What Makes a Strong LoR for Residency?

Letters of Recommendation (LoRs) are one of the most important components of every residency candidate’s ERAS Application. This is the opportunity for Program Directors to hear from your supervisors how you worked in the field and what you are like as a person. You must choose which LoR’s to share with programs carefully. A strong LoR can really bolster your application.

ERAS Letters of Recommendation serve several key functions in your residency application:

  • Demonstrate experiences specific to the specialty to which you are applying
  • Demonstrate good rapport with multiple physicians
  • Showcase work ethic, commitment to the specialty, and contributions to medicine
  • Exemplify personal characteristics, academic performance, and involvement
  • Reinforce and integrate aspects of your ERAS Application and Personal Statement

It is important to note that not a candidate may not have access to all of their Letters of Recommendation. If you waive the right to see it, most applicants will NOT have the opportunity to review those LoRs.

What does a Strong LoR for Residency look like?

  • Length: In order to achieve the correct length for the strongest Letter of Recommendation, we recommend the letter be about 400-500 words and ideally one page.
    • If the letter is too long, review the letter for anything you feel is not necessary for a strong Letter of Recommendation and suggest revisions to your Letter Writer. Avoid any repetition, irrelevant information and over-the-top praise.
    • If the letter is lacking in length, we suggest meeting with your Letter Writer and providing them with more materials for them to use to create more content such as your Personal Statement, CV or ERAS Application. 
  • Formatting: It is important that your LoR appears polished and professional. A messy LoR will discredit the Letter Writer’s words.
    • Handwritten signature – A Letter of Recommendation without a handwritten signature is not as authentic to residency programs. If your letter is currently lacking a signature, be sure to contact your Letter Writer and ask them to hand sign the letter before they submit it. 
    • Letterhead – Letters of Recommendation should have a professional letterhead that includes the institution name and ‘logo’, the date created, as well as the author’s name and title. 
    • Date – It is best to submit LoRs that have been written within the past year. If you’d like the same Letter Writer, but your LoR is too old, consider asking them to update it.
  • Specialty Specific: The strongest Letters of Recommendation are specific to one specialty. If the letter is generic, consider initiating a conversation with your Letter Writer and asking them to mention your strengths and suitability for one specialty of your choice. 
    •  You should apply with 2 or more specialty-specific LoRs out of the 3 or 4 total LoRs you submit with each application.

What experience is best for a strong LoR?

  • Origin: The type of LoR you submit is a key factor to a beneficial LoR.
    • The Experience should be US based, as this will demonstrate your ability to work in a US environment.
    • The type of experience is important – hands-on clinical settings in the specific specialty are ideal. All LoRs should be relevant to medicine in some capacity, whether that is through research, public health, or otherwise. 
  • Relationship with Author: Letters of Recommendation must demonstrate a genuine knowledge, care, and confidence in the applicant. However, they should not be excessive, boastful, or hyperbolic. 
    • The nature of the relationship and the time the writer has known the applicant should be included
    • Avoid requesting LoRs from superiors that you did not interact with.
  • Quality of Content: It is vital for Letters of Recommendation to include specific examples of the applicant’s competence, characteristics and behaviors.
    • Characteristics – Characteristics that exemplify your strengths are most useful. Examples could include ACGME Core Competencies, GPAs, or stats of any kind. 
    • Weaknesses – Weaknesses can be mentioned in a Letter of Recommendation. However, they should end as evidence of your growth as a person or professional. If possible, address the weakness with your Letter Writer and ask them if they could include any steps you took to improve, confirmation the behavior has been fixed and/or something about how you’ve grown as a person. 
    • Spelling & Grammar – All LoRs should be written with excellent spelling, grammar, syntax, and prose. If your author has poor writing skills or is not a native English speaker, it is highly advisable to have your LoR edited by a professional.  


Obtaining a strong Letter of Recommendation can be a tricky process. Our experts are highly skilled at editing your LoRs to bolster your residency application. Contact us today to have a professional help you! Call (858)-221-8580 or email support@residencyexperts.com.