LORs

[Pam_Beesley]

If one has two to three SLOES, do they really need a fourth letter? Someone told me yes. I can't imagine a non-SLOE would add any additional value at this point.

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[DrMcCoyDO]

If one has two to three SLOES, do they really need a fourth letter? Someone told me yes. I can't imagine a non-SLOE would add any additional value at this point.

The value is that you’ve got a fourth person who thinks you’ll be a competent physician. If you have fewer than four, programs may wonder if you were unable to get many physicians to write one due to some personal fault.

 

[Keladry]

No. I applied with 2 SLOEs + 1 EM LOR and that was it. Check program websites, but I know that none of the places I applied to required 4 letters.

 

[gro2001]

The value is that you’ve got a fourth person who thinks you’ll be a competent physician. If you have fewer than four, programs may wonder if you were unable to get many physicians to write one due to some personal fault.

Can't the same be said for four letters though? If only four people are willing to say you will be a competent physician but not five, that also does not bode well. Personally I'd want, at least like seventeen people to be confident in your abilities. We don't commonly advise people to get that many letters though.

 

[DrMcCoyDO]

Can't the same be said for four letters though? If only four people are willing to say you will be a competent physician but not five, that also does not bode well. Personally I'd want, at least like seventeen people to be confident in your abilities. We don't commonly advise people to get that many letters though.

True, but four letters is generally the limit for programs. You’re required to have at least 3, no more than 4. So while you CAN have only 3, some programs will be wary about an application with that many. It’s stupid, but it doesn’t make it any less the way things often are.

 

[Keladry]

True, but four letters is generally the limit for programs. You’re required to have at least 3, no more than 4. So while you CAN have only 3, some programs will be wary about an application with that many. It’s stupid, but it doesn’t make it any less the way things often are.

That's really not true for EM - SLOEs are pretty much the only thing that matter. You can have other letters, but they carry way less weight.

 

[RPedigo]

You should have three letters at least. Whether that be two SLOEs and one LOR or three SLOEs, that part doesn't matter. No program requires three SLOEs. I would only recommend having a 4th letter if you think you can get an additional strong letter and it can speak to something that wouldn't be in your SLOEs. Examples of this would be a letter from your research mentor if you are MD/PhD, letter from a longitudinal preceptor, etc. I wouldn't get a 4th letter if you don't think it would add anything to your application - because in that case, it won't!

 

[tamman55699]

What do you do if you have your 3 letters (2 SLOE + LOR) but will be getting a 3rd SLOE after 9/15? I plan on applying with what I have so far on 9/15, but is there a way to upload the 3rd SLOE later to programs? How is this done?

 

[RPedigo]

What do you do if you have your 3 letters (2 SLOE + LOR) but will be getting a 3rd SLOE after 9/15? I plan on applying with what I have so far on 9/15, but is there a way to upload the 3rd SLOE later to programs? How is this done?

Yes, you can assign SLOEs to programs after you submit your initial application. However, we don't get any specific update e-mails or anything whenever new letters are uploaded (we will see it in your file when we open/reopen it, though, because the LORs are listed with a timestamp next to them). If it's early October probably no notification needs to be done because people probably won't be reviewing the majority of the applications until after ACEP this year (early October). I would say if it's late October or later for your new SLOE you could reach out to programs and let them know you have a new SLOE uploaded to your file for consideration.

 

[Pam_Beesley]

SLOEs are signed by multiple attendings, so in theory, that’s more than two to three attendings who think I’d make a good physician. I don’t think the additional letter (which will be outside of EM) would add much. I’m thinking maybe I’ll get it and just not assign it. I don’t really want to waste that attending’s time. Also, it’s been a while since I worked with this attending. I can’t be 100 percent certain it won’t come from a template/be generic. (Got phenomenal feedback at the time though).

 

[Dares Dareson]

I've never heard of needing more than three letters. Maybe if the rest of your application is lacking. I'm rolling in with two SLOEs and one LoR and that's it.