EM Residency LOR Mess: I may have too many and too few letters simultaneously

theWUbear

EM PGY2
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Jun 7, 2009
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Hi all - thank you in advance for any information that may help me with my situation

I am a US MD M4 who is applying to EM residencies this September.

I am one rotation off-cycle, starting my fourth year in August with my home ED rotation. Because of this, I will have one EM rotation completed when applications go out mid-September. (I will at that point be on my second EM month, first away).

Because of this, my Deans asked me to prepare LORs from my third year so I don't have only 1 letter (home SLOE) going out when apps are submitted.

I volunteered last December in our Peds ED and did a lot of shifts with our head of PEM - this person has written me a letter regarding my PEM clinical performance. Furthermore, I have done 3 years of EM research under our old department chair who is now department chair at another hospital/residency's ED - this person has also written me a letter regarding my exceptional work in the ED over three years.

Therefore, September 15th I will be prepared to send one SLOE and those two letters. At the end of September I finish my first away rotation and have a second SLOE coming from a community ED/residency program, that makes 4 letters.

In November I do my second EM away rotation at an urban EM program. Multiple residency directors have told me (in video conferences, personal conferences) to get SLOEs from aways regardless of how late they are. This second away rotation/third EM rotation will give me a SLOE in late Nov/early Dec making for my third SLOE and fifth overall letter.

Apparently ERAS lets you give a program only 4 letters. Therefore, I have only few available on Sept 15 (research letter, PEM one-faculty letter, home SLOE), or only 1 if we only count the sloe. I have five letters, too many, when all is counted. I don't know how to remedy this situation. I guess I should determine whether or not to value the last sloe since it's in december. i wish i could add it to every app and put the programs on notice for another LOR because I will be performing my best work and it is in a great location for other ER programs to value it. Or, I value having the research letter and the PEM letter early. Thanks for your thoughts on my issue
 

gro2001

SOCMOB
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Jul 4, 2006
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Hi all - thank you in advance for any information that may help me with my situation

I am a US MD M4 who is applying to EM residencies this September.

I am one rotation off-cycle, starting my fourth year in August with my home ED rotation. Because of this, I will have one EM rotation completed when applications go out mid-September. (I will at that point be on my second EM month, first away).

Because of this, my Deans asked me to prepare LORs from my third year so I don't have only 1 letter (home SLOE) going out when apps are submitted.

I volunteered last December in our Peds ED and did a lot of shifts with our head of PEM - this person has written me a letter regarding my PEM clinical performance. Furthermore, I have done 3 years of EM research under our old department chair who is now department chair at another hospital/residency's ED - this person has also written me a letter regarding my exceptional work in the ED over three years.

Therefore, September 15th I will be prepared to send one SLOE and those two letters. At the end of September I finish my first away rotation and have a second SLOE coming from a community ED/residency program, that makes 4 letters.

In November I do my second EM away rotation at an urban EM program. Multiple residency directors have told me (in video conferences, personal conferences) to get SLOEs from aways regardless of how late they are. This second away rotation/third EM rotation will give me a SLOE in late Nov/early Dec making for my third SLOE and fifth overall letter.

Apparently ERAS lets you give a program only 4 letters. Therefore, I have only few available on Sept 15 (research letter, PEM one-faculty letter, home SLOE), or only 1 if we only count the sloe. I have five letters, too many, when all is counted. I don't know how to remedy this situation. I guess I should determine whether or not to value the last sloe since it's in december. i wish i could add it to every app and put the programs on notice for another LOR because I will be performing my best work and it is in a great location for other ER programs to value it. Or, I value having the research letter and the PEM letter early. Thanks for your thoughts on my issue

Unless they've changed this in the last few years, ERAS lets you upload 4 letters at a time. You can upload whatever letters you have now and then when you get another SLOE, delete one of the LORs and replace it with the SLOE. In fact, if the program has already downloaded your application by the time you replace one of your letters, it will push the new letter to them too (though I understand it will be up to the program coordinator to download the new letter 'manually'). When I was applying that was a trick some people used to get more letters into their files than permitted by ERAS. Don't overdo it though, I hear some PDs don't like this trick.
 

gutonc

No Meat, No Treat
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Unless they've changed this in the last few years, ERAS lets you upload 4 letters at a time. You can upload whatever letters you have now and then when you get another SLOE, delete one of the LORs and replace it with the SLOE. In fact, if the program has already downloaded your application by the time you replace one of your letters, it will push the new letter to them too (though I understand it will be up to the program coordinator to download the new letter 'manually'). When I was applying that was a trick some people used to get more letters into their files than permitted by ERAS. Don't overdo it though, I hear some PDs don't like this trick.
This trick no longer works. Once you assign a LOR to a program, that slot is blocked. There's no more un-assigning. It's also a web-based system this year so no more downloading either.
 
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theWUbear

theWUbear

EM PGY2
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Jun 7, 2009
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Yes, thank you for your responses thus far and indeed I have confirmed that there are only 4 letters able to be assigned, and you can no longer use that workaround. I guess my decision comes down to the following:

Do I value a 3rd SLOE (second away SLOE) that should be great, is in NYC (therefore putting other NYC programs on higher notice), but comes in late November?
- if I do this, do I scrap either
- - my PEM letter from a single faculty member? PEM being something I have a strong interest in, and this letter presumably being great, but it only being from 1 faculty member, OR
- - my Chair of EM letter from my mentor, now Chair at an NYC institution, who i did ED research and analytics for for 3 years - a unique and excellent but not clinical letter

Or, do I value both of those letters and not an away letter that comes in late November
 
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theWUbear

theWUbear

EM PGY2
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Jun 7, 2009
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This issue has been resolved.

I have been informed by current interns that I will be asked on the interview trail for that late SLOE.

My home PD resolved the issue by stating that I should submit all the LORs and that the late SLOE can be emailed to programs from the institution rather than transmitted by ERAS.