Internal medicine letter of recommendation required/suggested for prelim/TY?

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Dear Friends:

I will apply to preliminary internal medicine & transitional year programs this fall. I completed my internal medicine core clerkship 5+ years ago, before I started my Ph.D. I understand that some internal medicine programs require a letter from the Chairman of the Internal Medicine department - I believe I can get such a letter in my school based on my clinical performance on my IM core clerkship. However, I do not have any letters from an Internal Medicine attending with whom I have worked in the past 5 years. Is a letter from an internal medicine attending with whom I have worked recently required/strongly recommended when applying to an Internal Medicine preliminary year or Transitional Year program?

I checked the Web sites of several programs, but did not see such a letter explicitly mentioned. However, it seems reasonable to assume that such a letter may be expected. Any replies/advice much appreciated.

Thank you,
mudfud123

Originally Posted by mudfud123

Dear Friends:

I will apply to preliminary internal medicine & transitional year programs this fall. I completed my internal medicine core clerkship 5+ years ago, before I started my Ph.D. I understand that some internal medicine programs require a letter from the Chairman of the Internal Medicine department - I believe I can get such a letter in my school based on my clinical performance on my IM core clerkship. However, I do not have any letters from an Internal Medicine attending with whom I have worked in the past 5 years. Is a letter from an internal medicine attending with whom I have worked recently required/strongly recommended when applying to an Internal Medicine preliminary year or Transitional Year program?

I checked the Web sites of several programs, but did not see such a letter explicitly mentioned. However, it seems reasonable to assume that such a letter may be expected. Any replies/advice much appreciated.

Thank you,
mudfud123

I'm sure a more recent one would be preferred when applying. I think for people that take 1 year off in between 3rd and 4th year it is completely reasonable to include a letter from their IM clerkship. >5 years is more borderline given the significantly longer time in between. However, if you aren't able to do a medicine type rotation at the beginning of 4th year, opting for rotations in the field you'll be applying for (which is definitely a higher priority), then there's not much you can do. I doubt it would kill your chances if you used the one from your IM clerkship, especially if it's a good LOR.

This is why I think deviating from the 2/PhD/2 system often comes back to bite students in the butt...but I digress.

If you were applying for categorical IM, it would be a big deal to not have a recent IM LOR or 3. But frankly, for a prelim, nobody's going to expect much other than good performance in your clerkship +/- SubI. You're not planning to make a career in IM, they know that. Don't worry about it. Spend your LORs on your advanced specialty.

gasblaster and gutonc, thank you both for your replies that I should focus on LORs for my advanced specialty and not worry about IM letters.