How many letters from psychiatrist do we need as recommendations for residency?

[PS2summerdays]

Only one of my letters is from a psychiatrist I’ve worked with clinically. He’s the only permanent psychiatrist in my school - the others come and go. I am also getting a letter from the psychiatry department head. My other letters are from internal medicine/surgery. Is this okay? Or is this a red flag? Thanks all.

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[NickNaylor]

When I applied, I sent in two psychiatry letters and a surgery letter. From what I remember, most programs want two psychiatry letters out of three. Some will have different requirements, but I think that rule applies to most. You should be fine.

 

[PS2summerdays]

When I applied, I sent in two psychiatry letters and a surgery letter. From what I remember, most programs want two psychiatry letters out of three. Some will have different requirements, but I think that rule applies to most. You should be fine.

Thanks so much, that’s reassuring. Was getting a little worried there. Someone told me earlier that the psych department head letter didn’t count.

 

[Monocles]

Thanks so much, that’s reassuring. Was getting a little worried there. Someone told me earlier that the psych department head letter didn’t count.

That's not true. As long as it's a psych attending that can speak about your clinical skills then it's fine. Dept head is even better if they know you personally and can say nice stuff about you that aren't generic.

Having 1 letter outside of psych is NOT a red flag by any means. A lot of people I've spoken to said it's welcomed because it shows you are able to function well outside of psych and are well-rounded.

 

[samac]

One question to follow up on that.
I have one clinical psych letter, and then I have the “department chair” letter. But, the department chair is a family medicine doc since it’s a DO school and we don’t have an official psych department.

I worked with one other psychiatrist, but he pawned me off on the social workers from day 1 and stated from then he doesn’t do letters since he can’t actually get to know the students because he doesn’t have time. The social worker was super sweet, offered me a letter, but I didn’t get one.

How bad is the department chair letter going to hit me? Otherwise it’s family docs and a pediatrician.

 

[Monocles]

One question to follow up on that.
I have one clinical psych letter and then I have the “department chair” letter. But, the department chair is a family medicine doc since it’s a DO school and we don’t have an official psych department. I worked with one other psychiatrist, but he pawned me off on the social workers from day 1 and stated from then he doesn’t do letters since he can’t actually get to know the students because he doesn’t have time. The social worker was super sweet, offered me a letter, but I didn’t get one.

How bad is the department chair letter going to hit me? Otherwise it’s family docs and a pediatrician.

Hmm so this could get tricky... it sounds like you'll have

1) Dept chair who is family med
2) Social worker?
3) ??

I think for the dept chair, if he can specifically mention that you guys dont have a psych dept and talk about your psych skills or interactions in the context of MH cases, that might be okay.

I've never seen a SW rec letter but I think it might be better than no letter from a psych provider. Is the SW specifically a MH SW?

Will you get any away rotations or work at hospitals where you get some 1:1 experience with a psych attending?

 

[samac]

Hmm so this could get tricky... it sounds like you'll have

1) Dept chair who is family med
2) Social worker?
3) ??

I think for the dept chair, if he can specifically mention that you guys dont have a psych dept and talk about your psych skills or interactions in the context of MH cases, that might be okay.

I've never seen a SW rec letter but I think it might be better than no letter from a psych provider. Is the SW specifically a MH SW?

Will you get any away rotations or work at hospitals where you get some 1:1 experience with a psych attending?

Sorry about that, guess I wasn’t clear
I have
1. Department Chair (Not an actual psych doc)
2. Psychiatrist
3. Pediatrician
4. Family Doc

Offered one from a mental health SW and declined.

 

[PS2summerdays]

Hm in light of the latest comment I’m wondering if it’s possible to get away with just one? Hypothetically speaking. Thanks all for your input. It’s really useful to have this forum as a resource

 

[Coupd'Cat]

Hm in light of the latest comment I’m wondering if it’s possible to get away with just one? Hypothetically speaking. Thanks all for your input. It’s really useful to have this forum as a resource

Yes, at least from what I remember from a few years ago. Most programs require just at least one psychiatrist's letter. The psych department letter is not always required.

That being said, it might be worth it to glance through program's webpages to make sure. If I remember correctly, ERAS might also have a short summary on each program that lists their requirements.

Good luck!

 

[Jarisch-Herxheimer]

N/A

 

[downwithDTB]

You should probably include at least 1 non-psych letter in each application. As far as the other letters, the short answer is probably "the best letter for the program you're applying to." That may be the non-academic regional letter for a regional program or the strongest letter, but you don't actually know what's in that letter and maybe another one is better written.

You can send different letters to different programs, so if you aren't 100 on a letter, you can hedge a bit and send it to some but not all programs. This strategy will make sure that you don't get totally screwed by a worse than deserved letter.

 

[EarlyCareerAcademicPsych]

I'm an associate program director and I do a lot of ERAS screening.

I need just one LOR from a psychiatrist. If an applicant does not have any letters from a psychiatrist, then I think that they are applying in psychiatry as a back-up to another speciality. And I just skip that person.

Again - in our program, we need just one letter from a psychiatrist. I think that is much more relevant what the letter says about you.

You all may have heard this before, but I'll say it again -- I think that you will be less stressed and happier with this process if you focus on presenting the truth of yourselves. It is easier on you. It is easier on the residency programs. And you are more likely to go to a program which actually wants YOU, not some imaginary version of yourself which then you feel compelled to maintain as an intern (or on into residency).

This is the approach that our residency takes. We try our best to show the residency program for what it it is - warts and all - so that applicants can see what they are getting if they match with us.

Good luck everyone!

 

[hallowmann]

My caveat to the above is that you should be presenting yourself, but specifically, your "best" self. Everyone else will be presenting the same.

 

[OldPsychDoc]

Sorry about that, guess I wasn’t clear
I have
1. Department Chair (Not an actual psych doc)
2. Psychiatrist
3. Pediatrician
4. Family Doc

Offered one from a mental health SW and declined.

You'll be fine.

 

[PS2summerdays]

I want to ask for some advice. I have 1 psych letter and 1 IM letter already. I know some schools only read 3 letters.

So, should I wait until I get my 2nd psych letter to have 3 letters? Or should I add another unrelated letter now so my application is “complete” on time and then add my 2nd psych letter as my 4th LoR?

I know some programs might not look at 4th letter if I already have 3 in. But I also don’t want to have only 2 by September 15th. Thanks all.

 

[whopper]

I've worked in the admissions process extensively. Agree pretty much everything said above. There's no set in stone number you have to give. I'd want at least one psychiatrist just cause (this is obvious) you're applying into psychiatry. I'd also want 1 non-psych LOR cause I want to make sure this applicant has decent medical skills. I sometimes encountered applicants and residents who went into psychiatry for a turn-off reason such as they didn't feel they were something to the effect of "good enough" for a non-psych program as if psych was a lesser field. Good medical skills are important in psych just like they are in any field.

Aside from this it's fair game. Obviously the higher up the academic ladder will create a more positive if superficial impression. E.g. if someone is an associate professor it'll obviously look better than an assistant professor but that's superficial, kind of like putting a ribbon on a gift, but sometimes that ribbon is the detail that makes you look better than the other applicant. Despite what I just wrote don't get too bogged down in the superficial. Who you are as a candidate is the most important thing.

The LOR needs to reflect that the author got to know you for real and saw something in you that makes you a good potential physician. Someone overly concerned about the superficial methods to spruce up their presentation is possibly overly obsessed, setting themselves up to look too neurotic, and in doing so could look like they don't have confidence in themselves.

 

[Celexa]

I want to ask for some advice. I have 1 psych letter and 1 IM letter already. I know some schools only read 3 letters.

So, should I wait until I get my 2nd psych letter to have 3 letters? Or should I add another unrelated letter now so my application is “complete” on time and then add my 2nd psych letter as my 4th LoR?

I know some programs might not look at 4th letter if I already have 3 in. But I also don’t want to have only 2 by September 15th. Thanks all.

You do not want an incomplete application on Sept 15 unless there's no other alternative.

 

[PS2summerdays]

You do not want an incomplete application on Sept 15 unless there's no other alternative.

And by complete you mean 3 LoR?

 

[TexasPhysician]

I had 2 psych, 1 peds, and 1 neuro letter. They worked out great.

 

[PS2summerdays]

I had 2 psych, 1 peds, and 1 neuro letter. They worked out great.

Thanks! That's the same case for me, 1 psych + 1 non-psych submitted already. I'm just waiting on my 2nd psych letter. Was just wondering if it's okay to upload a peds letter by Sept. 15th (ERAS opens) and THEN a the 2nd psych letter AFTER the 15th. Wondering if the programs will even look at a 4th letter.

 

[Celexa]

And by complete you mean 3 LoR?

If the program lists three letters as a requirement, and most do, then your application will be incomplete without them.