One of those LOR questions again

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JustPass

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Sorry if this questions has been beaten to death already but I could not get at solid answer in any of the threads/forums. Some say yes while some say no.

I'm applying to IM residency soon (or should have submitted it already for DO/AOA).
Is 2 LOR from attending enough (1 IM and 1 non-IM)?
My school write the Department chair letter (and Dean letter, which doesn't count toward letters per se ).

It's my understanding that Department chair letter count as 1, making my total LOR 3.
Should I try to get 1 more (not going to be any special if I do get one)?

Or, should I go with what I have?
Thank you all.

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Some programs require 4 LORs. When I applied, I had four. I would recommend personally having another one available just in case. You shouldn't submit more than 3 though to the programs which require only 3.
 
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Some programs require 4 LORs. When I applied, I had four. I would recommend personally having another one available just in case. You shouldn't submit more than 3 though to the programs which require only 3.
Old wive's tale. 4 is fine everywhere.
 
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Any thought on the 4th letter coming from a NEWLY attending??

not sure how the letter readers will know this if they're not at your institution unless they purposefully look up not just your LOR writers but also look at educational details about their residency/fellowship dates.... ain't nobody got time for that

it won't help if your writer writes, "in my 6 mos as an attending, after having worked with 20 students and written 5 LORs, I can tell you that this student is one of the best I have ever worked with" so I would hope they would write a better letter than that.

Unless your LOR writer has a wide reputation within their field, well-known good or bad, it won't matter to anyone reading it
 
Any thought on the 4th letter coming from a NEWLY attending??

It's better to have a very good letter from a relatively new attending who knows you well than a crappy letter from a Professor with a Name who doesn't know you at all. That being said, it's good to have a combo of both.
As I recall, I had one "chair" letter, two subspecialty letters (one cards, one pulm/crit), and one medicine letter. Medicine letter was from a guy who had been an attending for 4 years. It worked out fine.
 
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not sure how the letter readers will know this if they're not at your institution unless they purposefully look up not just your LOR writers but also look at educational details about their residency/fellowship dates.... ain't nobody got time for that

it won't help if your writer writes, "in my 6 mos as an attending, after having worked with 20 students and written 5 LORs, I can tell you that this student is one of the best I have ever worked with" so I would hope they would write a better letter than that.

Unless your LOR writer has a wide reputation within their field, well-known good or bad, it won't matter to anyone reading it

I agree, don't think it matters that much for general medicine unless the reputation is VERY well known of the attending.. which is rare... I honestly can't think of any "famous" general internal medicine attendings (correct me if I'm wrong though folks). It becomes much more important for subspecialty - having a cardiology letter written by a nationally famous cardiologist is worth it's weight in gold.
 
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I agree, don't think it matters that much for general medicine unless the reputation is VERY well known of the attending.. which is rare... I honestly can't think of any "famous" general internal medicine attendings (correct me if I'm wrong though folks). It becomes much more important for subspecialty - having a cardiology letter written by a nationally famous cardiologist is worth it's weight in gold.

on my trail it astounded me how many people, in leadership and even just residents, knew the people in my home program, even just attendings and not leadership

it's a smaller world than you think

there's a lot of networking and name-recognition that happens at a lot of the various meetings that docs attend, especially when they're specialty specific, and it feels like to me that the types that go to meetings go to enough for this to happen
 
on my trail it astounded me how many people, in leadership and even just residents, knew the people in my home program, even just attendings and not leadership

it's a smaller world than you think

there's a lot of networking and name-recognition that happens at a lot of the various meetings that docs attend, especially when they're specialty specific, and it feels like to me that the types that go to meetings go to enough for this to happen

Oh for sure. It helped me when applying for my sub-fellowship as well - name recognition and who knows who is an incredible help. I would say that it's even more self-selective in the academic world - in the private world most people are too busy working and grinding to attend a ton of meetings.
 
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lol except the programs I applied to that made it very clear more than 3 would be taken as a sign you can't follow simple directions, and to basically just not do it
Name one single program that requires 3 and no more than 3 letters. Every one I'm aware of that had a 3 minimum allowed 4 as well.
 
Here's one for you, just cuz I'm nice like that

This is what Vanderbilt tells its students, but why listen to them when we have you?

https://medschool.vanderbilt.edu/cim/letters-recommendation

Number of Letters
Most residency programs request three letters of reference. Sometimes they specify certain departments or rotations from which the letters should originate; be sure to follow directions from the program brochure. Occasionally, a letter from a person not involved in the profession of medicine will be requested. Do not send more letters than are requested unless you have one that is especially dazzling. Some selection committees suspect "the thicker the application, the thicker the student." Some programs review only the first letters to arrive up to the number they request and subsequent letters are ignored. Therefore, it is in your best interest to follow the "N + 1 Rule," i.e., if "N" is the number of letters requested, send no less than "N," but send no more than "N + 1."

Admittedly, they still suggest that one can send one more letter than requested, however they also advise that it might not be ideal.

My opinion was based on my experience being told not to send more than requested, I honestly can't recall to where since I went on over 20 interviews years ago.

My opinion was based on my belief, which is echoed elsewhere, that it is best to follow instructions to the letter. You may believe that it is OK to send more letters than requested. I do not, and I have provided information that I believe supports my view.

The rest of you have shared your opinions and disagree. That's all they are.

Application | Internal Medicine Residency

Application Process - UPDATED:
The deadline for submission of a completed application is October 7, 2017, and all of the following items are required:
  • Dean's Letter
  • Chair's Letter (can be Chair designee).
  • At least 2 other Letters of Recommendation (you can submit up to 3 letters)
  • Medical School transcript
  • Personal Statement
  • Curriculum Vitae in ERAS format
  • USMLE Step 1 score of at least 205
  • Medical school graduation date of 2015 or later
  • 4 weeks of U.S. hands-on clinical experience within the past 6 months (observerships are excluded)
  • Valid ECFMG Certificate, if applicable
I tend to be pretty big on following things to the letter, so I don't agree with Vanderbilt that you can go ahead and send one more than you are told to by a program. However, even Vanderbilt acknowledges that there are programs that will only ask for 3 and no more.

If you read the instructions from Penn and think you should send more than 3 letters, more power to you, I guess. Vanderbilt suggests it might not reflect well on you. I guess that's the chance each of us can take with our own apps.

Raryn, if that worked out well for you, I'm glad. As for me, I did not send more letters than requested. Things worked out well for me.

Application Information - Internal Medicine - Wayne State University

Required Documents for Application
  1. Letters of Recommendation -- In addition to a Dean's letter from a medical school, three letters of recommendation must be arranged to be sent through ERAS. These letters should attest to the applicant's personal qualifications and scholastic and clinical abilities.
Did Wayne State stutter? I didn't know 3 meant 4.

Applying to Residency: Information Item #7--Letters of Recommendation (LOR's) | Advising Programs for Medical Students

Dear class,

Each of you will need to acquire LOR's from at least 3 faculty members to support your residency applications (these are separate from the MSPE, which is not considered an LOR). ERAS will allow you to send 4 letters to each program (though some programs will only accept 3; you'll need to check with each program to see if they have restrictions on the number of letters).

I mean, why should students listen to the advising from their school if they go to GW? Following instructions is overrated.

Let's say what Vanderbilt says is true, and of your 4 letters, they'll only read 3. Let's say you have 3 solid letters, and you think one of your 4 might not be as stellar as #1, despite 2-4 being pretty good. How do you know which letter is thrown away by the program, never to be read?

Application Information
  • 3 letters of recommendation, including one departmental support letter (typically from the Chair of Medicine and/or Medicine Clerkship Director).
  • A fourth letter of recommendation will be accepted
Wow, it's almost like programs will spell out how many letters they want, and if they will accept a 4th. I guess you don't have to assume 3 means 4.

But why listen to clearly spelled out instructions, when more than one institution specifies what they want, and it's suggested that if you send more one which you can't specify, might be thrown away, when we can just listen to people on SDN who say not to bother with actually following directions from a program's website?

There's nothing to what I'm saying, of course. Send all the letters you want. I was told not to, but we each have our own experiences, I think.
 
Application

A completed application includes:

  • ERAS application form
  • Medical school dean’s letter (MSPE)
  • Department of Medicine letter (typically from the department chair or clerkship director)
  • At least two other letters of recommendation from faculty members (total of three letters including Department letter)
Maybe you guys aren't wrong that 4 is permissible. It just astounds me to say I'm wrong to say that you should just do what the ****ing programs tell you to. I was told this by my school, by programs, and this is how I interpret various websites.

I'm not sure why someone would risk sending too many, when they can just follow instructions.

I only used 3 letters total. It went great. I had more than one program interviewer tell me that I had some of the best letters they have ever seen. Yes, and I'll brag about it. One PD told me that in their 20 years as a PD, one of my letters was the best they had ever seen, and that it actually brought them to tears reading it. Yes.

I'm really glad I didn't send more than those letters, and that none of the ones I sent were trashed, or that it looked like I wasn't following simple directions.

Like all advice on SDN, grain of salt. Students can read a number of experiences and what I have posted here and decide how to proceed.
 
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