Thanks
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one the LOR's I am submitting isn't a LOR. Its a letter from the PD of the program I am leaving. I wanted to use 4 LOR's but since this one eats up a slot its limiting me. Any suggestions ?
This letter is about 200x more important than any of the other letters you have. It doesn't so much "eat up a slot" as it "allows you the possibility of moving on with a career in medicine." Seriously, without this letter (assuming it says good things about you), nobody will care how many other letters you have, or how good they are.
My suggestion is to pick the 3 you think are the strongest and go with that. 4 LORs is more than enough.
It sounds like PPGMD is a current resident leaving a program to apply to another residency.what makes it that important? because it's from the home PD?