Crap--I've been avoidant. How do I get letters of rec?

[Trismegistus4]

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Many of you may remember me from my frequent posts earlier this year and last year about how I hated medical school, was doing horribly, wished I could quit, lived in constant fear of failing, etc. Well, I've somehow survived to the end of 3rd year, and it's time to apply for residency. Unfortunately, ERAS is due soon, and I have no letters of recommendation so far.

There are several reasons. I'm in a bit of a tricky situation. 3rd year ends late at my school to begin with (July), so there isn't much time to do electives and such before applying. Most people started 4th year with an AI. I failed Step I on the first try, and so I had to interrupt my rotations to take a review course, and thus am finishing 3rd year even later than most--still have 2 weeks left. I've been inspired to go into psychiatry for several reasons, including, but not limited to, the problems I myself have had during medical school. One of these problems was a tendency toward some avoidant behaviors during 3rd year--I knew that I hadn't studied hard enough during the first 2 years, and I was constantly afraid that people would "see through" me and realize this, so I didn't stick my neck out much. I tried to fly under the radar as much as possible and just stay in survival mode. So I didn't ask for any letters along the way, because I was so terrified that I was doing a bad job and that everyone thought I was incompetent and therefore asking for a letter of recommendation would be ridiculously presumptuous.

I'm doing a psych AI in September, and thus will get 1 letter out of that. But, where else do people get letters? I realize it might seem ridiculous for me to be asking this, but my school gives us very little guidance, banking insteead, it seems, on the notion that med students are type A ambitious people who will figure out whatever they need to do anyway.

I got pretty good evaulations on my psych and medicine rotations. Could I just email and ask if someone would be able to write me a letter? I don't really feel any attendings knew me that well--should I just email the clerkship directors?

Putting on my flame-******ant suit--I know, I know, "as a medical student you should know this stuff, if you want to be a doctor you're going to have to stay more on top of things than this, what were you thinking, it's way too late now, you'll never get your application together in time for this cycle, you're incompetent and lazy, etc., etc." But regardless of what I should have done, this is where I am right now.

 

[IHeartNerds]

How is your psych rotation done? I don't see why you couldn't get three letters out of it, unless you only work with one attending the entire month?

Alternatively, does the psych chairman get everyone a departmental letter? that would be a second. I have no idea if non-surgical fields do this.

 

[rachmoninov3]

I understand your frustration. Please know that it is certainly normal to feel unworthy in medical school, especially while applying for residency. Furthermore, requesting letters of rec, i.e. asking someone to say something good about you further lends itself to a sense of unworth. (you mean I have to ask?) I am trying to remember in the future to OFFER to write letters for medical students I feel did a good job, because I certainly feel embarrassed/nauseated asking. One more thing on LoRs: once you do get letters prepare to be asked "what do you want me to write?"

Unfortunately this is just how the game is played. Know that you have made it this far, so you have met standard. So just march on down to your Psych department's office, explain your situation and start asking questions.

Good news/bad news: They are going to kick you out of medical school...only it will be with a diploma!

 

[MCQ]

Just go ask them if they're willing to write a "positive" letter of recommendation for you. I would either email the letter director directly or call them. You'd be surprised at how willing a lot of them are (even if you think they don't remember you).

 

[mumd2011]

I would say you probably only want to use e-mail to ask them if they would set up a meeting with you about your upcoming application for residency. I have been told (and used the advice) that you don't ask for the letters in the e-mail. You'll want to go talk to them face to face and have your personal statement and CV with you. Good luck!

 

[Trismegistus4]

How is your psych rotation done? I don't see why you couldn't get three letters out of it, unless you only work with one attending the entire month?

Actually, we did. And it was almost a year ago now. I don't think he would remember me at all.

Alternatively, does the psych chairman get everyone a departmental letter? that would be a second. I have no idea if non-surgical fields do this.

I'm going to meet with the psych chairman (my advising dean suggested doing this even outside of the context of letters.) But I did my psych clerkship at the VA. I'm not sure how that works.

I am trying to remember in the future to OFFER to write letters for medical students I feel did a good job, because I certainly feel embarrassed/nauseated asking.

That is a great idea. I have often had the same thought myself. Except that, God willing, I will never be in a position to write letters for medical students, because I want to go into private practice and be done with the hell that is the world of academic medicine once and for all.

Good news/bad news: They are going to kick you out of medical school...only it will be with a diploma!

Great line; I am going to keep that in mind and quote it from time to time.

I would say you probably only want to use e-mail to ask them if they would set up a meeting with you about your upcoming application for residency. I have been told (and used the advice) that you don't ask for the letters in the e-mail. You'll want to go talk to them face to face and have your personal statement and CV with you. Good luck!

That makes sense, but it kind of stinks because my schedule's going to be tight. I'm on gyn surg the next 2 weeks and then start my psych AI. Anyone have experience finding time during "intense" rotations to have these types of meetings?

Also, people are talking about getting 3 psych letters. I thought it would look better for my letters to be a bit more broad. At least, it would look good to also get one from medicine, right? But I really have no pretense under which to talk to a medicine person about my upcoming application other than to ask for a letter. It's not like I'm going into their field.

 

[peppy]

Yes, generally for Psych the advice is to get 2 psych letters and 1 non-psych from something like IM or GenSurg.
Just try asking some of the attendings who filled out positive evaluations on you in the past if they would be interested in discussing a LOR. They're used to getting asked and some of the nice ones will do it even for people they never got to know all that well as long as you show them your personal statement or CV and offer to meet with them to answer any questions they might have.

 

[Jwax]

That makes sense, but it kind of stinks because my schedule's going to be tight. I'm on gyn surg the next 2 weeks and then start my psych AI. Anyone have experience finding time during "intense" rotations to have these types of meetings?

Yep - if you are on gyn surg and you want go in to psych, tell your upper level & attending that you need to meet with one of the psych faculty to obtain letters of rec. Trust me - people get that you have higher priorities right now than showing up for the regularly scheduled programing. I'd try to get it done before you do your AI. Your AI attending would probably be understanding if you needed to ditch out for a bit, too, but it's probably better if you can skip out during gyn.