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If I was your classmate that would rub me the wrong way. Because I would think that you might be getting hookups and preferential treatment for these things . So this is the reason I would advice you to be careful . As pure as your intentions are, it could be misunderstood.
 
I am a newly minted MS4 at an allopathic med school in the US. For the past 3 years I've been working with a physician (1/week) at their clinic. We've gotten to know each other pretty well and they agreed to write me a LOR for the upcoming match cycle (yay!).

In the past, maybe once or twice, I wrote a thank you card for all their help and I included a $5 Starbucks gift card as a token of my appreciation. I did this at the end of an academic year or near the holidays. I enjoy offering those who have done a lot for me (very) small gifts as a way to show my thankfulness. This preceptor was appreciative of the gift at the time.

This past week, as my clinic time with them came to an end, I wrote a heartfelt thank you card and included a $10 gift card, again to Starbucks. At this point, they had already agreed to write me a LOR. This time, however, they thanked me for the card but then gave the gift card back to me stating, "you'll need this way more than me!". I felt very awkward... did I overstep? I was told by many of my med school peers that they gave their preceptors similar-sized (some even larger) gifts at the end of their 3 years.

Hoping for some advice! I am nervous I might have done something wrong?
Your LOR gonna read “and then this kid walks up into MY clinic and tries to BUY MY AFFECTION.

does he even know how many calories are in that frappe?! DOES HE?!

best student I’ve ever had 3/5 PASS.”
 
I am a newly minted MS4 at an allopathic med school in the US. For the past 3 years I've been working with a physician (1/week) at their clinic. We've gotten to know each other pretty well and they agreed to write me a LOR for the upcoming match cycle (yay!).

In the past, maybe once or twice, I wrote a thank you card for all their help and I included a $5 Starbucks gift card as a token of my appreciation. I did this at the end of an academic year or near the holidays. I enjoy offering those who have done a lot for me (very) small gifts as a way to show my thankfulness. This preceptor was appreciative of the gift at the time.

This past week, as my clinic time with them came to an end, I wrote a heartfelt thank you card and included a $10 gift card, again to Starbucks. At this point, they had already agreed to write me a LOR. This time, however, they thanked me for the card but then gave the gift card back to me stating, "you'll need this way more than me!". I felt very awkward... did I overstep? I was told by many of my med school peers that they gave their preceptors similar-sized (some even larger) gifts at the end of their 3 years.

Hoping for some advice! I am nervous I might have done something wrong?

Honestly, a monetary-type gift from a student feels a bit inappropriate to accept. Generally I get thank you notes and that's it. If you really want to do something, perhaps a snack for the doc and their staff (like donuts or cake pops) or even a little cactus or plant for their office is a nice gesture, although not necessary.
 
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