"Dear [program director],
My name is [insert name] and I am a 4th year medical student who is scheduled to attend an Emergency Medicine rotation at your program in [insert month]. As part of the educational preparation for my residency training, I value your program as an integral part of my clinical and professional development. I see unique potential in your program that I feel will compliment my learning style and better prepare me for my residency experience.
As you may be aware, I have received a letter from your program informing me that I have not been invited to interview for a residency position. While I accept your position as likely a viewpoint of my own credentials that I need to improve upon, I am hopeful that during my rotation month with your program, you can help me identify these characteristics that need improvement, so I can mature and be a stronger resident as I pursue my career in Emergency Medicine.
I consider rotating with your department to be an opportunity that can only help me with my clinical, professional, and interpersonal development, and I look forward to working with you, your staff, and your residents. It is my hope that we can meet personally prior to the beginning of my rotation, and that your program can guide my focus, even for just a month of time, in the direction I will be best served for my future practice in our field. If you have any questions or need to contact me prior to the beginning of my rotation, I can be reached at [insert phone number].
Sincerely Yours,
[Insert Name]"
Mail this as soon as possible, and as far in advance of your rotation as possible. Call two weeks later to confirm receipt and schedule a meeting with the P.D. before your first shift. Ask to be scheduled for two shifts WITH the P.D. near the end of your month for on-the-job feedback. Be in that department every day, and work your ass off. Go out with the residents and know them. Get them to like you.
Most important - have fun.