LORs for radiology

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My application for radiology is coming together well (254 step 1, junior AOA, good clinical grads), but I am having a hard time deciding about LoRs. The problem is that we don't have a radiology residency program at my home institution so I will not be able to get an academic letter from a radiologist at my school. I have an away scheduled but it is only 2 weeks which seems like not enough time to get a LoR. I can get a letter from a private attending in radiology but am not sure how bad it would hurt my app applying without an academic radiology letter. Should I try to do a month long away in september to get a letter or is this too late? Is one radiology letter enough? Thanks.

Originally Posted by Doctor D

My application for radiology is coming together well (254 step 1, junior AOA, good clinical grads), but I am having a hard time deciding about LoRs. The problem is that we don't have a radiology residency program at my home institution so I will not be able to get an academic letter from a radiologist at my school. I have an away scheduled but it is only 2 weeks which seems like not enough time to get a LoR. I can get a letter from a private attending in radiology but am not sure how bad it would hurt my app applying without an academic radiology letter. Should I try to do a month long away in september to get a letter or is this too late? Is one radiology letter enough? Thanks.

It varies by program, but the majority of radiology programs I have seen want no more than ONE radiology letter (if any). They highly prefer letters from outside of radiology that show how you are in the clinical setting. The better thing to do than post on this website is to go to the individual programs' website and see what they require.

Radiology letters are weird to ask for since you don't really do anything on the rotation. But it's okay because most attd radiologists understand that. I got a letter from my rads clerkship director. We had very little contact, despite the rotation being 4 weeks long. She was happy to write me a letter, as she did the 10 or so other students in my class going into rads. (We all matched).

I say even if it's just a 2 week rotation, spend all your time in the same reading room as the clerkship director, sit beside them and show interest, then ask them for a letter. Make sure they know from the very beginning that you are going into rads, and they will help you out.

Even better, you could do it in IR, since you have more contact with the IR docs, and can even help out in the interventional suite.

September is too late, as your ERAS should be done and your LOR may be the limiting factor to having a decision be made on your application.

Either way, you have the Step 1 and the grades. You'll get the interviews.

I'd actually like to broaden the OP's question a bit. How many letters and from what rotations should you get the letters? What about a PhD PI letter?

Also, do you need to have your medicine sub-i done before ERAS is released?

Overall, radiology programs do not care about radiology recommendation letters. It was at least the case in my program which was/is one of the most competitive ones. They most care about recommendation from your core rotations. Nobody expect you to know radiology or anything about imaging when you start your residency. They expect you to be well-organized, hard working, responsible and easy going. This can be best assessed in the core rotations and not a 2 week radiology rotation. However, if you have your 4th recommendation letter from a radiology department in a reputable program that helps a little bit, as you show that you have see radiology closely and like it.

You don't need to do your sub-I. At least not for the grade. Most programs literally tally the number of third year honors you accumulate and look no further. I got a couple top tier interviews without doing my sub-I until Feb. (Then again, would I have gotten more if I had...? *shrug*)

The reason you WOULD want to do an early sub-I would be to get a strong medicine letter if you need one.

So re: letters, you need three letters, as many strong clinical ones like shark said. I believe the content is important though, i.e., a strong letter from a peds/OBGYN attending who knows you well would be preferable to a lukewarm letter from a medicine/surgery attending.

You can have a research LOR, but it should be icing on the cake and serve as a fourth letter. A good mix would be 2 clinical letters, 1 rads letter, and 1 research letter.

That having been said, I had a psych, FM, rads, and rads research letter. It can be done, haha...

I think the rads letters (especially if they're from a research mentor) are very important, personally. I had PDs, chairs, and very senior faculty at top programs tell me I was ranked to match who outright say that "people whose opinion they value very strongly had great things to say about me". who you know is a big part of this process at least at the top programs who can choose anyone. IMO the OP should really have an academic rads letter, preferably from a big name.

Originally Posted by drizzt3117

I think the rads letters (especially if they're from a research mentor) are very important, personally. I had PDs, chairs, and very senior faculty at top programs tell me I was ranked to match who outright say that "people whose opinion they value very strongly had great things to say about me". who you know is a big part of this process at least at the top programs who can choose anyone. IMO the OP should really have an academic rads letter, preferably from a big name.

What about research letters from a PhD in rads who happens to be really prominent and at a big time rads institution?

Originally Posted by RadicalRadon

What about research letters from a PhD in rads who happens to be really prominent and at a big time rads institution?

As a research letter, it's probably fine. I had the opportunity to have one of the very biggest names in rads/medical physics to write a letter for me, but chose to have my department chair write a letter instead; worked out fine. I had 10+ pubs with the phd in question which was probably equally effective. I think most people have MD rads letters, but I don't think it's wrong to have a phd letter.

Originally Posted by drizzt3117

As a research letter, it's probably fine. I had the opportunity to have one of the very biggest names in rads/medical physics to write a letter for me, but chose to have my department chair write a letter instead; worked out fine. I had 10+ pubs with the phd in question which was probably equally effective. I think most people have MD rads letters, but I don't think it's wrong to have a phd letter.

Interesting. Did your chair even know you? If you get a chair letter, does that mean they just write what other people tell them about you?

I'm honestly clueless about what letters to choose. I feel like I'll have the grades/step/institution prestige but the letters worry me. There really is no substitute for having someone personally vouch for you.

Originally Posted by RadicalRadon

Interesting. Did your chair even know you? If you get a chair letter, does that mean they just write what other people tell them about you?

I'm honestly clueless about what letters to choose. I feel like I'll have the grades/step/institution prestige but the letters worry me. There really is no substitute for having someone personally vouch for you.

Did you ever decide what letters to choose?

Originally Posted by Doctor D

The problem is that we don't have a radiology residency program at my home institution so I will not be able to get an academic letter from a radiologist at my school. I have an away scheduled but it is only 2 weeks which seems like not enough time to get a LoR. I can get a letter from a private attending in radiology but am not sure how bad it would hurt my app applying without an academic radiology letter. Should I try to do a month long away in september to get a letter or is this too late? Is one radiology letter enough? Thanks.

Two weeks is too short to get a strong recommendation letter, unless that person already knows you well from before. Better off getting a strong letter from one of your core terms.

I ended up getting 4 letters of recommendation. Two from medicine, one from my home schools' PD, and one from my rads research. I worked directly with both of the medicine attendings without any residents, so they were able to know me well in ~3 weeks. One of the two medicine ones showed me the letter and it was just awesome.

This pretty much makes most of the programs' requirement of at least 2 from outside of radiology... and also makes the requirement for programs that require at least 1 from radiology.

Originally Posted by greg1184

I ended up getting 4 letters of recommendation. Two from medicine, one from my home schools' PD, and one from my rads research. I worked directly with both of the medicine attendings without any residents, so they were able to know me well in ~3 weeks. One of the two medicine ones showed me the letter and it was just awesome.

This pretty much makes most of the programs' requirement of at least 2 from outside of radiology... and also makes the requirement for programs that require at least 1 from radiology.

hey i am applying next for year but is 2 clinical letters compulsory ? means i have one strong clinical letter and will get 3 rad letters ( good ones) . Although i can push in a another clinical letter but i feel it will be a mediocre one as i worked with the attending long time ago .

so if i put my best letters together it would be 3 rads and 1 clinical : how bad does that sound ?

A lot of programs don't want more than 1 rads letter.

Originally Posted by xrevision

A lot of programs don't want more than 1 rads letter.

Do you think getting one at the end of september/ early october would be too late to submit?

Originally Posted by Hitman1187

hey i am applying next for year but is 2 clinical letters compulsory ? means i have one strong clinical letter and will get 3 rad letters ( good ones) . Although i can push in a another clinical letter but i feel it will be a mediocre one as i worked with the attending long time ago .

so if i put my best letters together it would be 3 rads and 1 clinical : how bad does that sound ?

Read the individual programs' websites. Most dictate what their letter requirements are. Most dictate that they want at least two letters from attendings from core clinical rotations that know you the best. In ERAS you can send up to 4 letters. So I ended up doing 1 Rads, 1 Rads research, 2 core clerkships.

Originally Posted by Hitman1187

hey i am applying next for year but is 2 clinical letters compulsory ? means i have one strong clinical letter and will get 3 rad letters ( good ones) . Although i can push in a another clinical letter but i feel it will be a mediocre one as i worked with the attending long time ago .

so if i put my best letters together it would be 3 rads and 1 clinical : how bad does that sound ?

You have plenty of time between now and when apps are due to work with other non-radiology attendings who may be able to write you a letter. No stress

For future applicants think about asking for 4 letters and counting on 3. Don't let a letter delay your application. Submit on day 1.

this might be a dumb question but do you always tell the letter writers you're applying for radiology?

I would tell them. One of my letter writers, a pediatrics attending, customized my letter for radiology. I went with pedes, IM, radiology for y letters.. Just want to reiterate that having a great letter from an unknown person is better than an average letter from a famous person. Also, ask for four letters and expect 3 by the ERAS deadline. Don't let a letter delay your application.

My letters included one from IR attending, one from IM, and one from Gen Surg. I had a Peds letter as an alternate I would throw in every once in a while. Then I had one letter from my research mentor, because I had a good amount of research and I heard he wrote good letters.