MD "Worked hard and had a competent performance" - bad comment on a LoR?

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Caltechstud

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I am on the interview trail for IM. It was revealed to me that one of my letters stated that I worked hard and gave a competent performance on SubI.

Is this a red flag? Does being labelled competent, but not excellent, imply I was terrible?

I am scared ****less.

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Competent is usually codeword for not great. The physicans can chime in, at-least one doctor told me as such.
 
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Competent is usually codeword for not great. The physicans can chime in, at-least one doctor told me as such.

Was told the same thing by a PD. I'm in a field that relies heavily on LoRs from what I've been told so could be different, but she said anything short of a glowing LoR is a negative (at least at that program). Idk if it's necessarily a red flag, but certainly wouldn't help.
 
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I am on the interview trail for IM. It was revealed to me that one of my letters stated that I worked hard and gave a competent performance on SubI.

Is this a red flag? Does being labelled competent, but not excellent, imply I was terrible?

I am scared ****less.

When the interviewer told you this, did they say "good, we like competent people!" or "explain this"?
 
I should clarify - this is actually an evaluation on my MSPE. Would that be viewed differently as an individual LoR?
1. Probably shouldnt post from multiple accounts.
2. Who did you piss off to get that on your MSPE?

The physican I was talking to said that they usually use competent because they would rather not use incompetent.

Here is a qoute from an attending from a few years ago in another thread.
FWIW an admin in my med school confided that the deans letter was coded:

Outstanding- top 10%/ AOA
Excellent- top 20%
Very good- top 1/3
good- top 1/2
competent- erbody else
 
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My gut says mediocre.

Sadly, I agree. I'm interviewing radiology applicants this year and the word "competent" would stand out in a not-so-positive way. Usually, LORs are full of hyperbole, so if I'm not seeing words equivalent to "outstanding" and "excellent", my Spidey senses tingle.
 
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I am on the interview trail for IM. It was revealed to me that one of my letters stated that I worked hard and gave a competent performance on SubI.

Is this a red flag? Does being labelled competent, but not excellent, imply I was terrible?

I am scared ****less.
7d5.gif
 
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A LOR that says that seems to be one step above the letter writer refusing to give you a recommendation. But, after reviewing many apps I must say lots of people have mediocre comments like that. It doesn't help, but also not a "red flag" in my very short experience.
 
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1. Probably shouldnt post from multiple accounts.
2. Who did you piss off to get that on your MSPE?

The physican I was talking to said that they usually use competent because they would rather not use incompetent.

Here is a qoute from an attending from a few years ago in another thread.

Why do they even bother if everyone knows the deal...

A LOR that says that seems to be one step above the letter writer refusing to give you a recommendation. But, after reviewing many apps I must say lots of people have mediocre comments like that. It doesn't help, but also not a "red flag" in my very short experience.

How many people have mediocre comments?! I would assume the opposite.
 
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what was the context that they brought it up? Was it to ask you more about you working with the particular physician?
 
How many people have mediocre comments?! I would assume the opposite.
Lots of people. An example of a great comment would be "one of the best students I've worked with. We will likely be ranking them in a position to match at our program." If a letter writer gave that to everyone it would have no meaning.

Granted, I'm in a surgical subspecialty. Basically everyone has to get letters from the chair or PD, and many people go do aways at big places and ask for them from again the chair or PD. Most people who are interviewing know the letter writers so they have a reputation to upkeep. We don't care about some random person in another specialty or a private practice person that says a student is "amazing" or whatever. This might be very different in a specialty where students are expected to just get letters from whoever liked them the best.
 
Lots of people. An example of a great comment would be "one of the best students I've worked with. We will likely be ranking them in a position to match at our program." If a letter writer gave that to everyone it would have no meaning.

Granted, I'm in a surgical subspecialty. Basically everyone has to get letters from the chair or PD, and many people go do aways at big places and ask for them from again the chair or PD. Most people who are interviewing know the letter writers so they have a reputation to upkeep. We don't care about some random person in another specialty or a private practice person that says a student is "amazing" or whatever. This might be very different in a specialty where students are expected to just get letters from whoever liked them the best.
So private practice folks would have no bearing, even if they had ties to that program by being alums?
 
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So private practice folks would have no bearing, even if they had ties to that program by being alums?
It is generally not recommended. It might be fine for that one specific program. The other 50 places you applied to would definitely not care.
 
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Lots of people. An example of a great comment would be "one of the best students I've worked with. We will likely be ranking them in a position to match at our program." If a letter writer gave that to everyone it would have no meaning.

Granted, I'm in a surgical subspecialty. Basically everyone has to get letters from the chair or PD, and many people go do aways at big places and ask for them from again the chair or PD. Most people who are interviewing know the letter writers so they have a reputation to upkeep. We don't care about some random person in another specialty or a private practice person that says a student is "amazing" or whatever. This might be very different in a specialty where students are expected to just get letters from whoever liked them the best.

Ok so I'm applying to a surgical subspecialty, but I'm not to the point where I've thought about letters yet. As a result I have a few questions, if you wouldn't mind:
  • How many letters do we need overall?
  • Is it better to get a letter from a bigger dick (full professor, director of whatever) or a smaller dick (assistant professor) who will write you a better letter?
  • Does everyone need a PD/chair letter? Which one is better to have?
  • What would you say is the spread of people with excellent, good, ok, bad letters in terms of percent? Just curious because I'd assume people applying to a surgical subspecialty would be fairly good students, so just wondering how the stratification is at that level.
 
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For surgical specialties (I think requirement is pretty much the same across the board):

-chair letter is required or strongly encouraged at most programs
-PD letter is just a normal LOR that happens to be from the PD

Some programs the PD will “ghost write” a chair letter on behalf of the PD.

Letters should almost always be from someone more senior if at all possible.

3 letters are required and 4 letters are allowed. You should have 4 letters.

My LORs back in the day: chair letter, PD letter, and two LORs from full professors, both of whom are well known in academic circles.
So how does this work with away rotations or people who dont have home programs.
I am assuming it looks like this if you do have a home program.
2 letters from home program. (Chair and PD)
1 letter from away pd
1 letter from additional professor at home .

Thats seems like a lot of relationship building to get good letters. Plus do away programs every give you glowing letters considering you only interact with them on a short term basis.
 
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So you if you aren't in top 1/2 at HMS, you're going to get tagged "Competent?"
 
This whole process is a joke. It's no wonder we're getting replaced by nurses left and right; half of our education is based on subjective ass-kissing.
 
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For surgical specialties (I think requirement is pretty much the same across the board):

-chair letter is required or strongly encouraged at most programs
-PD letter is just a normal LOR that happens to be from the PD

Some programs the PD will “ghost write” a chair letter on behalf of the PD.

Letters should almost always be from someone more senior if at all possible.

3 letters are required and 4 letters are allowed. You should have 4 letters.

My LORs back in the day: chair letter, PD letter, and two LORs from full professors, both of whom are well known in academic circles.

So my department has 3 full professors. Chair, PD, Emeritus guy. Whats the optimum strategy to meet one (two?) more guys to fill out my list?

As a general rule of thumb on an away rotation it’s very hard to get a LOR from that’s program’s PD (since that’s usually one of if not the most desirable services it is often booked up the entire sub-I season by home program students).

For how students without a home program circumnavigate the chair letter requirement? Might get a better answer in the DO forum or with a search, im not totally sure but it’s obviously been dealt with in the past

Oh thats interesting. I thought it an automatic letter if you did an away rotation somewhere.

This whole process is a joke. It's no wonder we're getting replaced by nurses left and right; half of our education is based on subjective ass-kissing.

Thats every job everywhere.
 
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Is this a red flag? Does being labelled competent, but not excellent, imply I was terrible?
If I read that in an LOR, it would tell me the student had done what was required but didn't stand out. My question is, who the heck wrote that in your LOR? If I were asked to write a letter for a student I felt was merely "competent", I'd decline and tell him/her to ask someone else.

I am scared ****less.
Don't be. It's less than ideal, but it's only a single data point. Losing sleep over it won't change a thing except your ability to interview well. Let it go.


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So how does this work with away rotations or people who dont have home programs.
I am assuming it looks like this if you do have a home program.
2 letters from home program. (Chair and PD)
1 letter from away pd
1 letter from additional professor at home .

Thats seems like a lot of relationship building to get good letters. Plus do away programs every give you glowing letters considering you only interact with them on a short term basis.

I think your point plays a role in why it's harder for DOs to match into surgical fields (along with many other factors, obviously). For example, my school is not associated with a home hospital and we have multiple core cities. We do have a "Chair of Surgery", but he's actually part of the surgical department at an MD school's hospital in the same city where he is an associate professor. So while a letter from him is technically from a "Chair of Surgery", it's not from the chair of a surgical department and I'm guessing would likely carry less weight (@SouthernSurgeon can correct me if I'm wrong). Idk what the process is at other schools without home surgical rotations, but unless they could get a strong letter from a chair on an away I'd think it would be an inherent disadvantage in their app.

I know at my school at least, the students going for surgery set up a bunch of away/audition rotations to make sure programs they're interested in get to actually work with them. Basically trying to show them that they're solid and overcome some of the other disadvantages in their app.
 
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A LOR that says that seems to be one step above the letter writer refusing to give you a recommendation. But, after reviewing many apps I must say lots of people have mediocre comments like that. It doesn't help, but also not a "red flag" in my very short experience.

The biggest red flag I see in LORs (in the handful that I have reviewed) is using someone else's name in the body of the letter. Shows that you either didn't make an impression, or the letter writer was using a form letter and didn't have anything specific to say about you.
 
Yup.

Saw that a couple years ago - it was a great letter and then at the end it used the wrong name (wrong gender name too).

My immediate conclusion was form letter.

talk about competence...
 
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The real question is why would someone agree to write a letter knowing they are going to essentially screw the applicant? The amount of "damned if you do, damned if you don't" in medicine is absurd.
 
The real question is why would someone agree to write a letter knowing they are going to essentially screw the applicant? The amount of "damned if you do, damned if you don't" in medicine is absurd.

Some will basically tell you that if they write you a letter, it wont be the best. Some will flat out refuse to do it. Some are just dicks.
 
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Ok so I'm applying to a surgical subspecialty, but I'm not to the point where I've thought about letters yet. As a result I have a few questions, if you wouldn't mind:
  • How many letters do we need overall?
  • Is it better to get a letter from a bigger dick (full professor, director of whatever) or a smaller dick (assistant professor) who will write you a better letter?
  • Does everyone need a PD/chair letter? Which one is better to have?
  • What would you say is the spread of people with excellent, good, ok, bad letters in terms of percent? Just curious because I'd assume people applying to a surgical subspecialty would be fairly good students, so just wondering how the stratification is at that level.
These things vary. Usually to figure out who you should get a letter from ask people in the program. Some people may not be in some current position of authority, but may also be a very well known name in the field. I don't know if the advice from @SouthernSurgeon is different because maybe he's at a better program, or (I think) a general surgeon, but it seems like I have seen many generic letters. Again, in a subspecialty people all go on 2-3 away Sub-I's, and they almost all ask for a letter from the chair at a program. So, the chair of a big place may be writing 40 LORs between June and September, and from what I've seen some are just well known to write mediocre letters for all but maybe 2 or 3 students each year. I have seen many who have very generic letters, or just sort of rehash their grades and step score. While it doesn't help you out, it certainly doesn't go as a "red flag" for us.
 
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Some will basically tell you that if they write you a letter, it wont be the best. Some will flat out refuse to do it. Some are just dicks.
In my experiences, most people will do what requires the least work in life. It takes a non-zero amount of effort/time to sink someone with faint praise rather than decline to write the letter at all. Medicine is full of weirdos though so I guess I shouldn't be surprised. It also makes me wonder why anyone even pays attention to letters anyways? There are far more surgeons around than the 3 people each year who get a letter good enough for the BEST PROGRAM EVER that Southern Surgeon trains at so they can't be that important.
 
Some will basically tell you that if they write you a letter, it wont be the best. Some will flat out refuse to do it. Some are just dicks.

Does it badly reflect on you when you ask the person if they can write you a strong LOR? I know there're formalities and everything. But, sometimes, you just have to be direct.
 
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Does it badly reflect on you when you ask the person if they can write you a strong LOR? I know there're formalities and everything. But, sometimes, you just have to be direct.
Never asked for a letter of recommendation without wording like this
 
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Letters all kind of look the same to me. They only really stand out if there are major red flags, and I'm not sure that something like "competent" is going to scare me one way or another. I don't douse student evaluations in the rare times I did them in sparkly shimmery glittery bullsh-t and I'm not sure I really expect someone else to.
 
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Does it badly reflect on you when you ask the person if they can write you a strong LOR? I know there're formalities and everything. But, sometimes, you just have to be direct.
I think you should ask in those terms. If they say yes, great. If not, you've lost nothing. Whomever you ask for letters knows exactly why you're asking: you're an ambitious trainee looking to become a kickass doctor. Asking timidly doesn't hide that, it just makes you look timid.

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The real question is why would someone agree to write a letter knowing they are going to essentially screw the applicant? The amount of "damned if you do, damned if you don't" in medicine is absurd.
I know that this will come off super harsh, and maybe this is a Millennials expectations thing, but we LOR writers are under no obligation to be nice. We're obligated to be honest.

One thing about these letters, no matter what the venue, is that the judgment of the requestor comes into play. You should have a good relationship with your LOR writer. Why even take the risk of asking for a letter from someone who not write a good one?

This is why I always advise pre-meds to ask "Dr ___, do you know me well enough to write a good LOR for my app to med school?" So just change the wording for residency, and it's the same thing.

To be honest, I've told people "I don't know you well enough to write a letter" and also "I can't write you a good letter". To date, I wrote one bad letter, but that person simply didn't belong in med school.

There was grad student in my post-doc lab who was a real viper. She left before she finished her PhD, and got a technician job somewhere on the Eats Coast. One day, out of the blue, she called me and told me of some career plans and asked if I could write her a letter. "Sure", I said.

She never asked for the LOR, and too bad, because I would have put a stake through her heart.
 
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The biggest red flag I see in LORs (in the handful that I have reviewed) is using someone else's name in the body of the letter. Shows that you either didn't make an impression, or the letter writer was using a form letter and didn't have anything specific to say about you.

Curious question here... But why would the first impression be to blame the applicant of being mediocre? It could just be a case of negligence on the LOR writer. We're all humans here.

Would your opinion be diff if another LOR writer has the same things written about the applicant except that the format, name, gender, etc... are correct?
 
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I know that this will come off super harsh, and maybe this is a Millennials expectations thing, but we LOR writers are under no obligation to be nice. We're obligated to be honest.

One thing about these letters, no matter what the venue, is that the judgment of the requestor comes into play. You should have a good relationship with your LOR writer. Why even take the risk of asking for a letter from someone who not write a good one?

This is why I always advise pre-meds to ask "Dr ___, do you know me well enough to write a good LOR for my app to med school?" So just change the wording for residency, and it's the same thing.

To be honest, I've told people "I don't know you well enough to write a letter" and also "I can't write you a good letter". To date, I wrote one bad letter, but that person simply didn't belong in med school.

There was grad student in my post-doc lab who was a real viper. She left before she finished her PhD, and got a technician job somewhere on the Eats Coast. One day, out of the blue, she called me and told me of some career plans and asked if I could write her a letter. "Sure", I said.

She never asked for the LOR, and too bad, because I would have put a stake through her heart.
Goro, what in the hell does this have to do with Millenials? We are dealing with relatively smart people so I didn't think it necessary to say that every time you ask for a letter you need to be direct in asking for a strong letter. I also didn't think it necessary to explain that the word recommendation is in the name of the LoR and that someone would have to be purposefully obtuse and spiteful to not understand/ignore that when someone asks for a letter they are asking for help. They are asking for someone in authority to vouch for them on behalf. If you can't do that, you shouldn't write the letter. It doesn't matter if they didn't ask some super specific way. That just makes you look like a sad jerk who gets to say "gotcha" to some 20 year old.
 
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Curious question here... But why would the first impression be to blame the applicant of being mediocre? It could just be a case of negligence on the LOR writer. We're all humans here.

Would your opinion be diff if another LOR writer have the same things written about the applicant except that the format, name, gender, etc... are correct?
The applicant clearly didn't do his homework and look up past LoR recipients from this writer and see if they had any problems with their private/unreadable letters by way of mindreading. They also didn't directly ask the letter writer if they would not only write a strong letter, but also to ask the letter writer to explain to them what their definition of a strong letter is. *I think my eyes rolled so hard I pulled a muscle
 
Goro, what in the hell does this have to do with Millenials? We are dealing with relatively smart people so I didn't think it necessary to say that every time you ask for a letter you need to be direct in asking for a strong letter. I also didn't think it necessary to explain that the word recommendation is in the name of the LoR and that someone would have to be purposefully obtuse and spiteful to not understand/ignore that when someone asks for a letter they are asking for help. They are asking for someone in authority to vouch for them on behalf. If you can't do that, you shouldn't write the letter. It doesn't matter if they didn't ask some super specific way. That just makes you look like a sad jerk who gets to say "gotcha" to some 20 year old.

The point is that you DO need to do this! You can't take it for granted that you will get a strong LOR, especially if you do not have a solid steady working relationship with the writer. Look at how often people are saying that most LORs are "meh". That means most of the time, people are making positive impressions, but nothing overwhelming.
 
The point is that you DO need to do this! You can't take it for granted that you will get a strong LOR, especially if you do not have a solid steady working relationship with the writer. Look at how often people are saying that most LORs are "meh". That means most of the time, people are making positive impressions, but nothing overwhelming.
Maybe it's not clear but in the post you quoted I said that I thought it was obvious that one should ask for a strong letter. Like it's understood for medical students, even if it's not for premeds.
 
Maybe it's not clear but in the post you quoted I said that I thought it was obvious that one should ask for a strong letter. Like it's understood for medical students, even if it's not for premeds.
You also said that you didn't think it would be necessary. I trust that we're not talking past each other on points we already agree on!
 
I know that this will come off super harsh, and maybe this is a Millennials expectations thing, but we LOR writers are under no obligation to be nice. We're obligated to be honest.
^This.
One day, out of the blue, she called me and told me of some career plans and asked if I could write her a letter.
Yeah, that's odd behavior. Could be that she's just such a piece of work that she had to run through a long list to get enough letter writers. Who knows?

If anyone ever offers to write you a letter, though, you should file that away in your mind and call on it if needed. When I was a PGY-4, I went on an away rotation and impressed an internationally renowned anesthesiologist, and he pulled me aside and offered to write me a letter if I ever needed it. Three years later, I was transitioning out of the Army and looking for civilian employment. I reached out to that doctor, and he was very happy to make good on his offer. It was a huge feather in my cap.

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^This.

Yeah, that's odd behavior. Could be that she's just such a piece of work that she had to run through a long list to get enough letter writers. Who knows?

If anyone ever offers to write you a letter, though, you should file that away in your mind and call on it if needed. When I was a PGY-4, I went on an away rotation and impressed an internationally renowned anesthesiologist, and he pulled me aside and offered to write me a letter if I ever needed it. Three years later, I was transitioning out of the Army and looking for civilian employment. I reached out to that doctor, and he was very happy to make good on his offer. It was a huge feather in my cap.

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I never thought about that!

And many thanks for your service to our country! Hoooahh!
 
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^This.

Yeah, that's odd behavior. Could be that she's just such a piece of work that she had to run through a long list to get enough letter writers. Who knows?

If anyone ever offers to write you a letter, though, you should file that away in your mind and call on it if needed. When I was a PGY-4, I went on an away rotation and impressed an internationally renowned anesthesiologist, and he pulled me aside and offered to write me a letter if I ever needed it. Three years later, I was transitioning out of the Army and looking for civilian employment. I reached out to that doctor, and he was very happy to make good on his offer. It was a huge feather in my cap.

Sent from my Pixel 2 using SDN mobile

The Army sucks a lot of a$$ on a lot of occasions, but the medical officers do take care of their people. I had all of my letters written from O-5s when I was applying for medical schools. Recently, I was combing through the profiles of ACGME PDs and surprisingly about 20% of them are affiliated with the military in some manner.

Thanks for your service, doc. Best of wishes on your future endeavors.
 
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These things vary. Usually to figure out who you should get a letter from ask people in the program. Some people may not be in some current position of authority, but may also be a very well known name in the field. I don't know if the advice from @SouthernSurgeon is different because maybe he's at a better program, or (I think) a general surgeon, but it seems like I have seen many generic letters. Again, in a subspecialty people all go on 2-3 away Sub-I's, and they almost all ask for a letter from the chair at a program. So, the chair of a big place may be writing 40 LORs between June and September, and from what I've seen some are just well known to write mediocre letters for all but maybe 2 or 3 students each year. I have seen many who have very generic letters, or just sort of rehash their grades and step score. While it doesn't help you out, it certainly doesn't go as a "red flag" for us.

Yeah thats what I was kind of thinking. How much can you really glean from someone rotating in your department for a month anyway?
 
I know that this will come off super harsh, and maybe this is a Millennials expectations thing, but we LOR writers are under no obligation to be nice. We're obligated to be honest.

One thing about these letters, no matter what the venue, is that the judgment of the requestor comes into play. You should have a good relationship with your LOR writer. Why even take the risk of asking for a letter from someone who not write a good one?

This is why I always advise pre-meds to ask "Dr ___, do you know me well enough to write a good LOR for my app to med school?" So just change the wording for residency, and it's the same thing.

To be honest, I've told people "I don't know you well enough to write a letter" and also "I can't write you a good letter". To date, I wrote one bad letter, but that person simply didn't belong in med school.

There was grad student in my post-doc lab who was a real viper. She left before she finished her PhD, and got a technician job somewhere on the Eats Coast. One day, out of the blue, she called me and told me of some career plans and asked if I could write her a letter. "Sure", I said.

She never asked for the LOR, and too bad, because I would have put a stake through her heart.

My understanding is that if you agree to write a letter for an applicant, you are implicitly stating it is going to be a good, strong letter to their benefit.

I asked a few big names for letters in applying for fellowship and they said yes, but I don't know you very well.

If the letter writer does not enthusiastically say yes or offer themselves unprompted, you do not want that letter.

Who offers or says yes to a letter request and writes it luke-warm?
 
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Does it badly reflect on you when you ask the person if they can write you a strong LOR? I know there're formalities and everything. But, sometimes, you just have to be direct.

This is the way you SHOULD phrase it.

Always: "I was wondering if you would be willing to write a strong letter of recommendation in support of my application for XYZ."
 
Does it badly reflect on you when you ask the person if they can write you a strong LOR? I know there're formalities and everything. But, sometimes, you just have to be direct.

As others have said, this is the ONLY way to ask for a LoR.

If anyone ever offers to write you a letter, though, you should file that away in your mind and call on it if needed. When I was a PGY-4, I went on an away rotation and impressed an internationally renowned anesthesiologist, and he pulled me aside and offered to write me a letter if I ever needed it. Three years later, I was transitioning out of the Army and looking for civilian employment. I reached out to that doctor, and he was very happy to make good on his offer. It was a huge feather in my cap.

Sent from my Pixel 2 using SDN mobile

Also this. People that offer to write you letters will write you the best ones.
 
I know that this will come off super harsh, and maybe this is a Millennials expectations thing, but we LOR writers are under no obligation to be nice. We're obligated to be honest.

One thing about these letters, no matter what the venue, is that the judgment of the requestor comes into play. You should have a good relationship with your LOR writer. Why even take the risk of asking for a letter from someone who not write a good one?

This is why I always advise pre-meds to ask "Dr ___, do you know me well enough to write a good LOR for my app to med school?" So just change the wording for residency, and it's the same thing.

To be honest, I've told people "I don't know you well enough to write a letter" and also "I can't write you a good letter". To date, I wrote one bad letter, but that person simply didn't belong in med school.

There was grad student in my post-doc lab who was a real viper. She left before she finished her PhD, and got a technician job somewhere on the Eats Coast. One day, out of the blue, she called me and told me of some career plans and asked if I could write her a letter. "Sure", I said.

She never asked for the LOR, and too bad, because I would have put a stake through her heart.

The only thing that bothers me about your post is that you would agree to write a letter for someone, then say poor things.

Even if you don't like the individual, agreeing to write a letter in support of them and then "putting a stake through her heart" is super passive aggressive. We have enough people like that in medicine already.

You also seem to place all the blame on the person asking for the letter. Different people perceive relationships in different ways. If goes both ways. The letter writer should say NO if it is not going to be a strong letter, or at least give a caveat. Applicants should also not be idiots and ask individuals who they have never really worked extensively with.
 
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