LOR which specialties

[nortomaso]

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I'm wondering what's the right balance of letters of recommendation. Specifically, I have three solid letters from psych attendings. I have two possible medicine and family medicine letters, but don't think they will be as emphatic. Is it better to have three great psych letters or two great psych letters and a good medicine letter? Duke states explicitly that they require at least one internal med letter, but I didn't see such requirements on most of the other program websites.

 

[mosche]

I'm still trying to get this all organized as well; but, according to my PD, four is a good number to have submitted to ERAS. She said that it is a good idea to have one from a medicine physician, since you will likely have to a medicine rotation during PGI or, perhaps, PGII. Good luck at Duke -- perhaps we'll meet on the interview trail!

 

[Anasazi23]

I think the best formula is to have 2-3 psych letters, and one medicine letter. You'll find that most places require only three letters to begin with, so you'll have to choose the best two psych letters. A medicine letter shows that you're not a psychiatry one-trick pony, and can adapt and be competent in your other major rotation of your PGY-1 year.

There's a lot of medicine in psychiatry - a positive medicine letter can be valuable. That said, it wouldn't be too bad if the remaining letter was from FP, peds, or even neurology. All in all, however, I think the most successful formula is the 2-3 psych, and one medicine.

Good luck folks.

 

[nortomaso]

Thanks for the advice. One more question on this topic: when programs suggest an internal medicine letter, do they specifically mean a letter from a general medicine floor rotation or does a subspecialty elective (which is often outpatient: ID, endocrinology, rheum) fall under the rubric of medicine?

 

[atsai3]

Thanks for the advice. One more question on this topic: when programs suggest an internal medicine letter, do they specifically mean a letter from a general medicine floor rotation or does a subspecialty elective (which is often outpatient: ID, endocrinology, rheum) fall under the rubric of medicine?

i have always understood this to mean "get a letter from your inpatient medicine core clerkship". i'm told that the subspecialty letters don't mean nearly as much (unless, of course, you are applying for something like ENT and obtaining ENT letters from various away rotations and what not).

 

[Anasazi23]

I would tend to agree. "Medicine" in this case probably means general medicine - either your Sub-I or something similar.

 

[MDgonnabe]

i'd hope that the best letters would be letters from doctors who got to know you very well. unfortunately for me, not too many of the psychiatrists at my institution got to know me well during my clerkship (mainly because the rotation i was doing was in an isolated psych ed environment). but i think i'm making up for it on my psych sub-i... the other fields for me happened to be family practice and (of all things) gyn onc (long story that happens to relate to my interest in working with terminally ill patients). so yeah... i view the lor's as just another opportunity to show the pd's another side of who you are. choose by doctor, not specialty. 🙂

 

[nortomaso]

i'd hope that the best letters would be letters from doctors who got to know you very well. unfortunately for me, not too many of the psychiatrists at my institution got to know me well during my clerkship (mainly because the rotation i was doing was in an isolated psych ed environment). but i think i'm making up for it on my psych sub-i... the other fields for me happened to be family practice and (of all things) gyn onc (long story that happens to relate to my interest in working with terminally ill patients). so yeah... i view the lor's as just another opportunity to show the pd's another side of who you are. choose by doctor, not specialty. 🙂

MDgonnabe, I agree with your sentiments. I hate asking anyone who doesn't know me well enough to accurately portray an aspect of my character and abilities. I was just concerned by explicit requirements for "Internal Medicine" letters [actually, I went through the programs I am likely to apply to and only Duke and Longwood state this requirement]. I'm not sure how stringent they are about it; in another words, I'm concerned that some secretary tosses out all the applications that don't correspond to a checklist before the PD even sees them.

 

[MDgonnabe]

MDgonnabe, I agree with your sentiments. I hate asking anyone who doesn't know me well enough to accurately portray an aspect of my character and abilities. I was just concerned by explicit requirements for "Internal Medicine" letters [actually, I went through the programs I am likely to apply to and only Duke and Longwood state this requirement]. I'm not sure how stringent they are about it; in another words, I'm concerned that some secretary tosses out all the applications that don't correspond to a checklist before the PD even sees them.

hmmm... maybe you could call them up and ask them what happens if you'd prefer to substitute another letter that's somewhat related to internal med in lieu of a formal internal med letter. if they stated that as a requirement specifically, though, then chances are they probably do take it seriously for whatever the reason... that's kinda sad to hear. people should spend their ms 3's and 4's doing what they love, not kissing butts trying to obtain letters to fulfill requirements like this, especially if your grade and eval in medicine showed you were proficient at it.