LOR on physician's own letterhead vs hospital letterhead

[Vagueclient]

Hi everyone. I am currently applying for an elective in the US and I have come across 2 options which I'm not sure which of to pick.

Option A offers a better schedule as I intend to study for my Step 1 during that time, but the LOR is to be signed on the physician's own letterhead.
Option B has a more strenuous schedule but offers a LOR on a hospital letterhead.

Is it worth going for option B just because of the hospital letterhead? And does it make a difference when applying for a residency what the LOR is written on (assuming options A and B include similar content about my performance)?

Thank you!

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[GoSpursGo]

I don’t see any functional difference between a letter on one letterhead or the other. What likely matters more is if one rotation is affiliated with a more well-known academic center, as the letter coming from the better recognized place will likely carry more weight. Also an inpatient rotation would likely be viewed more favorably.

That said, assuming that you’re planning to take step 1 before it goes pass/fail, that is he single most important factor in determining whether you match. So if you’re not going to have a dedicated study time, then how effectively you will be able to study has to enter into your calculations.

 

[Vagueclient]

I don’t see any functional difference between a letter on one letterhead or the other. What likely matters more is if one rotation is affiliated with a more well-known academic center, as the letter coming from the better recognized place will likely carry more weight. Also an inpatient rotation would likely be viewed more favorably.

That said, assuming that you’re planning to take step 1 before it goes pass/fail, that is he single most important factor in determining whether you match. So if you’re not going to have a dedicated study time, then how effectively you will be able to study has to enter into your calculations.

Thank you for your reply. I am indeed planning on taking step 1 before it goes pass/fail, and sadly yes I will heavily rely on studying during that time period as my dedicated study is somewhat short.

That being said, I'd like to add this
- Option A (better schedule) is mainly outpatient with some hospital rounding, affiliated with the Norwegian American hospital in Chicago.

- Option B (tight schedule) is 100% hospital based, is said to be "affiliated with ACGME accredited teaching hospital" which my guess is Jackson Park hospital in Chicago.

Do you think option A is the more sensible choice still? And if the physician is affiliated with a hospital, is it considered a connection if I do end up applying for a residency at said affiliated location? I'm sorry I just never understood the importance of affiliation vs where I actually end up rotating.

Once again, thank you in advance!

 

[GoSpursGo]

Thank you for your reply. I am indeed planning on taking step 1 before it goes pass/fail, and sadly yes I will heavily rely on studying during that time period as my dedicated study is somewhat short.

That being said, I'd like to add this
- Option A (better schedule) is mainly outpatient with some hospital rounding, affiliated with the Norwegian American hospital in Chicago.

- Option B (tight schedule) is 100% hospital based, is said to be "affiliated with ACGME accredited teaching hospital" which my guess is Jackson Park hospital in Chicago.

Do you think option A is the more sensible choice still? And if the physician is affiliated with a hospital, is it considered a connection if I do end up applying for a residency at said affiliated location? I'm sorry I just never understood the importance of affiliation vs where I actually end up rotating.

Once again, thank you in advance!

I feel like it’s impossible to offer solid guidance here—option B probably looks better, but option A will give you better protected studying time. Only you can gauge how choosing option B might affect your score based on how you’re scoring on practice exams now.

 

[Vagueclient]

I feel like it’s impossible to offer solid guidance here—option B probably looks better, but option A will give you better protected studying time. Only you can gauge how choosing option B might affect your score based on how you’re scoring on practice exams now.

Thank you for your response. You are absolutely right, and I feel I will end up going for option A just so I would have more time to focus on studies. I was only worried that Options A's (better schedule) letter is on a private letterhead rather than a hospital letterhead as offered by Option B (strict schedule); but as you previously mentioned, what likely matters is the affiliation with a well-known institution.

Do you think the Norwegian American hospital (Option A) is a better known center than Jackson Park hospital (Option B)?

Update: I just learned that I will be unable to join a residency in either location because they do not sponsor any visas. So I think your point about being a more well-known academic center is more pronounced now since I would apply for the residency at a totally different location.

Thank you in advance, I do really appreciate your input.

 

[rokshana]

Thank you for your reply. I am indeed planning on taking step 1 before it goes pass/fail, and sadly yes I will heavily rely on studying during that time period as my dedicated study is somewhat short.

That being said, I'd like to add this
- Option A (better schedule) is mainly outpatient with some hospital rounding, affiliated with the Norwegian American hospital in Chicago.

- Option B (tight schedule) is 100% hospital based, is said to be "affiliated with ACGME accredited teaching hospital" which my guess is Jackson Park hospital in Chicago.

Do you think option A is the more sensible choice still? And if the physician is affiliated with a hospital, is it considered a connection if I do end up applying for a residency at said affiliated location? I'm sorry I just never understood the importance of affiliation vs where I actually end up rotating.

Once again, thank you in advance!

What is your goal for the elective?
An elective in name only to get time to study or an elective that gets you a great LoR?

Sounds like the hospital based one is with an actual residency program...and office based one is just that...

Personally would go with the elective that is with a residency program.

 

[Vagueclient]

What is your goal for the elective?
An elective in name only to get time to study or an elective that gets you a great LoR?

Sounds like the hospital based one is with an actual residency program...and office based one is just that...

Personally would go with the elective that is with a residency program.

Thank you for your response.

Just for reference:
Option A is affiliated with the Norwegian American hospital, but the elective is mainly done at a clinic - good for studying.
Option B is affiliated with "an acgme accredited teaching hospital" which I assume is Jackson Park hospital, where the elective is held at entirely - strict for studying.

I agree, ideally I would love to do the elective which is done at the hospital. But as I mentioned before, studying during the elective period is going be very limited if I do so. So I was trying to figure out if do apply to the more relaxed schedule elective (Option A), which isn't hospital based, and whose letter is on a private letterhead would be objectively worse than the hospital based, strict schedule (Option B).

If the difference is major, then I might consider rescheduling my entire study program. But assuming both letters from Option A and B are identical in strength, then I would go for option A that offers a more suitable schedule.

As I mentioned in my last post, both options do offer residency programs, Option A at the affiliated hospital, and Option B at the same hospital, but I am unable to join either unfortunately as they don't offer a visa sponsorship. So it all boils down to the strength of the LOR, do both options hold similar weight when used to apply for a residency in a different location - this is my exact point of confusion.

 

[rokshana]

Thank you for your response.

Just for reference:
Option A is affiliated with the Norwegian American hospital, but the elective is mainly done at a clinic - good for studying.
Option B is affiliated with "an acgme accredited teaching hospital" which I assume is Jackson Park hospital, where the elective is held at entirely - strict for studying.

I agree, ideally I would love to do the elective which is done at the hospital. But as I mentioned before, studying during the elective period is going be very limited if I do so. So I was trying to figure out if do apply to the more relaxed schedule elective (Option A), which isn't hospital based, and whose letter is on a private letterhead would be objectively worse than the hospital based, strict schedule (Option B).

If the difference is major, then I might consider rescheduling my entire study program. But assuming both letters from Option A and B are identical in strength, then I would go for option A that offers a more suitable schedule.

As I mentioned in my last post, both options do offer residency programs, Option A at the affiliated hospital, and Option B at the same hospital, but I am unable to join either unfortunately as they don't offer a visa sponsorship. So it all boils down to the strength of the LOR, do both options hold similar weight when used to apply for a residency in a different location - this is my exact point of confusion.

Your assumption that a letter from an academic residency program and an outpt clinic is flawed...they won’t be...the letterhead isn’t the issue here...the strength of the elective is...even the classic outpt heavy specialties like endo and rheum generally will have an inpt component and the student is generally expected to participate in things like morning report, noon conferences, and grand rounds...will that outpt rotation have that?
Again, if your goal is to study but still look like you are on an elective, then take the one that gives you study time...I did this with a radiology rotation to be able to study for step iii as an intern...rads residents really didn’t care if we showed up and in fact one told me that if I wasn’t going to come, I didn’t need to call him to let him know.

 

[Vagueclient]

Your assumption that a letter from an academic residency program and an outpt clinic is flawed...they won’t be...the letterhead isn’t the issue here...the strength of the elective is...even the classic outpt heavy specialties like endo and rheum generally will have an inpt component and the student is generally expected to participate in things like morning report, noon conferences, and grand rounds...will that outpt rotation have that?
Again, if your goal is to study but still look like you are on an elective, then take the one that gives you study time...I did this with a radiology rotation to be able to study for step iii as an intern...rads residents really didn’t care if we showed up and in fact one told me that if I wasn’t going to come, I didn’t need to call him to let him know.

Thank you for your reply. I have attached the exact description of Option A (good for studying) for your opinions on it. It is a Family Medicine elective.

Would you recommend that I ask further about some points, for example the exact day to day schedule such as morning reports, or conferences? And if you have any other recommendations I'm more than happy to hear them.

Thank you for sharing your experience as well; the radiology rotation that you did does indeed sound similar in several ways. If I may ask, did you face any issues with the LOR you received from the radiology rotation if you used it to apply for a residency down the line? Or have you had any regrets for chosing that rotation?

 

[fecalith]

Both of them are a waste of time if they are rotations through one of the 'infamous' observership agencies.
However, if you really want to do one of them, I would go with option B. Hospital letterhead and hospital rotations DO actually matter. Nobody cares about an outpatient experience you may have had.
This year I had 21 Interviews, 'been there done that!'