while we wait . . . some LOR advice if you can

Discussion in 'Emergency Medicine' started by Coleman, Mar 19, 2003.

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  1. Coleman

    Coleman Senior Member 7+ Year Member

    Dec 3, 2002
    Cooper Univ Hospital!!
    Let me add my congratulations into the mix to you all, valiant effort and work, and it is all paying off.

    I'm figuring out my Letters of Recommendation (LOR) and I wanted to get your opinions.

    *Did you get all EM letters? Do you think it is bad to have all EM?
    *If not, what other services?
    *What about the timing of away rotations and the letters you get from them - if it is after my application is submitted, do I add it on, change what letters were sent, or does it not count?
    *I'm planning to get my application out in early September, how long should I wait for subsequent letters at upcoming away rotations?
    *What is the MAX number of letters a program will accept? Are they all 3?


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  3. mikecwru

    mikecwru M.D. = Massive Debt 7+ Year Member

    Oct 21, 2002
    You can get as many letters as you want and that is actually advisable. Most places take 3 LORs, a few take 4. Some are anal about what they want, most want "at least one from an EM doc." If you're looking outside EM, the "big three are always good" -- peds, medicine, and surgery, keeping in mind that a lot of EM programs are divisions of surgery (mostly) or medicine.

    I would shoot for as early in the year as possible. If you want to do away rotations, *I* would do them in July + August. More than two EM rotations is overkill. That way your application should be complete by Sept provided the writers don't drag their feet.

    Please remember to get more than one EM letter and STAGGER the letters. ie, 3 EM letters (1, 2, 3) send program A letter 1, program B letter 2, etc., in the event one of your LORs contains a discouraging remark you won't be hosed at ALL your choices. DO NOT ASSUME THIS WON'T HAPPEN based on the writer's attitude. I had some very positive comments made to me in person, eventually got a lukewarm letter, and I stupidly sent it to ALL my programs. Learn from others' mistakes.

    Don't piss around with LORs... plan on all kinds of stuff screwing up... thats why I wouldn't be taking rotations or seeking letters probably past August.

    (just for discussion: my letters were (1) EM attending (2) EM att. I did research with (3) peds clerkship director, (4) medicine attending. All nonfamous.)

  4. Coleman

    Coleman Senior Member 7+ Year Member

    Dec 3, 2002
    Cooper Univ Hospital!!
    thanks for that Mike, actually, I have one from an EM attending I did research with as well. I was worried because I did not work with him "clinically" so-to-speak, i.e. no shifts in the ED. I was looking at the SLOR form on the EMRA site, and it asks all these specific questions about my performance on the EM rotation, etc, etc. I guess he'll just defer those questions, right?
  5. mikecwru

    mikecwru M.D. = Massive Debt 7+ Year Member

    Oct 21, 2002
    I had my EM researcher write a traditional LOR. You just need to make sure you have one clinical EM attending and make sure he/she definitely does the SLOR. (I had only one SLOR in my file.)

  6. DrQuinn

    DrQuinn My name is Neo Moderator Emeritus 10+ Year Member

    Dec 6, 2000
    Just to add to the mix:

    I had:
    One LOR from a trauma surgeon
    One LOR from a community EM Attending
    One LOR from a residency EM attending (non-famous)
    One LOR from a pulmonologist/critical care dude

    Mike (as usual) gives excellent advice, listen to him. THere is little I need to add. I did a rotation at the University of Maryland in November, and could have gotten letters from them, but by this point it was WAY too late, so I just had one LOR that I left in my file just for the UMD people.

    I even think October is too late, as atleast 1/2 of my interviews were sent to me that month.

  7. Scrubbs

    Scrubbs Chisellers beware! 7+ Year Member

    Feb 28, 2003
    I agree with Mike, but would add that I think Sept rotations are ok, as long as you make it clear early in the rotation that you're looking for a letter...

    I got my ERAS out the first week, and my first letter went up in early October (my writers just weren't getting them done). I did EM rotations Aug and Sept, and actually did an EM research block in October. I only had EM LOR's, though I think Med and Surg would be ok too.

    I actually had 4 LOR's:

    1: Chair's letter from my schools PD/Chair
    2: Letter from my advisor (non-famous)
    3: Letter from my away rotation (non-famous)
    4: Letter from my research advisor

    The first 3 were SLOR's, the last was a normal LOR that talked about my research projects (since they weren't on my ERAS). I think the really important thing to think about is whether the person is going to write you an awesome letter. I had REALLY nice letters, and I got a lot of comments on them during interviews. Also, if you can get someone well known, I think it helps. My schools PD/chair is pretty famous, and I got several comments along the lines of, "well, if he likes you, we do too." Obviously not always possible, but figured I'd mention my experience.

    Good luck!
  8. futrEDdoc

    futrEDdoc Member 7+ Year Member

    Nov 24, 2002
    All great advice so far. I had 4 letters..

    1 from medicine attending from 3rd year clerkship
    1 from peds attending from 3rd year clerkship (I applied to combined peds/EM programs) - he is also our PD for peds
    1 from my EM advisor who is also our PD and on the RRC (lucky break)
    1 from EM attending at away rotation (well known name nationally)

    I did my away in October...I thought that was late. It was only because the person who wrote my letter there was so prompt and efficient that it was received in time to be sent out to all the programs before the Nov 15 deadline. But, most letter writers are not that efficient, so be prepared to have to wait for a letter. If I had to do it again, I would have done my away in September, after having done a month at home.
  9. Nof55

    Nof55 Member 7+ Year Member

    Mar 23, 2003
    Good stuff from everyone so far.

    I had 4 letters. I was told you pretty much need to have 2 EM letters from your 2 EM rotations - all the more reason to do these rotations early. I did one of my rotations in July and one in October and had no problems with getting my letters in. My other letters were in Medicine and Peds.

    Pretty much you want them in the core rotations that apply somehow to EM (surg, med, peds). Try if you can to get a letter from a PD of an EM program you rotate at, note this is often a matter of luck - i.e. happen to be on shift a couple of times with them and they decide you are great! The letters all need to say you are the greatest student out there, mediocre letters really stand out!


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