How common is it for people to send supplemental materials directly to programs? Specifically, how many letters is too many? My ophthalmology advisor thinks that it's not uncommon for applicants to send 4-5 letters (with 1 or 2 being sent directly to programs), but I wanted to see what you guys thought about that. Do people send CV's directly to programs as well? I am concerned about annoying application reviewers by sending them too much paper. Do you think they would be upset or just ignore the supplemental materials? Thanks for your help guys!