10+ Year Member
Oct 12, 2007
Attending Physician
Hello! I'm applying to family med and have an LoR question. I have 3 outpatient FM letters: 2 should be very strong, the third is good but I'm not sure how good as I only worked with the writer for ~1 week. I did an IM acting internship on a Hem/Onc team in July, and an attending said I was one of the best AIs she'd worked with and she'd be happy to write me a letter. (Due to scheduling snafus I haven't done an FM AI yet.)

However, I made the mistake of telling the Hem/Onc attending that Sept 15 was best but as late as Oct 1 would be acceptable. She hasn't submitted her letter yet. After I sent her a somewhat concerned email 2 days ago to confirm she could still do it, she replied that she could but seemed a smidge annoyed (though it's hard to tell tone over email, she was really nice during the AI).

So... how important is it to have an inpatient letter for FM? I've so far submitted apps with only the 2 strong LoRs, so I'm incomplete most places... should I wait for her letter which I was hoping would be strong but may now be colored by annoyance? Or should I just submit the third outpatient FM one?

To further complicate things, at least one program I'm applying to requires a non-FM letter. I do have a generic department chair letter from my IM AI, so I could submit that, but everything in it is already in my Dean's letter as well...


Thanks in advance! :)


10+ Year Member
7+ Year Member
Nov 26, 2008
Resident [Any Field]
I can't say for certain about inpatient and outpatient. During my FM rotation, I scheduled a meeting with the program director of the FM residency at that hospital, and asked him for advice on LOR's for applying.

He told me he prefers to see at least one FM letter from a program director if possible, and also really likes seeing OB/GYN and Pediatric letters since those two fields can play a big part in family medicine as well.

I ended up submitting with 4 LOR's: PD from FM (Worked with him inpatient), Attending FM (Worked in his clinic), Pediatric program director, and OB/GYN attending who I worked with quite a bit.
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