Letter of Recommendation.

[TruTrooper]

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I have requested a LOR from the OBY/GYN educational director at the hospital where I completed my OB/GYN clerkship. During this clerkship, a few students kind of screwed the whole experience for the whole group of students rotating at the hospital during that block by basically coming and going as they pleased and not calling in when they didn't show up for the day. Because of this, the director threatened to give us all bad evals because he claimed that "the students were not taking the rotation seriously."


This upset me because I busted my butt trying to honor the rotation. Anyway, I explained to the director that I was always present and on time everyday and sought out work. I also suggetsted that he talk with the residents whom I worked with to get a better picture of my perfomance. He assured me by saying "I have not heard anything negative about you," trutrooper.

Well, by the time I received my evals, I found out that he gave me a decent eval with several marks in the "outstanding" category but the remarks were not glowing but pretty much stated what a hard worker I was and how much effort I put into the clerkship.

Anyway, I emailed him so that I can get another LOR since I am one short of the recommended amount of letters. After a week and a half, he still had not responed to the email. I called him today and asked him a dn he said "um, yeah, that shouldn't be a problem. Call me back in about a week if you haven't heard from me."

My concern is that he sounded less than enthusiatstic, even though he wrote the good eval which was, by the way, a couple of outstanding marks away from honors. Now, I am not sure if he is willing to put some "ummp!" in this letter or exactly what he might say in it. The other Attendings I asked were speedy with replies and pretty much showed some enthusiasm about writing me a letter.

So do you think this is a red flag?

 

[wook]

I have requested a LOR from the OBY/GYN educational director at the hospital where I completed my OB/GYN clerkship. During this clerkship, a few students kind of screwed the whole experience for the whole group of students rotating at the hospital during that block by basically coming and going as they pleased and not calling in when they didn't show up for the day. Because of this, the director threatened to give us all bad evals because he claimed that "the students were not taking the rotation seriously."


This upset me because I busted my butt trying to honor the rotation. Anyway, I explained to the director that I was always present and on time everyday and sought out work. I also suggetsted that he talk with the residents whom I worked with to get a better picture of my perfomance. He assured me by saying "I have not heard anything negative about you," trutrooper.

Well, by the time I received my evals, I found out that he gave me a decent eval with several marks in the "outstanding" category but the remarks were not glowing but pretty much stated what a hard worker I was and how much effort I put into the clerkship.

Anyway, I emailed him so that I can get another LOR since I am one short of the recommended amount of letters. After a week and a half, he still had not responed to the email. I called him today and asked him a dn he said "um, yeah, that shouldn't be a problem. Call me back in about a week if you haven't heard from me."

My concern is that he sounded less than enthusiatstic, even though he wrote the good eval which was, by the way, a couple of outstanding marks away from honors. Now, I am not sure if he is willing to put some "ummp!" in this letter or exactly what he might say in it. The other Attendings I asked were speedy with replies and pretty much showed some enthusiasm about writing me a letter.

So do you think this is a red flag?

Depends...Could be he is busy, but at first blush it doe sound like he's hesitating. Probably won't hurt to touch base again later. If it's not a good LOR, you could always use another (assuming you have several).

Wook

 

[community]

Keep in mind that it is always best to ask for a LOR in person, not by email or phone. In addition you should ask if they can write you a "strong" letter of recommendation. I would follow up with him in person rather than over the phone. Good luck to you!

community

 

[electra]

You should give him a copy of your CV with two SASE (one to your school and the other to you) for mailing. Also, this was a point made on SDN some time ago. You might write a short note with some information from you about what YOU think your strong points are and some examples specifically from the rotation, especially if you worked with him. If not, indicate which residents you did work with for those examples.

Good luck. and if the letter isn't "all that" you can always use another.

 

[automaton]

My high school and college letters of recommendation were always confidential. Are medical school letters different? Are you able to read them and pick the best?

 

[EM Junkie]

You should always waive your right to see your LOR's. A letter that you have seen is often thrown in the garbage without ever being read by residency program directors.

To the original poster, I would run from this guy like the plague. It sounds like your letter will likely be just as "ho-hum" as your eval comments. Some people just aren't skilled at writing comments on evaluations.

 

[electra]

You don't have to waive the right to see your letters. They are sent through ERAS to the programs after being loaded up to ERAS by your school. I would **NOT** under any circumstances send a recommendation letter for my residency application that I had not read and felt was a strong letter.

Note: Many PDs like to see letters from more than just your chosen discipline. Getting a great letter from a preceptor in another area is a very strong sign that you are a serious student. If you could stand out and do a stellar job in xyz, just think of how good you would be in what you want to do!

These are some reasons that it is very helpful to ask multiple people to write letters for you as you go through. 1) you won't be scrambling at the end, and 2) the letters tend to be more positive and more personal since the precptor actaully remembers you. Also, when you have a choice of which letters to send, you begin to recognize the difference between good letters and great letters. If you do not know this difference, ask someone that you trust (a 4th year, an intern, etc) to show you their letters.

 

[Mumpu]

Tru, are you going into OB/Gyn? If not, you probably shouldn't get a letter from OB in the first place.

If you are not 100% sure, the question you should be asking is "can you write me a STRONG letter." I'd be unhappy with an unenthused response as well.

 

[sacrament]

You should always waive your right to see your LOR's. A letter that you have seen is often thrown in the garbage without ever being read by residency program directors.

There are differing opinions on this, but for whatever it's worth the Dean of Students at my school has informed us that the clear majority of our students over the past many years have not signed waivers and have had no troubles with that whatsoever (or at least it would appear that way, since we match quite well). For whatever else it's worth, Iserson of Iserson's Getting Into a Residency fame recommends not signing a waiver.

 

[EM Junkie]

You don't have to waive the right to see your letters. They are sent through ERAS to the programs after being loaded up to ERAS by your school. I would **NOT** under any circumstances send a recommendation letter for my residency application that I had not read and felt was a strong letter.

There seems to be a disagreement on this point. Maybe it varies from specialty to specialty and between allopathic and osteopathic schools. I can tell you for sure that for allopathic emergency medicine residencies, it is a very bad idea to see your letters before sending them. I anticipate this is true for the more competitive specialties as well.

I agree, we all want to see what these letters say about us, but not at the expense of them not being taken seriously. To all MS3's and MS4's: I suggest talking with program directors in your chosen field before asking for letters - some misplaced advice could really hurt your application!

-Scott, MS 3.99999

 

[TruTrooper]

Thanks to everyone for the help. I usually never ask to view my letters but I feel that I should at least view the one from this guy. Matter-of-fact, my strongest letter came from a guy who kept asking me if I wanted to see or take the letter he had written for me. I told him I think programs look more favorably on letters that are not viewed by students but every time I saw him he would remind me that he had the letter written. I asked him to just hold on to it until I got my ERAS stuff. He asked me one more time last week so I just gave up because I didn't want him to think I didn't care about the letter and I was hoping that his persistence was a signal that he would not note that I actually read the letter.

I read the letter and almost did a backwards flip with no hands followed by a sommersault and then a split until I got to the last sentence that read "Trutrooper did not waive his right to view this letter..." My mouth dropped but he did state also that my veiwing of the letter changed nothing about what he wanted to say about me in the letter.

I plan on applying to Neurology programs and I just need more letters. I don't care what discipline the letters are from as long as I got at least one Neuro letter I think I should be fine since I feel that my CV is pretty strong but I don't think my OB/GYN will be a strong letter so I am going to take Electra's advice on this one and view that letter.

 

[Mumpu]

I don't know what other specialties count for neuro... I'll be applying to IM and we were very explicitly told that letters from anyone other than IM are absolutely worthless because the residency directors will not even consider what the person wrote.

 

[TruTrooper]

I don't know what other specialties count for neuro... I'll be applying to IM and we were very explicitly told that letters from anyone other than IM are absolutely worthless because the residency directors will not even consider what the person wrote.

That sounds pretty tough considering that you only get 1-2 rotations with IM and need 4 letters or more. You would ahve to stuff your schedule with IM electives and get them early enough to have them in with your application. My buddy got his first choice in Neuro residency with only one neuro letter.

 

[bigfrank]

Our Dean told me that "virtually every student" waives the right to see their letters and that it would be "inappropriate" to not do so. I think it's BS, but it seems to be the "standard."

 

[a_ditchdoc]

From what I have been told by students in my program, waiving your right to see the letter does not necessarily indicate that you do not get to see it. If you waive your right to see the letter, and the preceptor then allows you to see it, it does not mean that you refused to waive your rights. I know it sounds like semantics, but many of the students that did not request to see the letters were later provided copies. I suppose this very much depends on the physician.

 

[TruTrooper]

I just spoke with the person at our school who handles the ERAS applications and the Letters of Recommendation. She told me that students should always waive their rights to see the letters.

She looked me straight in the eyes and specifically said "trust me on this and take this as the tip of the day: When you waive your rights to view the letters, the attendings will usually write great letters but if you don't waive your rights then the letters seem to not be as good and solid."

She was pretty persistent about it. So I change my mind and will trust my OB/GYN Attending to write a good letter. I waived my rights when applying to medical school and was offered a spot at every school I interviewed at so I will have faith once again.

 

[DNAdude]

I don't know what other specialties count for neuro... I'll be applying to IM and we were very explicitly told that letters from anyone other than IM are absolutely worthless because the residency directors will not even consider what the person wrote.

I'm interested in IM too, and hope I didn't get some bad advice! I was told not to bother with LOR in the 3rd year rotations, only the 4th year rotations would matter since they are "auditions." So I am going to have to get them this year but hope that I can have enough for the ERAS deadlines. Do you have any idea how many would be needed? Do you think LOR from IM subspecialties would be okay (I have some of these rotations coming up)? Thanks for info and hope I didn't get the wrong advice!

 

[Cpt.Hook Hamate]

I'm interested in IM too, and hope I didn't get some bad advice! I was told not to bother with LOR in the 3rd year rotations, only the 4th year rotations would matter since they are "auditions." So I am going to have to get them this year but hope that I can have enough for the ERAS deadlines. Do you have any idea how many would be needed? Do you think LOR from IM subspecialties would be okay (I have some of these rotations coming up)? Thanks for info and hope I didn't get the wrong advice!

😕

It sure does sound like bad advice. You would have to get at the very least 3 letters and the recommended amount is 4. This would mean that you would have to do at least 3 IM electives in the first 3 months of 4th year and must impress impress almost everyone of them.

 

[Mumpu]

We've had several meetings with residency directors from the local IM programs and the only comment from them was "LORs from IM people only." My IM advisor told me 3rd year letters are fine and I'm getting at least one from my 3rd year attending who is on the committee.

 

[sacrament]

Just another nugget of info about waiving rights: I e-mailed the admissions director for the IM program at my school and asked what his thoughts were. His response: he had no thoughts about it. He rarely even notices the difference. I've also asked roughly 10 of my classmates in the past couple of days if they have waived their rights, and none of them have. Several of them note they were urged not to by various departmental advisors.
Now, clearly this a philosophical divide with strong advocates on both sides, and both sides have very compelling points. In the end, I have to wonder how much it matters either way. I already have letters that I haven't waived my rights to, but I suppose I'll split the difference and sign the waiver for the rest of my letters.

 

[Dr Alo]

I have them send me the letters directly. I am sure every school has a different policy. I have read every single letter I have received. I would not advise sending letters off without reading them. The risk is too high. The reward is too little. Is it worth not seeing your letters for that extra little smidgen of oomph when they read them?

I've talked to students from Rush, Northwestern, Loyola, and other schools, they all say that "our school tells us not to read them, but everyone we've talked to has read them." So it all depends.

I also have some friends that are program directors, most of them say it doesn't matter. One guy said, it's all about the interview and that he can size you up in a few minutes, he doesn't care to read about you. One guy said all they look at is who authored the letter and a few lines from it. Another said he reads them before each interview. So, it all depends.

Luckily for us, at our school it doesn't matter. You can read them.

 

[Mumpu]

Asked our excellent IM advisor today. She said to waive the rights and to be smart about selecting your letter writers instead. The question you should be asking is "can you write me a STRONG letter." Hesitation, reluctance, and lack of enthusiasm are bad signs. From personal experience, faculty who genuinely like you are thrilled when you ask them for a letter.

 

[AJM]

Several of you guys thinking of applying in IM were wondering about how many IM letters you really need. As someone who has just finished an IM residency, I can tell you that letters from subspecialists in IM are looked at by intern selection committees as being exactly the same as letters from people in general IM.

When I applied, I didn't have a single LOR from a general internist. The letters I had were from 2 pulmonologists (one was my attg in my ICU sub-I, and the other was my attg in a pulm elective), and the IM department chair letter (the chair letter is required for IM applicants), who in my case happened to be a rheumatologist. I don't believe I had a 4th letter, but can't exactly remember...

It's true that IM letters are considered much more heavily than letters from other specialties, and you should definitely try to get letters from IM attendings and IM subspecialists. But the intern selection committees don't just "throw out" your other letters -- they still take them into consideration.