Choosing Letters of Recommendation

[mjjdm1985]

Hello Family Med contributors,

I'm a 4th year medical student and will be submitting my residency application next week. I have received 5 letters of recommendation, but Family Med programs seem to accept no more than 4. I need to decide which letter to leave out. I would really appreciate advice. I believe all 5 are strong letters. The main drawback I can see with several of them is that I didn't do a clinical rotation with the author, but those authors have titles that the ones I performed clinicals with do not. I know all of the authors well. These are the letter descriptions:

1. Writer: Family Med doctor with whom I spent 3 months on clinical
Pros:
1. I became very good friends with this doctor. My wife and I attended his church during my time in town and were invited to his house several times. He wrote the letter soon after I finished the rotation.
2. He said he was very impressed with my performance and encouraged me to apply to the residency program he attended.
Cons: he is a private dr, not faculty

2. Writer: Family Med/Sports Med doctor (and associate OMM professor at my school)
Pros:
1. I did a 1 month clinical with him in sports medicine; I knew this doctor from class before clinical then got to know him well during clinical
2. He told me that he wrote an extremely positive letter
3. He is faculty (although not a chair)
Cons: only spent 1 month with him rather than 3

3. Writer: Department Chair of Family Medicine at my school
Pros:
1. I did research with him (just the two of us, no other students) for 5 weeks during the summer between first and second year.
2. Knew him very well. He didn't tell me how good the letter is, but I think it is probably very good.
3. He is Family Med chair
Cons: didn't do a clinical with him

4. Writer: Department Chair of Psychiatry (both at my school and local public hospital)
Pros:
1. I ran many large community service events (bimonthly events and annual week-long events) with this dr as my adviser. I'm sure it is a very good letter.
2. He is a department chair (although not in family med)
Cons: didn't work with him on clinicals
**Not sure if him being outside of family medicine is a good or a bad thing (all of my other letters will be from family med docs)

5. Writer: Associate Dean for Rural Medicine/Family Medicine at my school
(I want to go to a family medicine program that teaches broad-scope medicine that prepares students to practice anywhere (including rural). This dr is very well known as a champion of rural medicine in my state.)
Pros:
1. Know him pretty well, have had multiple conversations about residency programs and my aspirations
2. High-ranking faculty member, specifically in rural/family medicine which are the programs I am aiming for
Cons:
1. Didn't do clinical rotations with him

Thanks in advance for any help!

---

Members don't see this ad.

 

[playingfrombehind]

Hello Family Med contributors,

I'm a 4th year medical student and will be submitting my residency application next week. I have received 5 letters of recommendation, but Family Med programs seem to accept no more than 4. I need to decide which letter to leave out. I would really appreciate advice. I believe all 5 are strong letters. The main drawback I can see with several of them is that I didn't do a clinical rotation with the author, but those authors have titles that the ones I performed clinicals with do not. I know all of the authors well. These are the letter descriptions:

1. Writer: Family Med doctor with whom I spent 3 months on clinical
Pros:
1. I became very good friends with this doctor. My wife and I attended his church during my time in town and were invited to his house several times. He wrote the letter soon after I finished the rotation.
2. He said he was very impressed with my performance and encouraged me to apply to the residency program he attended.
Cons: he is a private dr, not faculty

2. Writer: Family Med/Sports Med doctor (and associate OMM professor at my school)
Pros:
1. I did a 1 month clinical with him in sports medicine; I knew this doctor from class before clinical then got to know him well during clinical
2. He told me that he wrote an extremely positive letter
3. He is faculty (although not a chair)
Cons: only spent 1 month with him rather than 3

3. Writer: Department Chair of Family Medicine at my school
Pros:
1. I did research with him (just the two of us, no other students) for 5 weeks during the summer between first and second year.
2. Knew him very well. He didn't tell me how good the letter is, but I think it is probably very good.
3. He is Family Med chair
Cons: didn't do a clinical with him

4. Writer: Department Chair of Psychiatry (both at my school and local public hospital)
Pros:
1. I ran many large community service events (bimonthly events and annual week-long events) with this dr as my adviser. I'm sure it is a very good letter.
2. He is a department chair (although not in family med)
Cons: didn't work with him on clinicals
**Not sure if him being outside of family medicine is a good or a bad thing (all of my other letters will be from family med docs)

5. Writer: Associate Dean for Rural Medicine/Family Medicine at my school
(I want to go to a family medicine program that teaches broad-scope medicine that prepares students to practice anywhere (including rural). This dr is very well known as a champion of rural medicine in my state.)
Pros:
1. Know him pretty well, have had multiple conversations about residency programs and my aspirations
2. High-ranking faculty member, specifically in rural/family medicine which are the programs I am aiming for
Cons:
1. Didn't do clinical rotations with him

Thanks in advance for any help!

Can you list the sports medicine doctor as a sports med doc not family doc? (to give your letters more variety). I don't know if it is a disadvantage that you only have FM letters but you should get letters from other Sub-Is/electives. My understanding is FM is across the spectrum care so for me I did all the sub-Is/electives in the fields we will be working in next year ICU/OBGYN/Pediatrics/Primary-care IM and then the rest were all family medicine. And I got my 4 letters from the ICU/OBGYN/and then 2 family docs from my M3 rotation and SUB-Is

I would try to find letters where you have done clinical rotations with the author not just research, running events etc. Authors have to be able to describe your clinical ability on top of your other attributes (good personality, team-player, geniuine interst in field, intelligent etc.) I.e. this guy will make an excellent physician because I witnessed his excellent clinical ability, etc. etc. At the end of the day you are going to mainly be a clinician at the hospital - your focus won't be in research (unles you are in reserach program), fundraising activities, etc.

I would also send them your CV so they can add stuff.

Also for chair letters they are very bare bones if you have not done rotations with them. They list out your comments, grades etc. and say student x will make a great candidate. I would avoid chair letters unless you have actually done clinical rotations with them.


That being said I would use all the letters where you did clinical rotations and leave out the psychiatrist. Since he can't attest to your clinical ability and he was only your advisor for running events. Maybe also list (as suggested above) the sports medicine guy as a sports medicine doc rather than family doc.

When you do your next elective that is non-FM try to do your best and get another letter.

hope this helps

 

[VenturaResident]

Your extra curriculars will be on your application and can be discussed during an interview to make things more interesting. IMHO, letters are most important to the extent that they reflect your clinical interactions with patients. I'd leave out the last letter.

My other concern is that you haven't commented on what type of clinical rotations these are: all outpatient family medicine? If you want to go to a full spectrum you'll really benefit from having a variety of letters but definitely including inpatient and outpatient experiences. I had a letter from an ER rotation, one from an IM rotation, and one from an outpatient FM rotation. And may have had one from the faculty member who supervised me as a T.A. in med school, but can't remember if I ultimately submitted that one.

 

[mjjdm1985]

First of all, thank you all. I really appreciate the responses. I feel like I should have posted on here a while ago. Here are some follow-ups in answer to your questions:

1. I believe there would be no problem labeling the sports med/family med doctor's letter as "sports medicine." He is sports medicine-boarded and his practice is solely sports medicine.

2. The reason I don't have more clinical letters:
--On many of my rotations I worked mostly with residents and saw the attendings very little. Therefore, despite performing well on rotations, I didn't feel like the doctors would truly be able to expound on my clinical skills. They would mostly be writing based on limited interaction with me, possibly one sit-down conversation, and from the materials I provided them (CV, personal statement, etc).
So, do you think it is better to get letters from attendings who, although clinical, didn't really interact with me much in the clinic?

3. I did request a LOR from a clinical ObGyn with whom I rotated at the local public hospital. He said he would write one, I sent him my CV/etc, then we sat down and talked. He seemed very impressed then I told him about the other letters I had already obtained. He told me he didn't think I needed a letter from him and that I "was set" (that the other letters sounded very good).
--Should I go back to him and request a letter? He told me he would still be willing to write one if I decided that I needed it in the future.

4. Our school schedules ER core rotations during fourth year. Mine is coming up in November. I could potentially get a letter out of that rotation.

Therefore, because the residency application opens next week, I foresee two possible paths:

1. I can stick with the letters I have and submit the application in its entirety on the first day we are permitted to submit.
2. I can submit the application on the first day we are permitted to submit, but only submit two LORs rather than four. I can then get a letter from the ObGyn and from the ER rotation and submit those at a later date.

Thoughts?

 

[playingfrombehind]

First of all, thank you all. I really appreciate the responses. I feel like I should have posted on here a while ago. Here are some follow-ups in answer to your questions:

1. I believe there would be no problem labeling the sports med/family med doctor's letter as "sports medicine." He is sports medicine-boarded and his practice is solely sports medicine.

2. The reason I don't have more clinical letters:
--On many of my rotations I worked mostly with residents and saw the attendings very little. Therefore, despite performing well on rotations, I didn't feel like the doctors would truly be able to expound on my clinical skills. They would mostly be writing based on limited interaction with me, possibly one sit-down conversation, and from the materials I provided them (CV, personal statement, etc).
So, do you think it is better to get letters from attendings who, although clinical, didn't really interact with me much in the clinic?

3. I did request a LOR from a clinical ObGyn with whom I rotated at the local public hospital. He said he would write one, I sent him my CV/etc, then we sat down and talked. He seemed very impressed then I told him about the other letters I had already obtained. He told me he didn't think I needed a letter from him and that I "was set" (that the other letters sounded very good).
--Should I go back to him and request a letter? He told me he would still be willing to write one if I decided that I needed it in the future.

4. Our school schedules ER core rotations during fourth year. Mine is coming up in November. I could potentially get a letter out of that rotation.

Therefore, because the residency application opens next week, I foresee two possible paths:

1. I can stick with the letters I have and submit the application in its entirety on the first day we are permitted to submit.
2. I can submit the application on the first day we are permitted to submit, but only submit two LORs rather than four. I can then get a letter from the ObGyn and from the ER rotation and submit those at a later date.

Thoughts?

Why did you mention the other letters when talking with the OBGYN. He may have told you that "you're set" because he saw that you had enough letters and just didn't want to take the time to write you a letter you may or may not use. You should probably let him know that all your authors are family docs and that you feel you need a letter from another discipline then he would have a reason to write you a letter.

If OBGYN disagrees then its not the end of the world. Apparently the LORs are not in the cateogry A criteria as mentioned by my school. They are more like Cateogry B maybe even C.

My associated dean told us everyone will have a letter saying they're the best, most professional, etc. etc. student. After some time from reviewing the letters they all seem to say the same thing. No one is going to ask a doctor who will write them a bad letter and I can honestly find no reason why a doctor would sabotage a student with a bad letter.

Usually revieweres don't look at application till complete you don't want your entire application riding on your performance in ER. How about if you work mainly with a resident again or your performance was sub-par

I would just play it safe - either use the letters you have now / ask the OBGYN again / if you really want to be risky then I guess use the E.R. letter but make sure you do well on the rotation and you talk/get exposed to the attending.