This is definitely a pity letter, and I would be apprehensive about using a letter that you only got after you essentially cried in front of the attending. The statement about "no one will care what residency you go to" is disconcerting. This is not the philosophy you want from someone writing a letter for your future.
EXACTLY. I don't plan on using the letter, even if I have to go through the work of collecting it to save face with the guy who is offering to do me this 'favor'. I'm not sure why he has this attitude, considering my evals, which he consolidated, were good and he gave me the Honors mark.
But yeah, I fully recognize this as a pity letter, I just didn't give all the details up front because, well...it's embarrassing. I had more detail initially, but it was honestly an intimidating wall of text and the rant served my own need to vent more than anything else.
Having said that, I definitely feel for you. I haven't followed this thread too closely, but it's clear you're in a tough spot not of your own doing. Going on a tangent, I've seen my own friends going into surgery have these same issues, and it's really unfortunate that some surgery attendings seem to have little interest in working with students on rounds/clinics. On my clerkship I had some who cared and went through care plans with us, but also had one attending who told students they wanted to know if the patient peed enough, pooped, or had a fever, and absolutely nothing else.
On the service I'm discussing, the attendings don't come to rounds, full stop. Ever. So OR is your only chance. And then they were on vacation for weeks.
I had a surgeon offer to write me an unrequested letter (despite my OR skills overall being very average) due to my outpatient clinic performance. I know clinic is supposedly anathema to you surgery types, but it allows you to demonstrate critical thinking, diagnostic skills, and compassion for care in a way you could never accomplish in the OR (where, in contrast, you demonstrate your arm strength and camera steadiness, and little else). I got to ask questions directly to the attending and review images with him, etc, stuff I could never do during speed-rounds.
OP: can you find the time to spend some clinic days with some attendings? Forget rounding, just shadow. You can also go to the OR to pick up cases with them when you're free. I know this can be hard to do with your time commitments, but think of it as building letters. I personally know an ortho resident with sub-par scores who matched because he spent his free time in the OR/clinic and earned extremely strong letters for it.
We had no way of knowing when our attendings' clinics were held, nor did they round with us. The attending who wanted those was on a different service and had his own students during those slots (I asked).
I did go to the OR on my own time to pick up cases. The attending I spent so much time with in the OR was very one-on-one about teaching, and I sought out at least 7 full OR days with him when my team gave me downtime. When I joined him, we discussed case management, reviewed imaging, he quizzed me on that patient's specific workup and what we might be doing differently if X had happened instead of Y, what we would do if we didn't find what we were expecting, what criteria we would use to determine success, workup of similar diseases, pathophysiology, heck even cancer genetics and zebras that I never learned for Step. He quizzed me on anatomy during the operations, including "what do you see in the field?" questions with no clues and having me point out what I did notice (for example, a normal parathyroid, which if you can recognize it without hints or prompting is actually pretty good). I did reasonably well on these, even earning a few fistbumps. I fully expected a solid letter from this guy, and the intern who worked with us basically told me I'd be silly not to ask. I've never spoken so much with an attending, even ones I've shadowed (I have been a huge proponent of shadowing since day 1 in med school). He didn't seem to think poorly of me, as he offered to contact other attendings at other hospitals to speak well of me and encourage them to work with me so they could write me letters. It was all very confusing.
