How to Obtain the Best Residency Letters of Recommendation

Residency Letters of Recommendation

The process of obtaining several very solid Letters of Recommendation for medical residency can be a daunting task. However, with proper planning and a few key insights, your residency Letters of Recommendation (LoRs) can put you ahead of the curve. I would like to share the best tips to make the process as stress-free and successful as possible.

Requesting Letters

  1. Plan ahead

    Starting to brainstorm who you may want to get letters from well before they start becoming due is key. Not only does it save you stress, but it is also more likely that you will be reaching out to your letter writers well before they have their own stack of LoRs to deal with. On the same token, you will also want to ask for more than 3 letters. It is always possible that a letter writer may not come through, or upon speaking with them, you, or both of you, realize that they may not be the best fit for your Letter of Recommendation. Thus, we suggest asking at least 4-5 people about writing your LoR for each specialty you plan to apply.

    When you request the letter, ask them if they are willing to write a “strong letter of recommendation.” Furthermore, give them at least 1 month before you will need it (at a minimum) to write the letter. It may behoove both of you to set a “due date” for when you can expect to have the letter completed. It is completely fine if you send a gentle encouragement to complete the letter if it is coming up to the due date or slightly past.

  2. Ask the right people for LoRs.

    The best residency Letters of Recommendation come from those who know you well, have worked with you in hands-on clinical settings, and are in the specialty you are applying for. So keep in mind, if you want strong letters of recommendation for 3 specialties you may be applying to, you should actually be planning on asking for about 10-15 letters! (This is a great time to remind you to plan ahead!)

    Be sure to ask for LoRs from rotations that you performed well in. It is also much more preferable to ask a letter from someone who worked with you and knows you well rather than someone who does not. They should be able to comment on your skill as a clinician, professional intentions, as well as personal strengths and qualities.

Meeting with Your Letter Writers

  1. Set a time to meet with each of your letter writers. An email simply will not cut it. Your letter will go from 3 stars to 5 stars with a simple 15-20 minute meeting with your letter writer. If you are unable to meet in person for any reason, try to set up a meeting via Skype or the numerous other similar online platforms.
  2. Bring all the essential documents which will help your writer create the very best LoR. I would recommend getting them all together in a manilla folder and labeling it (in very large dark print, “Full Name – Letter of Recommendation Docs” …. Or something along those lines). This information will ensure your letter writer has what they need in order to remind them of their experiences with you, understand your goals and intentions, as well as integrate and mirror aspects of your Personal Statement.

Here is what I would recommend sharing with each letter writer:

  1. Your picture. This is just to help remind them of who you are. Hey, not everyone has the best memory!
  2. A biographical sketch. You can include career goals and also some gentle reminders as to your experiences with the writer.
  3. CV / Resume. These will help showcase specific accomplishments. I’d even recommend highlighting which ones are relevant to the writer.
  4. Personal Statement. Your personal statement will help the writer understand your specific goals as well as what you see to be your strengths. A good letter writer may work to help reinforce the points you’ve made in your personal statement.
  5. Letter Request Form from ERAS. Each letter writer is given a unique ID in order to upload the LoR to ERAS. Providing them with this Letter Request Form definitely makes their job easier.

Discuss the essential aspects of you and your experiences with the author.

There are a few key areas you need to discuss. First, try to talk about some of your best hands-on clinical experiences you’ve had with the letter writer. Recording these as you go could be helpful for the author later when they are actually getting to writing. You can also discuss your career goals as well as personal characteristics and qualities which you’ve discussed in your Personal Statement. All these together should make for a consistent, concise, and powerful Letter of Recommendation.

By sitting down with your letter writer, you can help them understand your needs and expectations better by working together to create a letter which is extremely personalized, specific, and also reflective of other aspects of your application like the Personal Statement. You will also be sure to avoid receiving a short, template-like letter that lacks detail and says nothing real about you. In general, meeting with the author ensures a higher quality LoR that is integrated with your application and more likely to get you an interview. It’s worth it, trust me!


Exceptional Residency Letters of Recommendation

  1. Request LoRs from physicians who know you well. The ideal letter is from a senior staff member who has worked with you and knows you well. They will be able to comment on your ability to work on a team, your clinical knowledge, willingness to listen and learn, attitudes and behavior, relationships with staff, and your patient care.
  2. Specialty specific. The more specific your LoRs are to the specialty you are applying to, the better.
  3. Recent. Strong letters are written within 1 year of applying.
  4. US Clinical Settings. Programs want to know that you have clinical experience in the US and that your communication skills are proficient. Although Observerships, Volunteer and Research are not considered as US Clinical Experience, they do count as US-based Letters of Recommendation. You should do your best to have a MINIMUM of 1 US-based LoR. However, the more the merrier.
  5. Credibility. If you are able to get a letter from someone with prestige in the field, or a physician that the program you are applying to may know (in good favor), this could definitely boost the strength of your letter.
  6. Length. LoRs should not be a simple paragraph. Ideally, they will have an introduction, at least 1-2 body paragraphs, and a conclusion. Consider discussing the length and format of your letter with the author in order to prepare for an LoR of optimal size and content.


Avoid These Pitfalls

  1. Requesting LoRs from the Chair of the Department. Only do this if it is required of you by the program, or they are able to speak directly about your clinical skills based on personal experience. Otherwise, this is most likely going to a waste of time, both for you and the Chairperson.
  2. Sending specialty specific letters to other specialties. Don’t! If you need to request more Letters of Recommendation to avoid sending a Radiology specific letter to a Pediatric program, do it. Programs will feel like you are uninterested, lack planning, and/or are desperate. Spare yourself this pitfall.
  3. Not waiving your LoRs. If there is anything holding you back from waiving your letter, perhaps consider discussing it with your letter writer at your meeting. If you are able to waive your letters, this is absolutely the way to go. Not waiving them shows a program that you either don’t trust the ability of the letter writer, or you don’t trust what they have to say about you. Waiving letters shows your confidence of both to a program. It is not the end of the world if you do not waive your letters, but just understand that it is somewhat of a red flag to programs. (If you plan ahead properly, following the guidelines above, you should have a generally good idea of what will be within your letter. This way, you will have more confidence in the contents of the letter and will not feel like you are applying blindly.)


Alright friends, there you have it. The formula for successful residency Letters of Recommendations is not extremely complex. However, it will take a bit of time and persistence, so PLAN AHEAD! Getting started making requests in May or June is ideal. This way you will have time to work with slow writers, to meet with all your authors, and make sure your exceptional LoRs get to ERAS on time.

If you want professional feedback about your Letters of Recommendation, Residency Experts is at your service. Our team of dedicated Experts will help optimize your entire MyERAS Application, including helping you decide upon the all-important Letters of Recommendation. You can call us at 858-221-8580 and learn more about our LoR Review & Feedback services here.