Asking for Letters of Recommendation

Letters of recommendation have the potential to have a very positive impact on your overall competitiveness for residency. While at first glance it may seem that this aspect of your application may seem largely out of your control there are some important ways by which you can influence this process. The first, and most obvious, is to choose the “best” authors.

Think of your LOR’s as a “chorus” that is intended to sing your praises. Each “voice” (author) in the “chorus” should have a specific part to play in telling your story. Together these “voices” should complement one another help the “listener” (residency program) better understand you as an applicant. Remember, you are applying for a clinical job so the notes that need to be clearest are your abilities and skill as a clinician.

There are some general guidelines below that outline who you should ask to join your choir. Guidelines are just that and in some situations it might make more sense to adjust these recommendations. You should approach your advisor early in this process to help identify who you plan to approach to write a letter.

Guidelines for LOR’s:

  • 3-4 letters total (Most require 3 but some request 4)
  • At least 2 of your letters must be “Clinical” letters (someone who has seen your doctor skills personally)
  • At least one letter should come from a family physician (more is fine)
  • ACE letters make excellent “Clinical” letters as they most closely resemble your role as an intern. Not every student (in fact many will not) will be able to complete an ACE prior to submitting their ERAS application. This is fine!
  • Letters from clerkship preceptors can be used if needed but are generally not as “good” as letters from electives during the 4th There are always exceptions; check with your Residency Advisor.
  • Authors from individuals working in private settings and academic settings are both fine.
  • An author who can clearly state his/her experience in working with many students is a strong author
  • “Non-Clinical” letters can be appropriate so long as they have a compelling reason (CPD mentor, Research PI, Longitudinal mentor (GSP), Independent Scholarship Project Mentor, etc.). Again, check with your Advisor is uncertain.

Once you have worked out who you plan to ask to write your letters there are some additional things to consider to make the process run smoothly.

Tips and suggestions:

  • Always waive your right to see the letters (not doing so is a red flag)
  • Never ask for a letter before you work with someone (letters are not an automatic expectation of a rotation)
  • When possible try and make the “ask” in person (email should be a back-up)
  • Be prepared to provide your author with the background information needed to write your letter
  • Let your author know who else is writing letters for you. This will serve as a subtle reminder of the “role” that you are asking them to play. Depending on the situation and your comfort with the author you might even be explicit about this.
  • Ask as early in the process as possible. Don’t wait for memories to fade. With clerkship letters there may be a significant delay; this is fine.
  • Two weeks is the bare minimum time to give an author (a month or longer would be preferential) to write a letter
  • You can see if a letter has been uploaded in ERAS. If the letter has not been submitted give your authors a 1 week reminder by email. If it’s still not there the day prior to the deadline send (email or page) another reminder with the appropriate caveats (I know this is a busy time of year, etc.)
  • It’s not required, but a thank you note to all authors is certainly appreciated