Letters of Recommendation

• Most residency programs require 3 (or 4) letters of recommendation (not including your MSPE)
• Some departments also write a department letter – if so, the department letter counts toward the 4 letter maximum that ERAS allows. It’s important to consult the career advising website and/or meet with the specialty advisor near the beginning of Career Launch to clarify if a department letter is needed, and who will write this department letter.
• For students who are applying in a specialty field that also requires a Prelim-Medicine internship application: Please contact the Medicine Prelim advisor early in Career Launch, as this advisor will need to write you a department letter.  

• The best person to write a letter varies by field—please see the specialty-specific sections of the career advising website. Usually the best people to approach to write a letter are faculty who:  
  • Know your clinical or research skills best
  • Offer to write one
  • Can write a strong letter
• The strongest letters are often written by attendings who know your clinical skills from a specialty-specific sub-internship. These are valued by programs because they represent your peak and recent clinical performance. 
• Many students will request a LOR from an attending they worked with during F2. Again, check the specialty-specific sections of the website to clarify if this is recommended in your field. 
• If COVID-19 has significantly impacted the number of clinical experiences you are able to have in your chosen specialty and you are not certain who to ask for a LOR, consult with the main specialty advisor in your field.

• Request the letter early – so the writer will remember the experience and recall a lot of detail that shows they know you. 
•  It’s generally considered best to ask in real time (in person, through a video or telephone call), though it’s also fine to ask via e-mail if there is no way to ask through a 1-on-1 conversation. 
• Be direct about the request. (e.g., “I’m asking if you can write me a strong letter of support”).
• Give the letter writer a polite way to decline your request if they don’t feel they can write a very strong letter for you. (e.g., “I know you’re very busy…”)
• Once a letter writer confirms that they will write a letter for you, understand that they will not write it until it is close to the deadline to submit applications. Provide the writer a timeline of when the letter is due, and offer to send deadline reminders.
•  If there is some time between when the writer agrees to your LOR request and when it is due:
  • Jot down a (secure) list of patients that you worked with – so you can look up these records later. This list can remind both you and the letter writer about key clinical experiences you shared. 
  • Write down a short anecdote of something meaningful that happened during the time that you worked with the attending (for example: a patient vignette, or research experience). Save this for yourself. You might share this with the attending later.
  • Continue to keep in contact with the attending so that they remember you. This can be in the form of quick (infrequent) emails, and in some cases may facilitate building a mentoring relationship with the attending. 
• When you are a couple of months away from submitting your application, send the letter writer a near-final version of your CV and personal statement. 
• Always waive your right to see the letter. Many programs will not consider non-waived letters. 

Many programs require that one of the letters be a Department/Chair letter from the corresponding department on campus. Students applying in specialties that require a Chair’s letter should contact their respective specialty residency advisor.

• Limit your letter to one or two pages.
• Explain how you know the applicant and your relationship. Do you know this applicant from an academic, clinical or research setting? State how long have you known the applicant and how well.
• Tailor your letter. Give the reader a sense of the applicant’s potential as a future physician, as well as in other areas on which you can comment (e.g., research, advocacy, their chosen specialty). Specific areas to comment on include: intellectual ability; analytical skills; attitude toward learning; communication skills; initiative, motivation, and persistence; and personal achievements.
• Be specific. Give specific examples of your observation of the student, or stories about your experiences with them that reflect his/her potential, professionalism, clinical acumen, interpersonal and leadership skills, passion for medicine, etc.
• Avoid personal remarks and implicit bias. Please review Strategies for Avoiding Bias. Do not mention age, race/ethnicity, marital status, children, physical characteristics, or other personal attributes. If you believe this is an important factor in demonstrating the applicant’s performance and potential, ask the student if they want that information included in the letter.
• Conclude with an overall recommendation. Indicate how well qualified the student is for residency and as a future physician. Indicate whether you would select this applicant for a residency program.
• Add that you welcome requests for information. Include your contact information if it is not already included on the letterhead.
• Carefully proofread your letter. Pay particular attention to the spelling of the applicant’s name. If you are using a template, ensure that you have changed the name throughout the letter.

• Address the letter, “Dear Program Director”
• Include the student’s AAMC ID number somewhere on the letter
• Ensure you have spelled the name of the applicant correctly throughout the letter
• Sign the letter, either by signing a printed copy and scanning, or adding an image of your signature to the letter
• Put the letter on official letterhead. If you do not have letterhead, be sure to include your current contact information
• Save the letter as a PDF file
• Letter writers, or their designees, must upload letters in PDF format via the ERAS Portal. The applicant should provide you with a Letter Request Form, which will include a unique identifying number for your letter, as well as instructions for uploading