Recommendation Letter: Who should write it?

[cyanide12345678]

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I am heading into EM. I will have two SLOEs and 1 letter from my research PI who i worked with for 2 years. My head of the EM department told me that I need a 4th letter and that it can be from IM, Peds, or surgery. I've done very well during third year and have had several people offer to write letters throughout. Fortunate enough to be graduating top quartile at a top tier school. Now I'm having a tough time picking:

Option 1: IM attending - Pros: Saw me at the beginning of my 3rd year. Thought I was a "raw product" (below avg) med student starting out. Worked a lot with me, and saw significant improvement. Was very impressed by my progression, hard work, and effort towards self improvement that he predicted that I will be a clear honors student within a few weeks time. He played a tremendous role in my subsequent 3rd yr success. His comments on my deans letter are very personalized, detailed, and the best comments on my entire deans letter. I think his letter will be very personalized as well.
Cons: Newer attending. Kind of worked with him at my beginning of third year when I hadn't honed in presentation skills. Worked with him 1 yr ago, he may not recall who I was.

Option 2: IM attending - Pro: Vice chair of entire hospital. Really liked me and offered to write a letter when I was literally on my first ever rotation (first ever attending of mine).
Con: I think he didn't get to work with me as much as option 1. He will write a positive letter, but I think it will be more generic. Plus, he also worked with me when my skill level wasn't that great.

Option 3: IM attending - Pro: Thought I was one of the best medical student he has ever had. In my 2 weeks with him, had him say "dude you're so smart! You already know everything" about 10 times.
Con: Newer attending. Worked with him 1 year ago. Could end up being a generic letter (but he will likely say that I'm amongst the best medical students he has had - Followed by generic statements one can think of 😛).

Option 4: IM attending - Pro: Offered me a letter on rotation. Thought I was significantly above avg. And that my knowledge level was significantly above my level of training. Bumped into him a few times over the last yr.
Con: Worked with him 1 yr ago. Probably will be a generic "above average" medical student letter.

Option 5: Peds attending - Pro: Very recently worked with her, so she'll remember me very well. She was very impressed.
Cons: Newer attending. Only worked for 1 week with her!!!

Option 6: Family medicine attending - Pros Thought I was one of the best medical students to have rotated there. He was very impressed. 1 month long rotation, so quite a lot of exposure. He offered to write a letter. Worked with him much more recently (3 ish months ago).
Cons: Family med attending (I asked my head of EM department if family med works, he discouraged it and said stick to IM, Peds, surg).

Alright...please help me decide!!! What would you guys pick if you had to pick? Based on this information, which guy do you think will be the best letter writer?

 

[slopes23]

I am heading into EM. I will have two SLOEs and 1 letter from my research PI who i worked with for 2 years. My head of the EM department told me that I need a 4th letter and that it can be from IM, Peds, or surgery. I've done very well during third year and have had several people offer to write letters throughout. Fortunate enough to be graduating top quartile at a top tier school. Now I'm having a tough time picking:

Option 1: IM attending - Pros: Saw me at the beginning of my 3rd year. Thought I was a "raw product" (below avg) med student starting out. Worked a lot with me, and saw significant improvement. Was very impressed by my progression, hard work, and effort towards self improvement that he predicted that I will be a clear honors student within a few weeks time. He played a tremendous role in my subsequent 3rd yr success. His comments on my deans letter are very personalized, detailed, and the best comments on my entire deans letter. I think his letter will be very personalized as well.
Cons: Newer attending. Kind of worked with him at my beginning of third year when I hadn't honed in presentation skills. Worked with him 1 yr ago, he may not recall who I was.

Option 2: IM attending - Pro: Vice chair of entire hospital. Really liked me and offered to write a letter when I was literally on my first ever rotation (first ever attending of mine).
Con: I think he didn't get to work with me as much as option 1. He will write a positive letter, but I think it will be more generic. Plus, he also worked with me when my skill level wasn't that great.

Option 3: IM attending - Pro: Thought I was one of the best medical student he has ever had. In my 2 weeks with him, had him say "dude you're so smart! You already know everything" about 10 times.
Con: Newer attending. Worked with him 1 year ago. Could end up being a generic letter (but he will likely say that I'm amongst the best medical students he has had - Followed by generic statements one can think of 😛).

Option 4: IM attending - Pro: Offered me a letter on rotation. Thought I was significantly above avg. And that my knowledge level was significantly above my level of training. Bumped into him a few times over the last yr.
Con: Worked with him 1 yr ago. Probably will be a generic "above average" medical student letter.

Option 5: Peds attending - Pro: Very recently worked with her, so she'll remember me very well. She was very impressed.
Cons: Newer attending. Only worked for 1 week with her!!!

Option 6: Family medicine attending - Pros Thought I was one of the best medical students to have rotated there. He was very impressed. 1 month long rotation, so quite a lot of exposure. He offered to write a letter. Worked with him much more recently (3 ish months ago).
Cons: Family med attending (I asked my head of EM department if family med works, he discouraged it and said stick to IM, Peds, surg).

Alright...please help me decide!!! What would you guys pick if you had to pick? Based on this information, which guy do you think will be the best letter writer?

Seems obvious to me, of all the choices listed Option 1 is your best and most clear choice. His comments were already positive and a highlight of the deans letter. Sounds like he took an interest in you personally and was a major factor in contributing your growth as a physician to be. Finally, can speak to your ability to learn new things quickly and easily and continue to perform at a high level there after which is an important and often coveted trait. All these things also add to the increased propensity of the most personalized letter of the bunch compared to a generic letter. Otherwise, all the rest sound like they are at risk for being generic in nature. If you feel so inclined to go this route, then all things being equal letterhead matters -- so Vice Chair should be your next choice.

 

[doc05]

find out who writes the best letters, and take it from there.