Looking ahead (do I need to be?) - Letters of Recommendation

[TexasTriathlete]

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I'm starting MS2 on Monday, and I was curious... who typically writes your letters of recommendation for your residency applications? Is this the kind of thing that should start thinking about now?

I'm at an osteopathic school, and SOMA gets us a "special" letter of recommendation for doing x amount of community service. I will easily meet these goals, but I'm not sure how much weight this will carry.

I'm also doing research at another (allopathic) institution in the area, and I have done a good enough job that I am fairly certain that I can count on a couple of very good letters from my PI's, who are emergency medicine faculty. I know this will carry a lot of weight at their program, and frankly, I am pretty comfortable about my chances there, at this point.

But what if I decide I'd rather do something else, besidess EM? How specific are these letters? A girl I used to work with (ER doc) told me that she had her recommenders write letters for both specialties she was considering, and made each one specific to the specialty. Is this pretty common?

How many letters should an application typically have?

 

[SouthernSurgeon]

I'm starting MS2 on Monday, and I was curious... who typically writes your letters of recommendation for your residency applications? Is this the kind of thing that should start thinking about now?

I'm at an osteopathic school, and SOMA gets us a "special" letter of recommendation for doing x amount of community service. I will easily meet these goals, but I'm not sure how much weight this will carry.

I'm also doing research at another (allopathic) institution in the area, and I have done a good enough job that I am fairly certain that I can count on a couple of very good letters from my PI's, who are emergency medicine faculty. I know this will carry a lot of weight at their program, and frankly, I am pretty comfortable about my chances there, at this point.

But what if I decide I'd rather do something else, besidess EM? How specific are these letters? A girl I used to work with (ER doc) told me that she had her recommenders write letters for both specialties she was considering, and made each one specific to the specialty. Is this pretty common?

How many letters should an application typically have?

In general, you only want letters from people who have worked with you clinically. Some people who have extensive research will go to their PI for a letter as well.

The composition of your letters otherwise will be very variable. If you are applying to a surgical field, they will typically want your letters to be from surgeons. Other fields don't seem to care as much and people will have a diverse set of letters (however I've mostly only looked at what the expectations are for surgery so others can speak better to those fields).

But, bottom line - the time for letter gathering is third/fourth year (often mostly fourth year). I wouldn't worry about it now. If you are a building a good research relationship with your PI that is a nice possibility.

Last note - I can't speak to osteopathic applications, but ERAS (the residency application service) only allows you to upload four letters. Most programs request 3 letters from clinical faculty, with some programs allowing for a "+1" letter (in many cases written by the department chair of your chosen field). So unfortunately, that extra letter for community service probably won't matter for your ACGME programs.

 

[TexasTriathlete]

Got it. Thanks for the info.

 

[Bitsy]

Yeah, unless you're going into some very heavy research-oriented field (rad-onc), you're not going to want to use 1 of your 4 on your PI. If it relates to your field, maybe....but ER is not very research oriented so listing your research in ERAS should be enough, unless it is going to be an amazing letter. Most if not all of your letters should come from preceptors who can comment on your clinical abilities (during 3rd year rotations and 4th year sub-i's). You'll want a CV put together to give to those preceptors you are going to ask for letters of rec's from, but 2nd year is too early to be looking for who is going to write your letters of rec's. Worry more on learning the 2nd yr material well and rocking your step 1 later in the year. Good luck!

 

[TexasPhysician]

In general, you only want letters from people who have worked with you clinically. Some people who have extensive research will go to their PI for a letter as well.

The composition of your letters otherwise will be very variable. If you are applying to a surgical field, they will typically want your letters to be from surgeons. Other fields don't seem to care as much and people will have a diverse set of letters (however I've mostly only looked at what the expectations are for surgery so others can speak better to those fields).

But, bottom line - the time for letter gathering is third/fourth year (often mostly fourth year). I wouldn't worry about it now. If you are a building a good research relationship with your PI that is a nice possibility.

Last note - I can't speak to osteopathic applications, but ERAS (the residency application service) only allows you to upload four letters. Most programs request 3 letters from clinical faculty, with some programs allowing for a "+1" letter (in many cases written by the department chair of your chosen field). So unfortunately, that extra letter for community service probably won't matter for your ACGME programs.

I agree with most of what you said, but your last paragraph is a little misleading. You can upload all the letters you want onto ERAS, but each program can only receive up to 4 letters. So if you are applying to Pediatrics and Radiology for some reason, you can upload 8 letters. You just have to specify which 4 go to each program.

 

[SouthernSurgeon]

I agree with most of what you said, but your last paragraph is a little misleading. You can upload all the letters you want onto ERAS, but each program can only receive up to 4 letters. So if you are applying to Pediatrics and Radiology for some reason, you can upload 8 letters. You just have to specify which 4 go to each program.

Yes, that is right - should have been more specific; no more than 4 per program.