A few questions about LoRs.

[RussianJoo]

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I am really trying to complete my application before Sept 1st, and already have a few LoRs written and on file at the hospital waiting to be sent to ECFMG/ERAS. But I have a few quick questions and hopefully someone might be able to answer them. 1) what's the maximum number of letters that I can send to a program? I have read on multiple program websites that they require at least 3, but I am sure the program wouldn't be too happy if I send them 8 letters of recommendation.. So is there a maximum number? How many do people usually send?

2) I am currently doing my 4th year anesthesia elective (which is the best time of my life by the way).. and I'll only be able to get letters from this one anesthesia program, my other anesthesia elective is late Aug. So is it ok to ask more than one attending for a letter? what about asking both the chairman and the program director for a letter? wouldn't that be kind of weird to ask both of them? I know it wouldn't look very impressive if I sent more than one letter from the same program but I would want to ask multiple people just in case one person takes too long.. would that be reasonable? or should I just ask either the chairman or the program director but not both? I just don't someone to get offended because I also asked someone else for a letter.


thank you in advance for your replies.

 

[bigdan]

RJ -

1) If my fuzzy memory serves, you can send a maximum of 3 to each program (might be a max of 4, but when you being to fill out ERAS, it will definitely tell you). You most certainly cannot send 8.

2) This is rehashed advice, but it seems theoretically sound to me: you want to get the letters from the people who know you the best AND will write the best things about you. In order of preference, you want a letter writer that will write you a great letter and: a huge name in the field > a huge title > a little title > no title. But I think the word on the street is that a letter from Miller himself that clearly shows he has no idea who you are is worth less than a letter from a community pediatrician that can show an obvious relationship with you and has written a superlative letter.

If you can't get other letters at all, I suppose you'd ask the chairman and PD both (again, only get them if they're gonna be good letters!). I got a letter from the Chairman at my home school and from a peds anesthesiologist at my home school, and the third was from a pulmonologist. No one had any trouble with it - or at least no one said they had an issue with it. Admittedly redundant, I'd stress to you to get the 3 best letters you can - even if that's from an OB, a pathologist, and one great anesthesia one.

Do you not have an anesthesia program at your school's hosptial?

Good luck with things, bro. Interviewing is tiring and expensive, but I had fun overall.

dc

 

[RussianJoo]

RJ -

1) If my fuzzy memory serves, you can send a maximum of 3 to each program (might be a max of 4, but when you being to fill out ERAS, it will definitely tell you). You most certainly cannot send 8.

2) This is rehashed advice, but it seems theoretically sound to me: you want to get the letters from the people who know you the best AND will write the best things about you. In order of preference, you want a letter writer that will write you a great letter and: a huge name in the field > a huge title > a little title > no title. But I think the word on the street is that a letter from Miller himself that clearly shows he has no idea who you are is worth less than a letter from a community pediatrician that can show an obvious relationship with you and has written a superlative letter.

If you can't get other letters at all, I suppose you'd ask the chairman and PD both (again, only get them if they're gonna be good letters!). I got a letter from the Chairman at my home school and from a peds anesthesiologist at my home school, and the third was from a pulmonologist. No one had any trouble with it - or at least no one said they had an issue with it. Admittedly redundant, I'd stress to you to get the 3 best letters you can - even if that's from an OB, a pathologist, and one great anesthesia one.

Do you not have an anesthesia program at your school's hosptial?

Good luck with things, bro. Interviewing is tiring and expensive, but I had fun overall.

dc

Thank you for your help. I am doing a rotation at my home program right now, and will ask for a letter from either the chairman or the program director depending on who I work with the most and who likes me the most. I also spent a few days with a cardiac anesthesiologists who after the first day offered to talk to both the chairman and the program director on my behalf. So if I work with him a few more times I'll ask him for a letter as well.

thanks again for your help. I am actually trying to prematch at my home program and not deal with the whole match process if i can save a few grand and have the knowledge that I have a job next year it will make 4th year so much more enjoyable..

 

[itwasalladream]

I could be wrong but I thought prematch was generally reserved for FMGs?

 

[RussianJoo]

I could be wrong but I thought prematch was generally reserved for FMGs?

you're not wrong.. FMGs, US-IMGs, and DO's can prematch into allopathic residencies.

 

[fakin' the funk]

1) what's the maximum number of letters that I can send to a program?

2) I am currently doing my 4th year anesthesia elective (which is the best time of my life by the way).. and I'll only be able to get letters from this one anesthesia program, my other anesthesia elective is late Aug. So is it ok to ask more than one attending for a letter? what about asking both the chairman and the program director for a letter?

RJ:
1. ERAS lets you send 5. Most programs want 3 or 4, with 1-2 of those being anesthesiologist letters.
2. If you're doing a month at your home institution you are pretty much expected to get a LoR from your chair. Forget the PD, unless that's also someone you worked several times with and knocked their socks off. The chair will get the word on the street about you from the various attendings you work with during your month and put together an "authoritative" LoR.
3. Late August is NOT too late to get another LoR. Remember ERAS opens Sep 1 or thereabouts but many many people have letters trickling in well into October and November since they're still doing AI's, aways, electives etc during those months. As long as you have the minimum covered by ~9/15 you can send in more letters and stuff later in the season, and the committees will have that info when you go to interview.

 

[RussianJoo]

RJ:
1. ERAS lets you send 5. Most programs want 3 or 4, with 1-2 of those being anesthesiologist letters.
2. If you're doing a month at your home institution you are pretty much expected to get a LoR from your chair. Forget the PD, unless that's also someone you worked several times with and knocked their socks off. The chair will get the word on the street about you from the various attendings you work with during your month and put together an "authoritative" LoR.
3. Late August is NOT too late to get another LoR. Remember ERAS opens Sep 1 or thereabouts but many many people have letters trickling in well into October and November since they're still doing AI's, aways, electives etc during those months. As long as you have the minimum covered by ~9/15 you can send in more letters and stuff later in the season, and the committees will have that info when you go to interview.

thank you for your help.. i guess i'll send 3 letters to the programs on sept1st. and then add one more anesthesia letter once i receive it after completing my second anesthesia rotation.


I thought the program director is the main dude that picks the residents? I mean I am sure the chairman has a say as well but I thought that was mainly the program directors job.. either way i am going to try to work with both and I am not sure how often attendings do this but I already had 2 attendings say that they would talk to the chairman on my behalf. I guess I am doing something right over there..

thanks again for the help.

 

[DoctorCsClub]

I also have some questions about LOR. Do I need to have a chairman write a letter for me? I currently have two surgeons and one anesthesiologist, I hope to have one from my ICU attending later this month.

Also, do I need two letter from each attending? One for preliminary year and one for the advanced programs? Thanks!

 

[fakin' the funk]

I also have some questions about LOR. Do I need to have a chairman write a letter for me? I currently have two surgeons and one anesthesiologist, I hope to have one from my ICU attending later this month.

Also, do I need two letter from each attending? One for preliminary year and one for the advanced programs? Thanks!

1. You don't have to have a chairman write one for you, if you do a rotation at your home program I don't see why they wouldn't though...
2. Just one letter from each attending, it may or may not mention anesthesia in it and it doesn't matter, prelim programs know you're going into anesthesia.

 

[fakin' the funk]

I thought the program director is the main dude that picks the residents? I mean I am sure the chairman has a say as well but I thought that was mainly the program directors job..

You're absolutely right, but that job has little to do with "clout," which is what you're going for on a chair LoR vs. a PD LoR. All else being equal a chair and a PD letter should have basically the same content (your performance and interactions with the faculty, based on what the other attendings have told them) plus the LoR writer's personal opinion of you. The Chair is the Chair for a reason and their name carries more weight.

 

[Salt Creep]

Whatever - people worry about who these letters come from way too much.

My main letters came from a pathologist, a pediatrician, and a pain doc. I had one from an anesthesiologist (separate from the pain doc), and I had one from an internist; I didn't send the same set of letters to every program.

I did a rotation at my home program, and I did not ask the chairman for a letter at all. I never worked with him.

Get good letters from people who know you well and can write good things about you. I really think my best letter (though I didnt see any of them) was from the pathologist. He's the path PD, so it's a little more than any random pathologist (since he could comment on attributes about me from a PD's perspective), but in the end, I'd say don't worry a lot about who they're from. Just get good ones.

 

[RussianJoo]

thanks everyone...