Confessions of a Program Director: Letters of Recommendation

[Pedsmdplease]

Pretty interesting: Confessions of a Program Director: Letters of Recommendation

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[mvenus929]

Varies a bit. In Peds, the department is quite large. My PD didn’t do much clinical work, so her giving a student a letter of recommendation would be weird. But the clerkship directors saw all the students on their third year rotation work clinically, so they might be a reasonable source. My clerkship director med school was a geneticist—I never worked with him clinically. The PD was half hospitalist and half ID, so we worked with her some, but we also did our Peds rotations at other hospitals, so it wasn’t guaranteed. So had I not specifically rotated on ID, and she happened to be the attending on, I might not have been able to get a letter from her.

I think it matters more in more procedural based specialties—surgery, anesthesiology, etc. But IM, FM, and Peds often have such large departments that are broken up so much that you may not see some of the big wigs in the residency program as a student.

 

[differentiating]

Agreed with the above that it probably varies. I didn’t follow these rules and was fine - didn’t have a PD letter (never worked with the home PD directly, even though it was a relatively small department) but did have one from someone else in the department, and didn’t have any research letters despite significant research experience on my application because I felt my clinical letters were more relevant and would be stronger. Can’t say whether these cost me any interviews or not, but I was never asked why I didn’t have those letters at the ones I went to.

I did have one letter from an unrelated specialty in my app, which I debated whether or not to use, but in the end I’m glad I went with it. I knew it would be a strong letter, and my alternative was a more related letter that I felt would be less impactful. Interviewers implied that I had very strong letters that impressed them - one actually read out a list of compliments from my letters, which was kind of awkward.

 

[Tenk]

This has little to no relevance to EM as well. We have SLOEs.

 

[Philosopher Jagger]

Also agree that it varies. I'm applying Peds and our Peds Chair writes a letter for every Peds applicant that takes into account feedback from a roundtable meeting with all of the faculty (since as the chair he is not always on service and wants to give real recommendations). Our PD works in Child Behavioral Health which, if we're being honest, is not the go-to clinical experience for 3rd year students, and most certainly not a Sub-i.

We have no issues matching Peds applicants to great programs throughout the country.

I do like what the author said about LORs including a reference to "hey we want him/her, so if you don't we will"...I had never heard of that and it's an interesting notion.

My plan is 4 LORs, 2 Peds (1 chair, 1 sub-i preceptor), 1 non-peds clinical LOR, 1 research LOR after an 8 year time working together. I don't see how that could go wrong