3 ophth LORs versus 2 ophth + 1 core clerkship LORs

[dk23]

I know the CAS manual suggests one letter be from a core clerkship, but if you can get 3 good letters from 3 ophthalmologists, would that be even better than 2 ophthalmology LORs and 1 core clerkship LOR?

(I know about the 4th LOR but that requires some tricky timing).

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[Andrew_Doan]

Follow the rules. You need one core clerkship letter. Personally, I think two strong eye letters is all you need. Three eye letters are overkill, because you're statistically likely to get one average letter out of three. An average letter is also bad if you're applying to really competitive programs.

 

[MD13]

Follow the rules. You need one core clerkship letter. Personally, I think two strong eye letters is all you need. Three eye letters are overkill, because you're statistically likely to get one average letter out of three. An average letter is also bad if you're applying to really competitive programs.

Can you provide more LORs than needed? Ie can you send in 3 Ophtho letters and 2 core letters for example?

 

[UAmeddan]

I tried to shoot for 2 ophth letters and one medicine. However, my med letter fell through due to life circumstances of the letter writer. I ended up with 3 strong ophtho letters, and later submitted the medicine letter to some programs as supplemental material. Even to programs which never received my med letter, I got interviews. I have a nice roster of programs with 3 ophtho letters. I don't feel it negatively impacted my interview set, but I'll never really know. I especially think that if a third letter from an ophtho could open some additional doors, then it might be worth your while to submit it over a med letter.

 

[tm12]

I tried to shoot for 2 ophth letters and one medicine. However, my med letter fell through due to life circumstances of the letter writer. I ended up with 3 strong ophtho letters, and later submitted the medicine letter to some programs as supplemental material. Even to programs which never received my med letter, I got interviews. I have a nice roster of programs with 3 ophtho letters. I don't feel it negatively impacted my interview set, but I'll never really know. I especially think that if a third letter from an ophtho could open some additional doors, then it might be worth your while to submit it over a med letter.

I had concerns about this and my letter writer told me, "you're applying to ophthalmology, aren't you?"

 

[MD13]

I tried to shoot for 2 ophth letters and one medicine. However, my med letter fell through due to life circumstances of the letter writer. I ended up with 3 strong ophtho letters, and later submitted the medicine letter to some programs as supplemental material. Even to programs which never received my med letter, I got interviews. I have a nice roster of programs with 3 ophtho letters. I don't feel it negatively impacted my interview set, but I'll never really know. I especially think that if a third letter from an ophtho could open some additional doors, then it might be worth your while to submit it over a med letter.

So it sounds like you can submit extra letters as supplemental material? Just went back and read the instructions and it said no more and no less than 3 letters... So should I plan to only submit 3 letters with one being medicine or do you think it would be advantageous to do an away rotation for example and get a 4th letter (to make it 3 ophtho and 1 medicine)?

 

[UAmeddan]

You can submit whatever you want to some/most programs. However, there are a few programs that specifically say no supplemental materials outside of what they get on SF Match. It's a gamble. However, if you are going to submit supplemental info, you can just send it to the program coordinator (their email addresses are provided on sf match), and most of the time they're happy to add supp material to your file. The tricky part is that if you're submitting letters with blinded content, then your school coordinator needs to send in all these letters on your behalf. It would be important to make sure someone at your school is willing to do this for you.

I wish I could comment for you on the "advantageous" aspect of medicine vs 3rd ophtho letter more than what I said above. At my interviews so far, many conversations have included discussions about my letter-writers, and some of those conversations revolved around the writers that I submitted as supplemental material. I have yet to have any comment on the medicine letter, except at TY or prelim programs. That doesn't mean they don't matter, but I haven't received comments on them as of yet.

 

[fourchambered]

I have spoken with a selections committee member at my home institution which is regarded as a "top research school." He said that they prefer the third letter be from a non-ophthalmology rotation. His reasoning was that it is easy to be on your best behavior and on top of your game in the field you plan on entering. It is more impressive when they see that you are able to outperform in a field that is not your own but nonetheless challenging. It shows that you have a natural interest in learning and helping others in multiple clinical settings. It also shows you are able to pick up a new proficiency quickly in different settings.

Having said that, I am sure every situation is different. If you have three excellent letters from three big time ophthalmologists, I would go with that over a luke-warm medicine or surgery letter. On the other hand, how many different ways can an ophthalmologist describe you in a favorable way? I'm sure by the third one it gets pretty repetitive unless you did unique projects with each. I think I would favor a strong surgery/medicine letter as the third letter unless you have three big name ophthalmologists writing letters for you.

 

[kwel]

Does this "rule" change depending on the strength of your home ophtho program? For instance, if you're at a school with a top 10 program would it be more advantageous to get 3 ophtho letters since the faculty are more likely to be "well-known" in the field?

 

[RestoreSight]

I think the general consensus is the third letter should be from a core rotation. It doesn't have to be medicine/surgery, but it most often is. Mine was a peds letter because it was my favorite core rotation and everything worked out fine. Its the entire application that matters most and ideally it should be balanced with strong STEP scores, excellent clinical grades, research, extracurricular activities and great letters.

Kwel - One serious big name faculty writing you a strong letter is more than enough. Two is great, Three is probably overkill and won't help that much more. I would be surprised too if during medical school a student could make that type of impression on three big name faculty in the first place. Most big name faculty are older and have seen it all to some degree.

 

[ophthope]

I think the general consensus is the third letter should be from a core rotation. It doesn't have to be medicine/surgery, but it most often is. Mine was a peds letter because it was my favorite core rotation and everything worked out fine.

Just to agree here - my third letter was from Peds as well and I consistently got comments in interviews about how glowing the letter was, even at interviews in the top 10 programs. Some interviewers even read me portions of it to comment on how much of an endorsement I got from that letter. I chose Peds not because I particularly liked Pediatrics more than Medicine or Surgery but because my attending in Peds was very very personable, very engaged in teaching me, and gave me good, honest feedback during my rotation. I got along with that attending very well and I felt like they knew me personally the best of all my core rotation attendings. I'd give the advice to pick your core rotation letter not based on which rotation it was (med/surg) but based on which attending you connected best with because they are more likely to write you a strong, personal letter.

 

[RestoreSight]

Just to agree here - my third letter was from Peds as well and I consistently got comments in interviews about how glowing the letter was, even at interviews in the top 10 programs. Some interviewers even read me portions of it to comment on how much of an endorsement I got from that letter. I chose Peds not because I particularly liked Pediatrics more than Medicine or Surgery but because my attending in Peds was very very personable, very engaged in teaching me, and gave me good, honest feedback during my rotation. I got along with that attending very well and I felt like they knew me personally the best of all my core rotation attendings. I'd give the advice to pick your core rotation letter not based on which rotation it was (med/surg) but based on which attending you connected best with because they are more likely to write you a strong, personal letter.

^This

 

[Melenema]

I think the general consensus is the third letter should be from a core rotation. It doesn't have to be medicine/surgery, but it most often is. Mine was a peds letter because it was my favorite core rotation and everything worked out fine. Its the entire application that matters most and ideally it should be balanced with strong STEP scores, excellent clinical grades, research, extracurricular activities and great letters.

Kwel - One serious big name faculty writing you a strong letter is more than enough. Two is great, Three is probably overkill and won't help that much more. I would be surprised too if during medical school a student could make that type of impression on three big name faculty in the first place. Most big name faculty are older and have seen it all to some degree.

What constitutes a well-known faculty member or "big-wig"? I always assumed big wigs were extremely famous, in that only a handful of people could get to know them, but people seem to throw the term around here like every dept chair is a big wig.

Did a quick google search and found this: http://www.beckersasc.com/lists/135-leading-ophthalmologists-in-america/all-pages.html

would these people be considered "big wig"?

 

[RestoreSight]

What constitutes a well-known faculty member or "big-wig"? I always assumed big wigs were extremely famous, in that only a handful of people could get to know them, but people seem to throw the term around here like every dept chair is a big wig.

Did a quick google search and found this: http://www.beckersasc.com/lists/135-leading-ophthalmologists-in-america/all-pages.html

would these people be considered "big wig"?

I think a big-wig for residency purposes is a leader in an academic field. They have been in their field for decades and have a long and distinguished record of authorship. They are often the chairmen or chairwomen of their departments. Most of these folks end up at top institutions and have strong research interests. A few examples: Joan Miller at Penn, David Epstein at Duke, Fred Jakobiec at MEEI, Joel Schuman at UPMC, Jay Duker at Tufts, Myron Yanoff at Drexel, Eduardo Alfonso at Bascom, Dimitri Azar at UIC...

That's why I think this discussion is a bit oversimplified. There aren't that many of these people and they aren't that easy to get to know. Most programs don't have 3 or 4 big-wigs. At programs that do have a bunch on staff how many can you conceivably work with as a medical student that will result in an outstanding letter? Its not that simple, but luckily its also not that critical to matching either.

 

[kwel]

How common is it for someone to write that you're "one of the best medical students they've worked with"? I have a letter from a lesser-known attending that says this and other nice stuff, but I also have a probably reasonably strong letter from a much better-known (maybe not "big wig" however that's defined) attending, but it's likely not as glowing as the first letter. Which one would be better to use? I know it's always good to use the strongest letters you can, so I was leaning toward using the first one because of that comment, but if being called "one of the best med student I've worked with" is in fact really common in LORs, then maybe it isn't as special as I'm making it out to be and it would be better to go with the more well-known attending's letter.

 

[OPPforlife]

How common is it for someone to write that you're "one of the best medical students they've worked with"? I have a letter from a lesser-known attending that says this and other nice stuff, but I also have a probably reasonably strong letter from a much better-known (maybe not "big wig" however that's defined) attending, but it's likely not as glowing as the first letter. Which one would be better to use? I know it's always good to use the strongest letters you can, so I was leaning toward using the first one because of that comment, but if being called "one of the best med student I've worked with" is in fact really common in LORs, then maybe it isn't as special as I'm making it out to be and it would be better to go with the more well-known attending's letter.

I see the predicament you are in, but, this has been addressed on this forum many many times. The conclusion I have drawn and what my advice to you would be is to go with the letter that is the most personal. It does not necessarily have to say you are the best med student ever...being the best med student ever frankly means very little in ophthalmology. Even the kid with the 270 and a glowing med school record could absolutely crumble as a microsurgeon. Residencies and PD's look at letters for information. It helps them come up with an image of their future resident. Hence, you should go with the most personal LOR. Use one from an attending who has spent considerable time with you and would have lots of things to say about you.