LOR - To ask or not to ask?

[technach]

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I am an IMG who completed a 1 month clerkship in Canada. I asked my preceptor for a letter of reference and he hesitated for a second before saying okay. On the evaluation that he sent to my school, he wrote a 2 page report saying that I functioned at the "expected level" and that most of my skills were appropriate but also that I was hardworking, dependable, professional.
My dilemna: To ask him for a LOR or send 3 LORs of guaranteed content from my home school which is not in North America.
Thank you for the sugestion.

 

[medsRus]

If the doctor said that you functioned at an "expected level", that is really not a good recommendation. It would be terrible if such a mediocre evaluation will ruin your residency chances. Perhaps, going with the LORs from your home school that are secured already is the best option. Keep us posted...

 

[Winged Scapula]

yeah, that's a pretty weak eval. I would be nervous about getting a letter from him.

 

[technach]

If he sends in the letter but I decline to waive my right to see the letter, can I look at it before sending it to the programs (once it's up on ERAS)?

 

[Winged Scapula]

If he sends in the letter but I decline to waive my right to see the letter, can I look at it before sending it to the programs (once it's up on ERAS)?

Yes, if you decline to waiver but that looks suspect to most programs, pretty much rendering the letter useless anyway. So why bother?

 

[NotAProgDirector]

I believe the process might be a bit more complicated, and timing-wise not helpful for you.

When you "waive your right" to see your letter, it does not mean that the letter writer will automatically give you a copy of the letter. It means that you have the legal right to request a copy of that letter from whomever the letter has been sent to.

Because you are an IMG, you will be using the ECFMG as your Dean's office, and so your letter will go to them. You can request that the original letter be returned to you (assuming you have not waived your right to it). However, ECFMG plans to start honoring these requests in Feb 2010, which will be way too late for you decide whether it is a strong letter.

Thoughts:

1. You could not waive your right to see the letter, and request that the letter writer send you a copy directly. Some will be happy to do so. Some will be very uncomfortable with this request.

2. Honestly, if you see the letter, are you really going to be any better off? If it says "technach sucked", well that would be helpful to know. But if you're not waiving your right to see it, it's clearly not going to say that. It's probably going to say exactly what your eval said -- expected level.

3. Not having a letter from a US (or canadian) rotation may be seen as a red flag.

 

[peppy]

3. Not having a letter from a US (or canadian) rotation may be seen as a red flag.

This makes me wonder if it might be better to get the letter after all. If you don't have a letter, the programs might imagine that means there were problems on the rotation and the doctor thought you did a subpar job. That could arguably hurt you more than getting a simply "mediocre" letter.

 

[medsRus]

This makes me wonder if it might be better to get the letter after all. If you don't have a letter, the programs might imagine that means there were problems on the rotation and the doctor thought you did a subpar job. That could arguably hurt you more than getting a simply "mediocre" letter.

Good point... But, having shining letters from your home country can counteract this "potential" thought.

Also, it depends on which country the LORs you have are from? Where are you studying?

 

[canal]

A LOR can come from attendings , program director and chief residents right?

 

[Winged Scapula]

A LOR can come from attendings , program director and chief residents right?

Program Director IS an attending.

Chief Residents for the most part, even Chief Residents in IM, are not good sources for letters. Fair or not, they will not be taken as seriously as a letter from an attending.

 

[dragonfly99]

I think it sounds like you are going to get a mediocre letter, though likely not blatantly bad. It doesn't sound like the person is underhanded or plans to write a blatantly bad letter, just perhaps that she/he was not super impressed with you (but doesn't hate you).

I don't see a point in asking to see the letter...it might make the LOR writer not like you as well. Usually if someone doesn't waive the right to see the LOR's, they won't be taken as seriously. So I would not do it.

I can't answer the question of whether having 3 strong LORs from your home country and 1 mediocre Canadian letter is better than having just 3 strong LOR's from your home country b/c I just don't know enough. If you are not sure, I suppose you could consider sending the Canadian letter to some places, but not others. In other words, you could get 4 LOR's but only send your 3 "from your country" letters to certain programs. It might sound bizarre but it's kind of like hedging your bets I guess...just one idea.

 

[Winged Scapula]

ANother option would be to have the letter writer (from Canada) send your LOR to ECFMG and the provide them an envelope to send to your Dean's office (or equivalent). This only works if someone in your Dean's office will alert you if the letter isn't supportive and would know how American faculty interpret letters. It couldn't hurt, IMHO and you might be able to find out if the letter is mediocre without seeing the letter yourself and not waiving the right.

 

[technach]

.

 

[technach]

Good point... But, having shining letters from your home country can counteract this "potential" thought.

Also, it depends on which country the LORs you have are from? Where are you studying?

I study in Israel.

 

[technach]

I think it sounds like you are going to get a mediocre letter, though likely not blatantly bad. It doesn't sound like the person is underhanded or plans to write a blatantly bad letter, just perhaps that she/he was not super impressed with you (but doesn't hate you).

I don't see a point in asking to see the letter...it might make the LOR writer not like you as well. Usually if someone doesn't waive the right to see the LOR's, they won't be taken as seriously. So I would not do it.

I can't answer the question of whether having 3 strong LORs from your home country and 1 mediocre Canadian letter is better than having just 3 strong LOR's from your home country b/c I just don't know enough. If you are not sure, I suppose you could consider sending the Canadian letter to some places, but not others. In other words, you could get 4 LOR's but only send your 3 "from your country" letters to certain programs. It might sound bizarre but it's kind of like hedging your bets I guess...just one idea.

You hit the spot!