Surgery vs. IM LOR?

[Thaitanium]

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Would Path PDs prefer one vs. the other, considering both are equally strong letters?

 

[mlw03]

i personally would think IM because IM is a more diagnostic type of specialty like pathology, while surgery is more procedurally focused.

 

[trent05]

I vote for the surgery letter. We deal with surgeons a lot more than IM's. Getting along well with surgeons is essential for a future surgical pathologist.

 

[TheCritic]

Well IMO I would say surgery but just barely. We deal with internists a lot in various aspects of clinical pathology e.g. Heme, Micro, TM, Cytogenetics, etc. etc. Also Heme/Onc docs are internists too. GI docs are internists....get the idea.

Obviously though your ability to interact with surgeons is extremely important in Anatomic Pathology, so the surgery letter wins by a field goal with thirty seconds left.

 

[Thaitanium]

Well IMO I would say surgery but just barely. We deal with internists a lot in various aspects of clinical pathology e.g. Heme, Micro, TM, Cytogenetics, etc. etc. Also Heme/Onc docs are internists too. GI docs are internists....get the idea.

Obviously though your ability to interact with surgeons is extremely important in Anatomic Pathology, so the surgery letter wins by a field goal with thirty seconds left.

Yeah I was thinking surgery too. I think surgeons might be more adept at attesting to your potential as a pathologist than an internist would.

I would be getting a letter from a hospitalist. So, I don't think a letter from a hospitalist would make a stronger impact than a surgery letter. But what do I know?

 

[Neddy]

Would Path PDs prefer one vs. the other, considering both are equally strong letters?

I'd definitely go with a letter from a general surgeon over a general internist, for reasons stated by others. However, there are certain medical subspecialties (i.e. GI and heme-onc) that may be as important as surgery in terms of their relevance to path. I found that demonstrating an up-to-date interest and familiarity with oncology was money on the path interview trail.

 

[yaah]

I'd go with whichever one is going to be better, and which one worked with you more and will say more about your good qualities. Which field it is (since it's not path) is a peripheral question and far less important.

 

[Fluble]

If I were a program director, that distinction would be irrelevant. I'd like at least one letter from a pathologist (or something related), and aside from that there's nothing that would really sway me related to what specialty they are from.

For me, the most important factors for any given letter are:

1) If the letter is from someone they know or heard of (maybe the surgeon who wrote your letter trained/worked at a hospital you are applying to)
2) If the letter says anything noteworthy or unexpected

In interviews, you will get questions about your letters, but they are essentially "why pathology?".

 

[CameronFrye]

I agree with yaah and Fluble, it really doesn't matter. The only one of my LOR's that was ever specifically mentioned in my interviews was the one that came from a big name pathologist. (Well, Dr. Fantone at Michigan went to med school with one of my other letter writers, so he mentioned that one.) If you have a LOR from a clinician, it's going to be mostly ignored, unless there is a red flag in there.

 

[mlw03]

so from the comments here by the residents, is it a fairly accurate generalization that unless a LoR comes from a well-known pathologist or says disparaging things about the applicant then it contributes very little to the application?

 

[trent05]

so from the comments here by the residents, is it a fairly accurate generalization that unless a LoR comes from a well-known pathologist or says disparaging things about the applicant then it contributes very little to the application?

Bingo!

 

[CameronFrye]

so from the comments here by the residents, is it a fairly accurate generalization that unless a LoR comes from a well-known pathologist or says disparaging things about the applicant then it contributes very little to the application?

Not exactly true. While having a great LOR from a big name pathologist is going to have a lot more "impact factor" and will open more doors, a great LOR from any pathologist is going to help you. I don't know if the same can be said about a great LOR from a clinician.

 

[yaah]

so from the comments here by the residents, is it a fairly accurate generalization that unless a LoR comes from a well-known pathologist or says disparaging things about the applicant then it contributes very little to the application?

No, no one said that at all. Well, one person said it would be ignored, but that's not accurate. What was said is that the best type of letter is one that can speak to your skills and talents in a positive fashion. And you need a letter from a pathologist. If it is a "big name" pathologist it may help a bit, but not if it's just a generic form letter.

They may not comment in your interviews about letters from the IM attending who thought you were the greatest student ever, but they will take it into account.

 

[mlw03]

No, no one said that at all. Well, one person said it would be ignored, but that's not accurate. What was said is that the best type of letter is one that can speak to your skills and talents in a positive fashion. And you need a letter from a pathologist. If it is a "big name" pathologist it may help a bit, but not if it's just a generic form letter.

They may not comment in your interviews about letters from the IM attending who thought you were the greatest student ever, but they will take it into account.

thanks for the clarification. good advise as usual, yaah. obviously we all try to submit the "best" letters possible, but figuring out what exactly that means is sometimes tough.

 

[Thaitanium]

So how about three strong letters from pathologists. From what you guys are saying it seems as if three strong letters from pathologists would trump the "1 letter from pathologist and the rest from non-pathology specialties" combo.

I know some have talked about the latter "making you a more well-rounded applicant," but why not just go "all-in" with your stack and get three letters from pathologists. 1 from a community pathologist, 1 from research (an academic, university-based pathologist) and 1 from an academic pathologist you did a rotation with. If the latter combo were all strong letters I would think you would be more impressive than any other combo of letters.

 

[TheCritic]

So how about three strong letters from pathologists. From what you guys are saying it seems as if three strong letters from pathologists would trump the "1 letter from pathologist and the rest from non-pathology specialties" combo.

I know some have talked about the latter "making you a more well-rounded applicant," but why not just go "all-in" with your stack and get three letters from pathologists. 1 from a community pathologist, 1 from research (an academic, university-based pathologist) and 1 from an academic pathologist you did a rotation with. If the latter combo were all strong letters I would think you would be more impressive than any other combo of letters.

I don't think this is a good idea. Just my opinion but think about it, we're physicians too. Your application should be somewhat diverse in letters. People need to know that you're going to interact well with other physicians. IMO, this is a huge part of pathology. I think others are down playing the importance of at least having that one letter from a clinician. Maybe it doesn't matter if it is a 3 page testament to your abilities as a clinician, but I think you should at least have one.

 

[yaah]

As I said, the dean's letter will usually speak to that. Just get the three best letters you can. If they all happen to be pathologists (as in my case, which probably isn't that common), so be it.

 

[TheCritic]

As I said, the dean's letter will usually speak to that. Just get the three best letters you can. If they all happen to be pathologists (as in my case, which probably isn't that common), so be it.

I agree with this. If your best letters happen to be from pathologists then yeah sure use all three. But if you have at least one good letter from a clinician, I would throw that one in. Just my opinion.

 

[CameronFrye]

No, no one said that at all. Well, one person said it would be ignored, but that's not accurate. What was said is that the best type of letter is one that can speak to your skills and talents in a positive fashion. And you need a letter from a pathologist. If it is a "big name" pathologist it may help a bit, but not if it's just a generic form letter.

They may not comment in your interviews about letters from the IM attending who thought you were the greatest student ever, but they will take it into account.

"Ignore" was probably too strong of a term. If you have a strong letter from a clinician, it will be read and taken into account, but it's not going to make much of a difference. Honestly, after reviewing a lot of these LOR's, just about all of them say the same thing. Even a letter from a big-wig probably isn't that significant, but it does give your interviewer something else to talk about. As has been mentioned before, once you've been offered an interview, your final position on the rank list depends a huge amount on your interview day and your ability to stand out from the crowd. Ok, sounds easy enough. However, all of you will discover that your interview goes much more smoothly if there is something unique about you to talk about. Whether it's your previous research, your LOR from "big name pathologist", etc., it makes your interviews go much more smoothly. You want to avoid the interviews where 5 minutes into the interview, you get asked the dreaded, "So, do you have any questions for me?".

 

[Fluble]

You will be surprised by some of the comments that you get about your letters. Pathologists aren't big on ignoring things. Also you will likely have some interviewer who knows the pathologist(s) writing your letters whether they are "famous" or not.

Also, I don't know exactly how things work, but I had to fill out some form that said that I couldn't see my letters beforehand. It may not be possible to know which are your "best letters", you just have to kind of know who would write a good or meaningful one. Probably someone who doesn't write letters often will do the most personalized job. (At least, that was the case for me.)

Your letters will probably make a difference in subtle ways that you cannot really predict. One of my letters was from an FP doctor who said something to the effect of "he is good with patients". I'd say about 15% of interviewers asked something like, "if you are so good with patients, why do you want to be a pathologist?" I'm paraphrasing, but you get the idea. There were probably just as many interviewers who didn't read any of my letters who asked more or less the same question.

In the end, there are many more important things to your application, but letters can be sneaky good.

 

[yaah]

"Ignore" was probably too strong of a term. If you have a strong letter from a clinician, it will be read and taken into account, but it's not going to make much of a difference. Honestly, after reviewing a lot of these LOR's, just about all of them say the same thing. Even a letter from a big-wig probably isn't that significant, but it does give your interviewer something else to talk about. As has been mentioned before, once you've been offered an interview, your final position on the rank list depends a huge amount on your interview day and your ability to stand out from the crowd. Ok, sounds easy enough. However, all of you will discover that your interview goes much more smoothly if there is something unique about you to talk about. Whether it's your previous research, your LOR from "big name pathologist", etc., it makes your interviews go much more smoothly. You want to avoid the interviews where 5 minutes into the interview, you get asked the dreaded, "So, do you have any questions for me?".

It's true, people see what they want to see. If they like your candidacy (for whatever reason, be it research, your recommendations, your attitude on interview day, etc) they will look favorably on other parts of your application. If not, they will pay less attention. Which again goes more to your candidacy being a combination of everything in your application - the relative weight of different factors is different for everybody. For the "average" candidate board scores may be crucial. For the person with years of experience and publications, the board scores are minor. For the excellent interview with outstanding recommendations, the board scores are also more minor.

You can't really avoid the "do you have any questions for me?" though. I had one interview where that was the first thing the guy asked me, although he prefaced it by saying I was a great candidate and he didn't really need to know much else. If I can offer any advice to people about to start interviews, it would be to have many questions to pose in response to that statement.

 

[CameronFrye]

It's true, people see what they want to see. If they like your candidacy (for whatever reason, be it research, your recommendations, your attitude on interview day, etc) they will look favorably on other parts of your application. If not, they will pay less attention. Which again goes more to your candidacy being a combination of everything in your application - the relative weight of different factors is different for everybody. For the "average" candidate board scores may be crucial. For the person with years of experience and publications, the board scores are minor. For the excellent interview with outstanding recommendations, the board scores are also more minor.

Absolutely. There are no cookie cutter criteria.

You can't really avoid the "do you have any questions for me?" though. I had one interview where that was the first thing the guy asked me, although he prefaced it by saying I was a great candidate and he didn't really need to know much else. If I can offer any advice to people about to start interviews, it would be to have many questions to pose in response to that statement.

Very true, but you always want to at least delay the pain (but you're right, some interviewers will ask you that up front).

 

[b&ierstiefel]

Ditto with what yaah and other said. It doesn't matter what you go with...you want the stronger letter.

Now, if you're going for a lengthy letter and if surgery letters of recs are anything like their inpatient notes...maybe a letter from an IM doc specializing in infectious disease might do you well. I'm being sarcastic of course...