was. However, ES also knew when her experience and knowledge limits were met and was not afraid to ask for help. ES was consistently pleasant, personable, easy going and demonstrated great communication skills. Everyone felt that ES was a strong team player, and a professional who would often volunteer to call consults and help with admissions that did not involve her own patients.

Intellectually ES was exceptional. She frequently sought out opportunities to broaden her knowledge base and took an active part in self-directed learning. She read independently on his own patients as well as others and offered to give presentations on various topics. ES presented at our morning conference about cholecystecomy complication and her work was at a resident’s level.

ES consistently impressed me on a daily basis and demonstrated that she is a bright and extremely motivated young woman. I am confident that she will be a tremendous asset to your department and make you proud to have her on your team. I give ES my absolute highest recommendation and consider her to be in the top 5% of students with whom I have worked with in my career. I congratulate the program that is lucky enough to recruit ES. If I can be of any further assistance, please do not hesitate to contact me.

Best regards,
The Doctor

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