Thanks for your help,

myiasis

In short, no.

Nothing is necessary other than the letter from the chair and letters from faculty in medicine who know you. You are better off having someone who can write a meaningful letter for you than choosing someone just because they were the attending on your sub-I (esp. if you had minimal opportunity to "shine" in front of them...). If you want your performance in your Sub-i to be reflected somehow in your application you can ask your chair (or whoever writes the letter from the department of medicine) to include your evaluation comments in his/her letter.

But why not get the letter. ERAS will allow you to upload as many letters as you want. You can then choose the best 2-3 to actually send out to programs. You could upload 30 if you wanted to, last year I had 7 - but of course I only sent 4 to programs.

C

if you rock your sub-i, it wouldn't hurt to get a letter because most likely it will be glowing given that they are grading you highly...

for myself, I got an HP (which was alright) .... so I got a letter anyway, and in the end uploaded the letter but used it at only one place...if i were you, stick with glowing letters, from medicine people/people who know you well....

in summary, you don't have to have a sub-i letter but decide if you want it based on how the sub-i goes....