Asked to write my own LOR. Content? Ethical?

[Tyrone Slothrop]

The head of my psychiatry department has asked me to write my own LOR. I'm a FMG that graduated last year, and am now putting together an app for the US. The head knows me quite well, as I did my clerkship under him and additional psychiatry electives. I asked him to write me a LOR, and he said he was happy to. However, he's asked me to write a draft myself and then meet with him so he can amend it.

1. Is this ethical? Should I disclose that I wrote the draft? I know him well enough to know that he'll make sure the final document is accurate. If he's going to have the final say, am I even writing my own letter? Is this a normal practice? Probity is very important to me, if this isn't an acceptable practice I'd be willing to decline the LOR.

2. What should I write about myself? I don't want overly praise myself. I don't want to undersell myself either. I'm a hard worker and I've shown an obvious interest in psychiatry which is why he's willing to endorse me. He doesn't normally write letters, which is also why he wants me to draft my own. I'm having a very hard time writing about myself this way.

3. What do I write about the university? I graduated from a good school, that has a strong history in medicine and the sciences. We count quite a few famous names amongst former students and faculty. A few Nobel laureates as well. I'm very proud of the education I received here, but I'm afraid that American PDs would be entirely unfamiliar with the school. I don't want to toot my own horn though, none of those accomplishments are mine or had anything to do with me. At the same time I don't want the quality of my teaching institution to go unnoticed.

4. How important is it that the LOR comes in directly from him through ERAS? His preference is to give me a written letter and then answer any followup questions via email or phone.

I appreciate any input in this, I'm really at a loss as to how I should proceed.

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[Psychotic]

Completely ethical. It is up to the signer of the letter to edit and correct anything he won't put his signature to. You do not disclose that you are the author.

 

[¯\_(ツ)_/¯]

1. i don't feel it's very ethical to write your own LORs. others may disagree. also if you click the box saying you waive your right to see the letter (most do and if you don't it could be argued that the letter would lose a little value), it would be unethical on more than one level.

2 & 3. not applicable. explain to him the rules with eras and that you'd love for him to write it himself.

4. the only way to get the letter uploaded is for him to sign up with eras using his email address and uploading the signed and scanned letter from that account. anything else would raise suspicion. it should be on his institutional letterhead and the signature can be done either with pen (in case of scan) or digitally.

 

[Psychotic]

1. i don't feel it's very ethical to write your own LORs. others may disagree. also if you click the box saying you waive your right to see the letter (most do and if you don't it could be argued that the letter would lose a little value), it would be unethical on more than one level.

2 & 3. not applicable. explain to him the rules with eras and that you'd love for him to write it himself.

4. the only way to get the letter uploaded is for him to sign up with eras using his email address and uploading the signed and scanned letter from that account. anything else would raise suspicion. it should be on his institutional letterhead and the signature can be done either with pen (in case of scan) or digitally.

Believe me, it is 100 percent ethical to provide a draft letter as requested - it is up to the signer to edit, delete, amend, or sign as is. At that point it is 100 percent the professor's letter. You have no responsibility, no issues RE the waiver (yes, you still waive your right to see the letter).

Edit: If you want to argue that the professor has an ethical dilemma, you may be right, especially if he simply signs the letter without reading it or something like that. But that is HIS problem, not yours.

 

[¯\_(ツ)_/¯]

i agree it's the letter writer's responsibility to edit it to make it correct but i just don't feel it's 100% right as it is kind of leading or at the very least influencing the letter writer. especially since i feel the writer in all probability wouldn't change it all that much. but i guess that's just me. if the consensus is otherwise, that's great!

 

[peppy]

Yes, ideally he should be writing the letter himself, but the reality is he is probably too busy to want to sit down and write a letter for you. Id still state I waived my right to see the letter since you have no control over whether he chooses to show it to you - he could have made it private if he wanted.
At least this is better than the letter writer who had a form letter for all LORs. We had two applicants where we realized "Hey this is the exact same letter..."

 

[MacDonaldTriad]

Ethical or not, this happens all of the time. I would wave your right to see the letter you write because you don’t know what changes were made. I absolutely would not refuse to write it and then plan on using this person’s letter. Either write it and use it, or get a letter from someone else. Irritating someone while asking for a LOR is not a good idea.

 

[Tyrone Slothrop]

Ethical or not, this happens all of the time. I would wave your right to see the letter you write because you don’t know what changes were made. I absolutely would not refuse to write it and then plan on using this person’s letter. Either write it and use it, or get a letter from someone else. Irritating someone while asking for a LOR is not a good idea.

I think you're right.

That's how I'll proceed, I'll write it and let him do what he sees fit. He runs a department I'm sure his judgement on these things is correct. An attending within the department is also writing me a letter and he's writing his own. I'm confident the content will be congruent.

I'm just worried as a FMG I'll be scrutinized so much, I don't want any unintentional irregularities to cast a shadow over my application. I've always been taught and believe that probity is the most important quality of a physician, if your patients and co-workers don't trust you then you can't be effective in your role. The same goes for programs, nobody could hire someone they didn't trust.

Thank you for the input, you've eased my mind about this.

 

[Chimed]

I've had this happen a couple of times and I really can't stand it. The only reason I can think of as to why someone would ask the applicant to write their own letter is because they don't have time or just don't feel like writing it. Not my favorite...

 

[Tyrone Slothrop]

I've had this happen a couple of times and I really can't stand it. The only reason I can think of as to why someone would ask the applicant to write their own letter is because they don't have time or just don't feel like writing it. Not my favorite...

This is the most confounding element of it. He's asked me to write it but he's also scheduled a meeting to discuss what I've written. If he doesn't have time or interest, why have a meeting? I think it's just an unfamiliarity with the concept. LORs aren't used over here.

 

[Bartelby]

1. Agree with Psychotic. Totally ethical. The Prof should edit it as he sees fit. Do not write in the letter that you wrote it yourself on the off chance that the Professor sends it through without careful editing (unlikely) because it would make both of you look bad.

2. Be immodest in your praise of yourself. Since this is coming from a Professor it will not sound like bragging (because it's not you speaking). If it is over the top the Prof should tone it down before it ships out.

3. You might include a brief line or two that highlights the rigor / impressiveness of your education / institution. If you do I would make it enough to convey the sense that the place is impressive but then move on, the focus of the letter should stay on you.

4. It is very important that it comes directly from him through ERAS. Essential actually. Waive your right to read the submitted version and let him know that you have done so, you don't know what changes will go into the final draft and that's okay.

I have encountered a similar situation myself, I think often times the Prof wants to give you a glowing letter but is unsure what would best sell you as an applicant (for example a psychology professor writing a letter for medical school). For all you know this letter will just offer him guidance about what kind of things will stand out to an admissions committee. Take this as the compliment that it likely is and don't sell yourself short!

 

[MacDonaldTriad]

The practice of asking an applicant to write their own letter isn’t so unreasonable. I have never done it, but it is fair game to ask an applicant to elaborate on what they think makes them a good candidate. Asking them to put it in writing isn’t particularly nefarious in my opinion. He / She can plagiarize your letter as much or as little as he/she wishes. You are being asked by this person to do just what he/she is being asked to do. This gives you an opportunity to highlight just what you want. This gives you some control and if you over sale yourself, he/she can tone it down a bit. It is hard to toot your own horn, but some people can do it quite easily.

 

[splik]

I wrote my LORs for residency, they were glowing! don't leave anything to chance! also remember that American letters tend to be over-the-top compared to references written in the rest of the world. from my FAQs thread: "In US terms good=bad, very good = satisfactory, excellent = good, outstanding = very good, exceptional = excellent. So it will come across negatively if your letter reads ‘Dr x is a good clinician, whose attendance and punctuality were satisfactory. I have no concerns about his professional behavior’ etc. Even though that may be standard in the rest of the world."

If you think it sounds over the top you've probably got it right. If you write modestly it will sound like damning with faint praise. You must also put that you have waived your right to see this letter in the first paragraph. This is not unethical - waiving your right to see the letter doesn't mean you can't see the letter, it just means you've waived you right to see it! entirely different. it means you cant ask ECFMG/ERAS/your residency program for them for example.

I wouldn't waste time talking about the institution. and remember that how impressive people are has nothing to do with how good the teaching is or nothing about you. nobel laureates are often the worst teachers as wonderful scotch drinking companions as they may be...

You should cover:

clinical knowledge
clinical skills
interpersonal skills - patients and families
interpersonal skills - with multidisciplinary team
professionalism
future goals and something about reasons for pursuing psychiatry residency in the US
and a ranking statement comparing you to other students/residents at your level - e.g. "Dr Slothrop is in the top 10% of all students I have ever worked with" etc

try and give specific examples "with one particular patient who was having her first episode of psychosis, Dr. Slothrop was the only one who was able to gain the trust and build rapport with this terrified young woman, as well as build an alliance with her distraught parents". Or "Dr. Slothrop gave a fascinating presentation to the team on conversion disorder, demonstrating excellent communication and teaching skills".

not less than a page, not more than 2

 

[whopper]

I believe that most (repeat most) evaluators that allow the person to write their own letter is simply try to blow off a job, but if you're told to write your own letter, take the opportunity.

An issue I find extremely hypocritical among medical education programs is I rarely see doctors on admissions boards know anything of the science of these processes. Industrial psychology has extensively studied the application, test score, LOR, interview phenomenon in several areas, and I don't know one medical doctor that utilizes this data.

It's so ironic that we are supposed to be scientists but don't use the science out there to make this process better for all of us.

 

[Jorje286]

It's unethical from the attending not the applicant. Especially if they don't really bother to edit what's written, and I suspect that's what happens in most cases. If you're not willing to write a letter then you probably won't spend much time editing one.

 

[hamstergang]

The head of my psychiatry department ...doesn't normally write letters

Does this not seem odd to anyone?

 

[Nasrudin]

Idk what's odd or unethical. What I can is that I wrote one of my own letters and I shocked even myself with how amazing I was.

 

[Tyrone Slothrop]

Does this not seem odd to anyone?

It's just Europe. LORs aren't really a thing. If they graduated a student they're competent. If they weren't they would have failed and that would have been the end of the their medical education.

 

[Tyrone Slothrop]

To update, I had my meeting with the department chair today. It went very well. We spoke for about an hour, he complimented me on my writing, but told me I'd been too modest at points. He said he strengthened the language and mentioned some additional points about myself I'd neglected.

He read me what he'd written and it really had kept very little of my draft. It was far more flattering than anything I could have said about myself. I think he just wanted the draft to see my own assessment of my work and development. I waived my right to see it and he'll send it in.

It's encouraging to feel that I have the respect of the people who've taught me, and that he cared enough about my app to write his own version and meet with me. I wanted to thank everyone for their input here, it's helped.

 

[whopper]

I've sat through the admissions process and had to sift through several dozens of LORs. After reading several, all of them just start to melt into each other and I really can't tell a difference between most of them.

Point being is if you want your LOR to make a difference, it has to stand out. While I do think it's unethical on some level for a doctor to allow the applicant to write it, several docs I know couldn't write a good LOR simply because they don't have good writing skills and don't feel they can do the student justice, though yes, of course, a lot of it is pure laziness.

Out of humility, I think several students will be too modest. Humility is usually a good thing. In this case no. You have to make your self standout. That is, unless you really aren't that good and you're not selling yourself well because you really are being honest in your description that you don't standout.

 

[Nasrudin]

I was actually kidding with the intent that the OP err on the side of braggadocio. It went down the same for me as it did for him.

But I fail to see any lapse of ethics. It's a good exercise in self-appraisal, helps put you in the frame of mind of potential bosses, streamlines the process and keeps your letter writer's burden of inertia low, and they're the ones who are putting their signature on it. If they disagree they don't have to sign it.

This seems like a perfectly legitimate practice. A busy attending might have to write a dozen or more of these every season. That seems unfair to them. Does the president write all his own speeches? Does the named partner in a law firm write all the briefs? What the difference between these other processes and writing the rough draft of your own evaluation?

 

[Tyrone Slothrop]

Out of humility, I think several students will be too modest. Humility is usually a good thing. In this case no. You have to make your self standout. That is, unless you really aren't that good and you're not selling yourself well because you really are being honest in your description that you don't standout.

What is standing out for a student? I got the highest possible grade for the psychiatry block. The department offered an additional optional week of training to a few students who performed well, and I also took that. I volunteered to give presentations and lead groups. I showed enough of an interest that the chair agreed to write me a letter. As far as I know, I'm the only letter he's writing this year.

Beyond that though, I didn't do anything special. I was a medical student, I just made sure I did all my study duties to the best of my ability, and took any extra opportunities that were presented. I was noticed for it and that was all.

My life prior to medical school was a lot more interesting. I had a successful career as a programmer, a mildly successful run as an entrepreneur, and I played poker professionally for 4 years. I'm well-traveled and I speak 3 languages. None of my letter writers know much of that about me though, in medicine I've tried to be as humble and observant as I can be. I thought it'd be best to be judged for my academics and effort, in retrospect though I suppose that makes me just the same as any other good student.

My mentor in medicine is a German surgeon I met over the poker table. We struck up a friendship and he encouraged me to go into medicine, as I was starting to become bored of poker. Unfortunately, he liked me enough that I ended up becoming his son-in-law. So I doubt I can have him write a letter for me. Can I?

He knows me best, and obviously thinks highly enough of me that he introduced me to his daughter. My wife's older brother suffers from schizophrenia and his case is what made me first consider psychiatry as a career. Seeing the destructive effects his disease has had on his life and the lives of everyone around him, I realized that there was a real opportunity in psychiatry to maximize the utility my work provided.

I appreciate your input on this. I'm not very good at selling myself on paper. I didn't take a traditional path to medicine, and at times it makes me feel like an inferior applicant to those whose trajectories were straighter.

 

[ahmedjq]

What is standing out for a student? I got the highest possible grade for the psychiatry block. The department offered an additional optional week of training to a few students who performed well, and I also took that. I volunteered to give presentations and lead groups. I showed enough of an interest that the chair agreed to write me a letter. As far as I know, I'm the only letter he's writing this year.

Beyond that though, I didn't do anything special. I was a medical student, I just made sure I did all my study duties to the best of my ability, and took any extra opportunities that were presented. I was noticed for it and that was all.

My life prior to medical school was a lot more interesting. I had a successful career as a programmer, a mildly successful run as an entrepreneur, and I played poker professionally for 4 years. I'm well-traveled and I speak 3 languages. None of my letter writers know much of that about me though, in medicine I've tried to be as humble and observant as I can be. I thought it'd be best to be judged for my academics and effort, in retrospect though I suppose that makes me just the same as any other good student.

My mentor in medicine is a German surgeon I met over the poker table. We struck up a friendship and he encouraged me to go into medicine, as I was starting to become bored of poker. Unfortunately, he liked me enough that I ended up becoming his son-in-law. So I doubt I can have him write a letter for me. Can I?

He knows me best, and obviously thinks highly enough of me that he introduced me to his daughter. My wife's older brother suffers from schizophrenia and his case is what made me first consider psychiatry as a career. Seeing the destructive effects his disease has had on his life and the lives of everyone around him, I realized that there was a real opportunity in psychiatry to maximize the utility my work provided.

I appreciate your input on this. I'm not very good at selling myself on paper. I didn't take a traditional path to medicine, and at times it makes me feel like an inferior applicant to those whose trajectories were straighter.

Wow, if I interviewed you, I'd rank you numero uno because of your story.

 

[Nasrudin]

What is standing out for a student? I got the highest possible grade for the psychiatry block. The department offered an additional optional week of training to a few students who performed well, and I also took that. I volunteered to give presentations and lead groups. I showed enough of an interest that the chair agreed to write me a letter. As far as I know, I'm the only letter he's writing this year.

Beyond that though, I didn't do anything special. I was a medical student, I just made sure I did all my study duties to the best of my ability, and took any extra opportunities that were presented. I was noticed for it and that was all.

My life prior to medical school was a lot more interesting. I had a successful career as a programmer, a mildly successful run as an entrepreneur, and I played poker professionally for 4 years. I'm well-traveled and I speak 3 languages. None of my letter writers know much of that about me though, in medicine I've tried to be as humble and observant as I can be. I thought it'd be best to be judged for my academics and effort, in retrospect though I suppose that makes me just the same as any other good student.

My mentor in medicine is a German surgeon I met over the poker table. We struck up a friendship and he encouraged me to go into medicine, as I was starting to become bored of poker. Unfortunately, he liked me enough that I ended up becoming his son-in-law. So I doubt I can have him write a letter for me. Can I?

He knows me best, and obviously thinks highly enough of me that he introduced me to his daughter. My wife's older brother suffers from schizophrenia and his case is what made me first consider psychiatry as a career. Seeing the destructive effects his disease has had on his life and the lives of everyone around him, I realized that there was a real opportunity in psychiatry to maximize the utility my work provided.

I appreciate your input on this. I'm not very good at selling myself on paper. I didn't take a traditional path to medicine, and at times it makes me feel like an inferior applicant to those whose trajectories were straighter.

There are other places in the application to talk about these other things. Your LOR's don't have to say everything about you. You have to enter previous work experience and there is also your personal statement. Plenty of impetus to display your experience without being arrogant. You're probably just feeling awkward being put in the position to write you're own letter. Write it from the perspective of a supervisor being extremely pleased with the performance of a clerk.

Edit. I forgot you said you already wrote it. Then what I meant was just that if it doesn't indicate all the interesting things about you there is space for that elsewhere. Don't forget to waive you're right to read it and have it sent straight to ERAS.

 

[notdeadyet]

My mentor in medicine is a German surgeon I met over the poker table. We struck up a friendship and he encouraged me to go into medicine, as I was starting to become bored of poker. Unfortunately, he liked me enough that I ended up becoming his son-in-law. So I doubt I can have him write a letter for me. Can I?

Nope. No letters from family of any kind.

I'm not very good at selling myself on paper. I didn't take a traditional path to medicine, and at times it makes me feel like an inferior applicant to those whose trajectories were straighter.

An interesting, non-traditional background can make for a great personal statement, depending on the reader.

How it helps you otherwise depends on whether it informs your work. "Non-traditional" now seems to be becoming the new norm, at least from many off the apps I've seen. I reckon more people have come to med school after taking a year or more out than came straight through from undergrad.

But whether your background makes for more than good cocktail chatter depends on how you use it. Do you approach cases with particular cultural humility because of your travels? Are you particularly methodical and thorough because of your programming background? Does your poker playing somehow make for better risk assessments?

I don't know, because for some folks, stuff doesn't seem to register and all of your life experiences may have not changed you in one iota and your no better off than if you'd come straight in from undergrad. But I have a hunch those experiences DID have an impact and did show through in your interviews, write ups, and approaches. You likely performed BETTER in medical school because of your life experience, not worse. This will be particularly helpful in psychiatry.

But it's a show don't tell thing. Techies can make for thorough or rigid and formulaic. Travelers can be sensitive and open-eyed or snobs looking for pampering. Etc. if you did well in med school, and it sounds like you did, your experiences probably helped you. If you're a superior or inferior applicant, it's your own doing.

 

[Tyrone Slothrop]

Nope. No letters from family of any kind.

That's unfortunate, I'll have to tell the wife it's over

Does your poker playing somehow make for better risk assessments?

The poker is the thing I have the most concern over. It's also what I'm perhaps proudest of, second to becoming a physician. I fear it carries a stigma of gambling and self-destructiveness, perhaps even predatory behaviour. The truth is though to make a comfortable living at it, you have be brutally self-aware and very sharp at assessing the risk in a situation. You have to quickly develop rapport with strangers and model their internal states, all while in the context of an adversarial relationship. It requires a lot of emotional intelligence and control. The time I spent playing, was an education in far more than just cards.

if you did well in med school, and it sounds like you did, your experiences probably helped you. If you're a superior or inferior applicant, it's your own doing.

You're absolutely right. Seeing people not matching this time around, has rattled me a little. I've lived my life as I've seen fit, and have few regrets. The thought of not being able to come home to work though is a bit distressing. I'm going to stop worrying about it, hopefully my application will get me a few interviews. Hopefully my quality will show through in face to face interactions.

Once again, I really appreciate all of you lending your experience here.

 

[OldPsychDoc]

The poker is the thing I have the most concern over. It's also what I'm perhaps proudest of, second to becoming a physician. I fear it carries a stigma of gambling and self-destructiveness, perhaps even predatory behaviour. The truth is though to make a comfortable living at it, you have be brutally self-aware and very sharp at assessing the risk in a situation. You have to quickly develop rapport with strangers and model their internal states, all while in the context of an adversarial relationship. It requires a lot of emotional intelligence and control. The time I spent playing, was an education in far more than just cards.

Great opening paragraph for your personal statement.
(Tons better than any I read last season!)

 

[Tyrone Slothrop]

Great opening paragraph for your personal statement.
(Tons better than any I read last season!)

Well, you'll get to read the rest this coming season . Thank you for the feedback, I feel far better.

 

[masterofmonkeys]

I've written a lot of letters for people whose attendings asked them to write their own letters. What's THAT ethical dilemma lol.