When to worry about missing LoR?

[PMnR11]

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I was wondering if you all might have an opinion here.

One of the LoRs that I've included on my ERAS application to PM&R programs still hasn't been submitted. The letter is from a well-known physiatrist at a top tier program that I did an away rotation at. The doc gave me a glowing review at the end of my rotation with him and thought that I could do great as a resident in their program and said he would be willing to write me a strong LoR. That was in the second week of August. A week later I wrote him a card thanking him for the support, and as a subtle reminder to write the letter.

As the Sep 1 ERAS submission date approached my office of medical education still hadn't received the letter, so I emailed him on Sep 1 to inquire on the progress of the LoR. No response. I gave it a few days and sent a similar email again. No response.

Now its Sep 12 and the letter hasn't been submitted, the doc hasn't responded to my inquiries, and programs are downloading my application without that LoR. I have submitted letters from 2 physiatrist and have another solid letter from another physiatrist at my medical school that I could submit in place of the missing one, but it would be great to have a letter from a doctor outside of my medical school, especially if he truly believed what he said to me at the end of the rotation.

So, I guess what I'm asking is what is the best way to try to get the missing physiatrist to write the letter without being annoying and pestering? How long should I give him before I should move on and retract his missing LoR from my application and replace it with a solid one that is in place and ready to go? Thanks all!

 

[Prof Moriarty]

You should call his office and inquire directly. Email often falls through the cracks. Did you give him a deadline before? If not, be prepared to give him one that still works for you. Cordially, of course. Let him know you have other letters you could use but you'd prefer to have his recommendation if he's still willing to do it. That gives him an "out" if he doesn't want to do it for whatever reason. But main thing is: Call directly. Leave a mssg w/ his secretary if necessary. If you don't have some news by the end of the week, proceed with the other letters.

 

[MSKmonky]

I agree with the above post. Try calling the physicians secretary/office and have them deliver the message. Attendings are often so busy with so much, that things slip their mind easily. The office clerks/secretaries are often the "den-mothers" who help remind them.. haha.

 

[PMnR11]

I contacted his secretary this week. She let me know that the letter was on his list of things to do, but reiterated that he is a very busy man. Unfortunately, she couldn't ponder a guess at all as to when it might be completed. I did my best to politely let her know that my application is already being downloaded and reviewed by programs and that I'd really like to have his letter available to those programs because I think it can carry a lot of weight. She said that she could put a bug in his ear and remind him again but couldn't guess at when he might do it.

For the residents out there. Has anyone else been in this situation? With having other very solid LoRs in with my application, how might this missing letter affect how programs evaluate my application for interview offers? When is it that programs like to see applications complete?