Should I or Shouldn't I???

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I'm confused.

That's like saying no one will write you a strong letter because they don't want you to match elsewhere.

If you can get a strong letter from a good attending, do it. I wouldn't try and overthink this.
 
Agreed. You'll still need a letter, even for the location that you're auditioning at, so I doubt they would write something detrimental. Also, if the person honestly likes you and has your best interests in mind, they will understand that you will apply at other places and may not rank them #1.
 
TweetyPie said:
I'm having a tough time figuring out whether this will be an advantage or liability....everyone says and strives to get an Attending LOR or even better a Program Director LOR while rotating at a residency program they are interested in, right?

Here's my deal: Currently, I'm doing an away/audition rotation. The Program Director has taken a real liking to me giving me an impression that I really might have a chance to match here.

And so naturally, I was thinking about asking him for an LOR. But here's the deal....I got to thinking....if I was a program director and I really liked a student and intended to rank them the highest, why would I want to write them a "glowing" recommendation when that recommendation would be used for other programs, thereby increasing the chance that the student would match elsewhere???

I mean, it seems like the incentive would be to write a mediocre recommendation, wouldn't you think? (BTW, in this case, the committee chairman is the Program Director and makes the final decision of who gets in).

Any insight anyone?
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I agree with you. You have a dilemma. You could use the letter only for that program if it really is bugging you too much.
 
wow, way to flatter yourself. you must have made quite an impression that a doctor, a program director no less, would try to find a way to sabotage your application in order to keep his star medical student a secret to other schools.

newsflash, medical students are not that important.
 
TweetyPie said:
No...."that's like saying".... there is a conflict of interest because in my case, we're not talking about a huge teaching hospital with numerous attendings where committee members (to include the PD) have an equal vote. As is common, in a case like that using a PD LOR in the PD's own program would be beneficial.

At this particular program, the committee members consist of the PD, one other attending, and a couple of residents.

To you, it may be "overthinking", to me it is obvious. However, I do concede that I may not get a thoughtful reply to this since undoubtedly I am not the first to be in this situation.
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Get the letter, you can always have your advisor or dean vet the letter before you actually use it for eras and if it is "evil" as you think it might be simply not use it.

Again, you are overthinking and it is NOT obvious.
 
In rethinking, if this guy liked you, he'd be the foolish one to write you a mediocre letter.
 
So that's why I keep getting bad LOR's. Its not that I'm doing bad, its that I'm doing TOO GOOD, and all the PD's want to keep me for themselves! :horns:
 
General tactic of keeping a student I would think is less likely to be "writing a mediocre LoR" and more likely to be "delaying sending out the GREAT LoR they wrote".

Delaying till like End of Oct and start of Nov...
 
TweetyPie said:
I'm having a tough time figuring out whether this will be an advantage or liability....everyone says and strives to get an Attending LOR or even better a Program Director LOR while rotating at a residency program they are interested in, right?

Here's my deal: Currently, I'm doing an away/audition rotation. The Program Director has taken a real liking to me giving me an impression that I really might have a chance to match here.

And so naturally, I was thinking about asking him for an LOR. But here's the deal....I got to thinking....if I was a program director and I really liked a student and intended to rank them the highest, why would I want to write them a "glowing" recommendation when that recommendation would be used for other programs, thereby increasing the chance that the student would match elsewhere???

I mean, it seems like the incentive would be to write a mediocre recommendation, wouldn't you think? (BTW, in this case, the committee chairman is the Program Director and makes the final decision of who gets in).

Any insight anyone?
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Hi there,
If the Program Director was your preceptor, then they will write a letter of rec for you. If not, but you have a good relationship, the PD will write a LOR for you provided you ask.

No medical student is that much of a "gem" that one letter will make any difference in you matching or not matching at any particular program. This program director has no idea of other programs that you will apply to unless you have discussed these matters (and you could have been lying). No Program Director cares that much about one student that they would stick their neck out to sabotage the career of said student.

If you are a good student and have performed well in your clinical rotations, you should have a stack of great letters (which you choose to send) for your ERAS and you won't need that letter anyway.

If you are such a great match for any particular program, then you will be interviewed by other members of the faculty at said program (in addition to the PD) who will evaluate you and your application. If for instance, the PD did write a letter as you have described, the other faculty members would be very hesitant to rank you at that program anyway.

You scenario doesn't make sense if the PD really wants you in the first place.

njbmd 🙂
 
TweetyPie said:
I appreciate your reply but it is "glowing" versus "mediocre", not "evil". I have outstanding 3rd year LORs that the programs have already received and to replace any of them with a mediocre letter would be foolish.

As a reminder of my OP, let me be succinct: If I was a PD (having the final say in who is admitted) and I wanted a student to come to my program and they requested a letter from me, it would be present within my mind that the student would use it for other programs. Hence, I would then have a difficult time writing an unbiased letter (in this case I would be tempted to tone it down to exclude the more steller comments).

The vetting suggestion would be subjective and impractible.
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A.) Letters are always somewhat subjective. Having an impartial reviewer may help. Even having a biased reviewer may be useful if you know the bias.

B.) With that attitude, where you would be willing to consider sabotaging the potential career of a talented student/physician for personal gain, you have no business being in any position of authority.

Consider what you said: It tells the world you are willing to alter the truth or at least minimize the truth for personal gain.

This is the height of professional dishonesty.

If you would consider doing it for a professional credentialling document such as a letter of recommendation, would you also alter a transcript? do it in a medical record? If not, how is this any different? Your thinking process demonstrates a serious lack of intellectual and personal ethics.

I suggest you find a good counsellor, parish priest, or someone like that outside of your school where you can meet and discuss in private these issues and explore how you can develop a sense of personal ethics and honesty.
 
Tweety,

I know you have been unwilling to accept the responses of others earlier, but I have to say I agree with them. I do think you're putting too much weight into a) a letter (most candidate decisions are initially made on scores and whether the person is a known entity and then after the interview on "fit/personality") and b) how that letter affects your matching ELSEWHERE.

Matching is not about getting a good letter, although it is certainly part of it. Any PD will know that while a good LOR from him may elevate you in the eyes of another program, the most important thing is HOW YOU RANK YOUR PROGRAMS. Therefore, it doesn't make a hill of beans difference if his letter sways other programs to rank you highly if you don't rank them highly.

If you rank the program at which you're rotating at at the top of your list and they do the same for you, it won't matter where other programs rank you and how much (if any) effect his letter has.

I'm not sure if we're missing something else in your query here.
 
TweetyPie said:
Hello Dr. Cox 😀

Look. This was a query in which the content of the OP reflects a reasonable observation, and thereby requests what is the general view. That's all. Instead, I was taken down a road of hyper-personalization.



Okay.

(1) My scores are at a competitive level for this specialty and I've made the cut for the programs (there are 8 total programs for the speacialty I'm apply to);

(2) I am a "known entity";

(3) The PD/attending and all the residents have given me good feedback so I take that as being a good "fit/personality" for the program (and we're all having such a darn good time 🙂 );

(4) Since there are only 8 programs for this specialty, all of the PD's (a) know each other, and (b), a sub-competitive environment exists between these 8 programs. Therefore, a letter takes on a greater significance.

Prioritized residency selection criteria for sites one does a rotation at:

(1) Board scores;
(2) Clinicals; (#'s 2 & 3 may be interchangeable)
(3) LOR's;
(4) Your personality and how it interacts with the rest of team (#'s 4 & 5 may be interchangeable)
(5) Research (depending on the specialty)

And so on....

In general, the weight I place on LORs is according to this list. I add extra weight to an LOR when only 8 programs are involved and when it also comes from a PD attending who is practicing in the specialty vs. let's say, a faculty LOR (non-Ph.D candidate).




Of course, this goes without saying, but where you rank the program and where the PD ranks you never comes into play at this stage. I haven't discussed ranking with him and I don't expect him to bring it up. It's usually bad form in asking, and I believe if the issue is ever raised by any of us, the Match rules frown upon or prohibit it entirely. At the end of the rotation, more than likely we will not know where we stand rank-wise.
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Perhaps I am not understand where you are coming from because it seems like we are talking about different things here. I understood you to be concerned that a certain PD might write you a mediocre LOR in an effort to "prevent" or at least curtail other programs from being "too" interested in you. This is in contrast to the wonderful experience you are having and belief that your LORs from this rotation will be great.

I'm not suggesting you aren't competitive or that you weren't a known entity. But rather that the decisions about inviting someone for an interview and then ranking them are not based on the letter - you've even given a list of the potential factors in ranking residency applicants and LORs are 3rd, beind scores and grades. I might agree that the first two are important in interview invites and perhaps even the personal statement (for programs that aren't totally about the numbers) but that LORs don't come into play really until you have interviewed. Now you are applying to a small and competitive specialty so it is true that in that case, "who you know" is probably more important than in most, so I wouldn't discount that LORs in your field are more important, even at this stage of the game, than in other larger fields.

I also am not suggesting that you ask the PD whether or not they will be ranking you. I agree - its bad form, and probably not necessary at this point. Let them broach the subject.

However, I am still confused because it seemed as if you wanted to know the general consensus about whether we thought that the scenario you painted was realistic. The majority of the posters here and I agree, feel that it is not. We feel it unlikely, unprofessional and unethical that a PD would write a good candidate a mediocre letter to curtail other program interest in that candidate. However, if you feel so strongly that this individual WOULD engage in such actions, then don't have him/her write the letter. I thought I and the other posters were clear about this, so am therefore concerned that perhaps I(we) are missing the point. 😕
 
It also seems that the OP is not really asking a question ("Should I or Shouldn't I???"), but rather looking for validation of her own opinion. If that's the case, our differing opinions aren't going to matter much.
 
Tweety,

Make it easy for yourself. There's such an easy solution: just don't waive your right to view the letter.

Thus, after you get the LOR, you can read it for yourself and then decide whether or not you're going to submit. In my opinion, a LOR that has been seen by the applicant is not viewed any less favorably than a LOR that has not been viewed by the applicant.
 
TweetyPie said:
Sorry to hear you did so poorly on your clinicals or perhaps it is my signature line and/or America that provoked this supposed familiararity with a complete stranger.
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what in the world are you talking about? i didn't even notice your signature until you pointed it out. again, you are not that important. 🙄
 
TweetyPie said:
I have outstanding 3rd year LORs that the programs have already received and to replace any of them with a mediocre letter would be foolish.

.
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I'd be inclined to agree with what people are saying here...Honestly I doubt that he would intentionally write a subpar letter to keep you as a secret to himself...

That said, if the idea of this conflict of interest really makes you uncomfortable about what would be in the letter, and if you have enough LORs, and they're all great, then just don't get the letter. Your recs will still be great and you won't have to spend your time worrying about this.
 
TIVA said:
In my opinion, a LOR that has been seen by the applicant is not viewed any less favorably than a LOR that has not been viewed by the applicant.
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ehh...I don't know.

Clearly it's not always the case, but I think it says something to the reader that you didn't have enough trust in either the other person or your own performance to allow them to write their unobserved opinion.

Personally I would avoid doing this.
 
TweetyPie said:
Just so it's crystal clear, my question was never about nor did it imply some kind of nefarious plot of "sabotage" as more than one poster has supposed here. It was simply a meandering thought that I decided to pose to see if anyone else had even considered it before.

I think perhaps that you are missing the point. Let me give you an example:

Mr. PD just sat down to begin writing the LOR. Then he begins to think to himself, hmmmm, I know Suzy Candidate is rotating at Joe's program next month. "Yeah, I remember last year he ended up with Jim Candidate who we ranked very highly". So then, Mr. PD commences to write the LOR. He begins by saying, I had the priviledge of having Suzy on my service....she was

(A) a great student
(B) she was the best student I've seen since becoming an attending

Instead of writing how he really feels, "she was the best student I've seen..." (letter (B)), he writes, she was "a great student" (letter (A)). Now, writing "a great student" would not be considered "sabotage". In fact, most would probably consider it a good and useful LOR, right!

With respect to this matter, A PD failing to fully disclose how they feel about a candidate in an LOR would be ethical violation only when the result would commonly be considered a poor or untruthful LOR. And to think stuff like this doesn't go on is just naive.

Please read my OP. You will find two predominant things there, (1) whether I should ask the PD for an LOR (considering that I have outstanding LORs from third year in this specialty), and (2), do people think that a PD would write a good ("mediocre") LOR versus a steller, which would be a more accurate representation, in an attempt to prevent one from matching elsewhere.

And just so it's crystal clear, my question was never about nor did it imply some kind of nefarious plot of "sabotage" as many have supposed here. It was simply a meandering thought that I decided to pose to see if anyone else had even considered it before.



Shouldn't be any confusion there, the "general concensus" was precisely what I was after and perhaps any anecdotal evidence.



I never said that I disagreed with the majority of the posters. Perhaps, you mistook the absence of concession as disagreeing. Or confused my response to those posters who failed to give a direct answer but rather made an attempt at ridicule, brow-beating, and a supposed familiarity about who I am, as disagreeing.

I can't say that it does go on or not, but then nor can you, right? I've seen worse. Of course, the proof of whether it goes on would be a post from someone who has first hand knowledge of it occuring. In the absence of that, it would be unwise to concede that it catagorically does not occur, wouldn't you agree with this???



Wrong inference, Dr. Cox, never said that. I happen to think this particular PD is the greatest. I can't go on enough of how kind and supportive he has been to me. I admire him as a person and tremendously admire his skills. But objectivity must always predominate the conclusions we make, no matter how we subjectively feel. I don't think this PD anymore than any other PD would engage in such tactics.
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I'm short of giving up because I don't think you understand my posts anymore than you think I am misinterpreting yours.

I never meant to imply that you believe there to be a nefarious plot to sabotage your application. I truly believe you like this PD and were asking whether or not the situation could arise.

I understand your analogy that perhaps someone would be less than flowery than usual in the LOR hoping the candidate would not match elsewhere. I stand by my contention that it is very unlikely in most circumstances.

Do I know for a fact that does not go on? NO, of course I don't but perhaps my more optimistic outlook on life affects my ability to respond to this question. Perhaps I am naive, but after years of experience in the resident match process, I have yet to see faculty attempt to manipulate the match process in such a way. I'm sure somewhere it happens and maybe it will happen in your case, its just that the scenario you have given is not one I've heard of before - either in my experience, anecdotally from friends in other fields, or on these and other medically related boards. Therefore, I tend to believe that it is not something worth considering.

I DO think you should ask this PD for an LOR if you feel that it would enhance your application. I never meant that you thought he/she would write but rather if it were a consideration, then you should rethink asking him/her for the LOR. I never claimed you "said that" (ie, that the person would write you a bad letter). And if the above makes you so worried, then you should either forget about getting an LOR from this individual or not waive your right to see the letter.

But your last line that you don't think this PD anymore than any other PD would engage in such tactics should guide you to your answer. I think it apparent that most of us here have never heard of such antics going on, have never considered it a problem when applying for residency and that while some were apparently taken as being curt with you, the end result is that most of us agree that this isn't something worth worrying about. Maybe we're all living in La La land.
 
If I may ask, what specialty are you applying to?
 
TweetyPie said:
Very thoughtful, balanced, and reasonable post.

By way of SDN, I've watched your progression from Australia to Hershey, to....I believe you're doing a breast fellowship now??. There's one thing that I've always admired about you, Dr. Cox, and that's is the ability uncommonly found in these days to always leave a margin for things you may not know. And within that margin is where you keep your humility and grace.

Most med students and physicians these days put forth an effort maintain an infalliable front. As usual, I appreciate and respect your presence on SDN.
Click to expand...

Thanks - I reread my post and worried that it came off a bit curt sounding. I am indeed doing a Breast fellowship and will be looking for a job soon.
 
Shane2150 said:
If I may ask, what specialty are you applying to?
Click to expand...

With all the mental masturbation going on here, I would bet he/she is applying to Internal Medicine 🙂

Keep it simple: Ask for a letter and calm down.
 
TweetyPie said:
I'm having a tough time figuring out whether this will be an advantage or liability....everyone says and strives to get an Attending LOR or even better a Program Director LOR while rotating at a residency program they are interested in, right?

Here's my deal: Currently, I'm doing an away/audition rotation. The Program Director has taken a real liking to me giving me an impression that I really might have a chance to match here.

And so naturally, I was thinking about asking him for an LOR. But here's the deal....I got to thinking....if I was a program director and I really liked a student and intended to rank them the highest, why would I want to write them a "glowing" recommendation when that recommendation would be used for other programs, thereby increasing the chance that the student would match elsewhere???

I mean, it seems like the incentive would be to write a mediocre recommendation, wouldn't you think? (BTW, in this case, the committee chairman is the Program Director and makes the final decision of who gets in).

Any insight anyone?
Click to expand...

I think most physicians are ethical and mature enough to not try to sabotage applicants success elsewhere. I received a very strong letter from a program director who was sure I'd be joining them next year (and even introduced me to his residents as a future colleague). Ultimately my plans changed and he was willing to help me work towards my goals realizing that it was unlikely he'd be training me. Obviously program directors want the top canidates but I think they also want top canidates who want to be there. If you truly want to be at his program more than anywhere else you'll rank it #1 and if he deems you as competitive as you think he does he'll rank you highly and you'll match there. I really think the whole mind games around the match is more played up than reality. Sure there are students and program directors who play games, I went to school with a bunch and encountered several program directors on the interview trail (one who's program I didn't rank at all because he was very annoying and wanted me to commit that I was ranking their program #1 in order to be assured they would rank me--his program was a borderline rank for me to begin with and he pushed them to a no rank so it wasn't a big deal for me and I'm guessing it wasn't really that he thought I was super amazing but more that he operates this way with all canidates so it probably wasn't a huge deal to him either--although they didn't fill that year so his games didn't work)but I think they are a lot less prevalent than you would believe from SDN threads.

At any rate best of luck with the match. :luck:
 
and I thought this application process had made MY sphincter tight. I feel much better after reading this thread.
 
All this for just a question.

Tweety, when you ask a question, you are going to get lots of answers.

NOW YOU HAVE LOTS OF ANSWERS.

Good luck with you choice based on your own decision making ability and some of the input you asked for in you question.

P.S.

Next time if you did not really mean to ask a question, don't phrase it as such.


WILL SOMEONE PLEEEEEASE CLOSE THIS POST.
 
TweetyPie said:
Very thoughtful, balanced, and reasonable post.

By way of SDN, I've watched your progression from Australia to Hershey, to....I believe you're doing a breast fellowship now??. There's one thing that I've always admired about you, Dr. Cox, and that's is the ability uncommonly found in these days to always leave a margin for things you may not know. And within that margin is where you keep your humility and grace.

Most med students and physicians these days put forth an effort maintain an infalliable front. As usual, I appreciate and respect your presence on SDN.
Click to expand...
Wow, if your clinical skills are as good as your butt-kissing ones I wouldn't worry about a thing.
 
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