What makes a strong LOR for residency?

[dr.sartorius]

What in particular do residency directors look for in a LOR? What qualities/things do they want to see that make it a strong letter? Thank you🙂

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[colbgw02]

not an exclusive list, but:
1) the name at the bottom
2) the length and depth of the relationship

 

[operaman]

not an exclusive list, but:
1) the name at the bottom
2) the length and depth of the relationship

#1 above really should be bolded and all caps and in 36 pt font.

Ideally, you want a chairman or program director who knows you and will say you're the best student they've ever encountered and that you will be at the top of their own rank list. That's the sort of imprimatur you want to carry with you.

Beyond that, well known people who can vouch for you and tell detailed stories not only about accomplishments on your CV, but personal stories about how awesome you are.

 

[the argus]

not an exclusive list, but:
1) the name at the bottom
2) the length and depth of the relationship

#1 should actually be the 2 lines beneath the name at the bottom (i.e. title and institution), but otherwise, what s/he said

 

[dr.sartorius]

Thanks for the replies! Can anyone elaborate more on content. What types of things are they looking for in the applicant that they want to find in the letter, etc. Any specific qualities or traits?

 

[operaman]

Thanks for the replies! Can anyone elaborate more on content. What types of things are they looking for in the applicant that they want to find in the letter, etc. Any specific qualities or traits?

1) A statement that tells them how you compare to your peers (ie. best, top 5%, top 25%, above average, etc.)
2) A statement about how much they want you to match at your home program; there are varying degrees of this (ie. we will be ranking him vs. ranking highly vs. she will be at the top of our rank list and I sincerely hope she will stay here, but she will be an asset wherever she decides to go)
3) The name at the bottom (I'm just beating the dead horse, but it's a very important horse)

Those are really the crucial elements. Around that can be some relevant personal anecdotes, reiteration of highpoints from your CV, or additional words about how awesome you are, team player, etc., as these things can demonstrate how well the writer knows you. If someone was a research mentor, then some details about how you write, how well you manage multiple projects, how you work as part of the team, how you handle deadlines, etc., would be valuable information. Comments and examples of your work ethic, how you go well beyond the minimum required -- that kind of thing.

Even so, people will look first at the name, and then they will parse through it looking for clues as to your level of awesomeness.

 

[JP2740]

1. step 1 score
2. research
3. step 2 score
4. ???
5. LOR

 

[Wordead]

1. step 1 score
2. research
3. step 2 score
4. ???
5. LOR

For the smaller ultracompetitive fields, I'd put LORs and research above board scores.

 

[Kaustikos]

Thanks for the replies! Can anyone elaborate more on content. What types of things are they looking for in the applicant that they want to find in the letter, etc. Any specific qualities or traits?

One that doesn't screw you over.

 

[deleted390966]

How do you even get to know the Dean/chairman/director well enough so that they can write you a good LoR?

 

[the argus]

How do you even get to know the Dean/chairman/director well enough so that they can write you a good LoR?

Figure out when they are on service, and set up an elective/sub-I so you work with them.

This can be done a few different ways, i.e. talk to an advisor/mentor and get them to help set it up, talk to the administrative assistant, etc. You can also just email the person and say "I will be applying to [specialty] and a letter from you would be great for my application. I was wondering if I could set up a rotation where I could work with you" etc, etc.

Obviously you will want to make sure you word this request correctly so you come across as professional.

Remember, Deans/chairman/directors all were in your shoes once, so they know how the game works (and since they are in leadership positions, they are probably pretty good at playing the game as well). Most are kind and reasonable people who are happy to help.

 

[tiedyeddog]

2) A statement about how much they want you to match at your home program; there are varying degrees of this (ie. we will be ranking him vs. ranking highly vs. she will be at the top of our rank list and I sincerely hope she will stay here, but she will be an asset wherever she decides to go)

#2 was emphasized greatly during my interviews. My home program wrote about strongly recruiting me to join their program and I got great feedback on that everywhere I went. I was even told, that hypothetically, if the letter was glowing but at the end it said "he will do well wherever he ends up" instead of "we want him to join our program" then it is a bad LOR.

On the opposite side, I was often asked "It seems like your home program wants to keep you, why would you leave your home program?"

 

[tiedyeddog]

How do you even get to know the Dean/chairman/director well enough so that they can write you a good LoR?

1. go to their clinics
2. rotate on their service
3. scrub in with them/see their patients whenever possible
4. try to take call whenever they are
5. give a powerpoint presentation at the end of the rotation
6. try to do research with them, that would be a big bonus.

 

[MedSchoolSurvivor]

There are three factors to consider when obtaining a letter of rec:

1. How well does the attending know me?

2. How well known is the attending?

3. Is the attending a good writer/will they write me a good letter?

In my opinion the third point is the most important. You will want an attending that is a good writer and will embellish their description of you. The best way to do this is to ask your advising dean who generally writes good letters. I believe that most programs would rather see a detailed description of how great of a student and person you are rather than a pithy response by a famous attending. All that shows is that you asked a famous attending for a letter and they didn’t say no. However, if the attending is well known in their community, knows you well, and is a good letter writer then that is the best possible person to ask for a letter of rec.

 

[romeromerome]

For what it's worth, all three of the attendings who wrote my letters were at the assistant professor level. One was just a few years removed from fellowship. Another of whom I've done research with for almost the entirety of my medical school career. Got very few comments about my letters during interviews, and the ones I did get were favorable. I just matched at one of the "top" peds programs.

I'd go for letter content >> letter writer.

 

[Ophthoseidon]

This can be done a few different ways, i.e. talk to an advisor/mentor and get them to help set it up, talk to the administrative assistant, etc. You can also just email the person and say "I will be applying to [specialty] and a letter from you would be great for my application. I was wondering if I could set up a rotation where I could work with you" etc, etc.

.

Wouldn't you say this comes across as using the person for a letter? I'm wondering how you could word this in order to sounds professional and also sound like you actually want to work with the person.

On the opposite side, I was often asked "It seems like your home program wants to keep you, why would you leave your home program?"

How did you answer this question? haha, assuming you love your home program but would rather go somewhere else

 

[tiedyeddog]

How did you answer this question? haha, assuming you love your home program but would rather go somewhere else

Usually said something like I have been in my home programs city for enough time and want to live in a different city. I then tried to emphasize something different about the program I was interviewing at and my home program. I would never say anything truly negative about your home program, and I didn't.

It was tough because I actually do love my home program and I ended up ranking it #1.

 

[the argus]

Wouldn't you say this comes across as using the person for a letter? I'm wondering how you could word this in order to sounds professional and also sound like you actually want to work with the person.

By the nature of the relationship, you are "using" anyone you ask to write you a LOR. The letter writer doesn't ever get anything out of the transaction (other than potentially making their medical school look good by getting graduates into competitive residencies).

I would just be honest with the person in the email. Like I said before, these people have all been through this themselves so they know the name of the game. If you are not comfortable with emailing directly, then use someone you already have a relationship with (junior faculty member, etc) to make the connection.

Lots of people ask big names to write them a letter even if they don't know them, which I agree with previous posters is a stupid thing to do. A letter from a junior faculty member that knows you is better than a big name that doesn't. But a big name that knows you is the best. In my (limited) experience with this, if you are willing to work for the letter (i.e. want to rotate with the person first), people are open to it.

 

[operaman]

For what it's worth, all three of the attendings who wrote my letters were at the assistant professor level. One was just a few years removed from fellowship. Another of whom I've done research with for almost the entirety of my medical school career. Got very few comments about my letters during interviews, and the ones I did get were favorable. I just matched at one of the "top" peds programs.

I'd go for letter content >> letter writer.

It's definitely a balancing act and I think it varies between fields. A generic letter from a bigwig probably isn't that helpful, but a glowing letter from someone completely unknown may be just as unhelpful in smaller fields where everyone knows everyone else.

My advisors suggested trying for a nice mix of bigwigs and smaller wigs who really know you and will write glowing things about you, which I think is a nice balance. That said, my shortest letter was from my chairman (from what I could see upside down as interviewers referenced it) and it was far and away the one that got mentioned in every interview. Every. Single. One. Even had one PD at a top program comment that his letter was the reason I got the interview.

So for future applicants, definitely talk to people in your desired field to find out what you need to do.

 

[cs24]

For what it's worth, all three of the attendings who wrote my letters were at the assistant professor level. One was just a few years removed from fellowship. Another of whom I've done research with for almost the entirety of my medical school career. Got very few comments about my letters during interviews, and the ones I did get were favorable. I just matched at one of the "top" peds programs.

I'd go for letter content >> letter writer.

I could see that being the case for a field like peds (huge), but for a lot of the smaller fields (eg surgical subspecialties) the general advice consensus I've seen on here and places like otomatch are that name matters much more. Obviously a crappy letter from anyone will sink you, but apparently a glowing letter from an unknown is not that helpful.

 

[Wordead]

I could see that being the case for a field like peds (huge), but for a lot of the smaller fields (eg surgical subspecialties) the general advice consensus I've seen on here and places like otomatch are that name matters much more. Obviously a crappy letter from anyone will sink you, but apparently a glowing letter from an unknown is not that helpful.

One glowing letter from an unknown within the field is good as a "character letter", but 2-3 gotta be from reasonably well known academics.

 

[Mjolner]

How many LORs are normal in a situation like this?

 

[Psai]

I could see that being the case for a field like peds (huge), but for a lot of the smaller fields (eg surgical subspecialties) the general advice consensus I've seen on here and places like otomatch are that name matters much more. Obviously a crappy letter from anyone will sink you, but apparently a glowing letter from an unknown is not that helpful.

That's sad...

 

[Catalystik]

What in particular do residency directors look for in a LOR? What qualities/things do they want to see that make it a strong letter?

The essentials:
1) That you are a team player.
2) That you work hard.
3) That you get along well with colleagues.

Without those, it won't matter that your knowledge base is top 5%, that you gave a great public presentation, or that you performed various techniques flawlessly.

 

[TheWorldWarrior]

Thanks for the replies! Can anyone elaborate more on content. What types of things are they looking for in the applicant that they want to find in the letter, etc. Any specific qualities or traits?

I don't know what they wrote on my rec, but one attending, whom i got to know very well, wrote about our conversations together on my course evaluations , which included quantum theory and comic books. A good recommendation, like any good piece of literature, invokes a sense of wonder/enthusiasm for the reader. Those are the best Recs. Not too long, not too short, just right.