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Requesting Letters of Recommendation
for your Residency Application

Overview

Letters of Recommendation (LOR’s) are an important part of your application. Residency programs hope to learn several things from a LOR. They are interested in your fund of knowledge, clinical judgment, interpersonal skills and personal qualities. Equally important is what type of student you are and your potential as a resident. Essentially, will you be a “good fit”. Along with clerkship & Sub I grades and the interview, your LOR’s are one of the most important factors programs use when selecting candidates for interviews and in ranking candidates.

You can and should be asking for LOR’s early on, even before you have decided on a specialty or picked programs. However, the majority of LOR’s come from 4th year work. LOR’s from the work of your 3rd year may also be used.

It is very important throughout this process to keep in mind that programs and specialties may have different requirements. LOR requirements are program specific. It is your responsibility to research requirements prior to applying.

LOR’s submitted for your residency (Electronic Residency Application Service –ERAS or SF-CAS, Military) application must follow specific guidelines. Please review the links below for more details.

Quick Links
Who To Ask When To Ask How To Ask How Do I Ensure a Strong LOR? What Information Should I Provide To My Letter Writer How Many Letters Will I Need? Chairman Letter	MSPE Where do LOR's Get Sent and How Tracking Your LOR's Early Match How Do I Choose Which Ones To Use Tips

Who to Ask

The most important factor is to ask someone who knows you well and can describe your fund of knowledge, clinical judgment, interpersonal skills and personal qualities.
Letters should be from faculty who have observed your clinical work.
- The exception is a letter from a faculty research advisor, especially if research is important to your program or specialty
3rd year vs. 4th year rotations
- The majority of your letters should come from 4th year
  - As a 4th year student you are more experienced and mature, and your work is likely to be a better basis for a strong LOR.
  - Your most important letter will likely come from your Sub-I in your specialty. It is very important to ask early in this rotation for a letter and to work closely with this attending.
- LOR’s 3rd year are also valuable, especially if
  - You performed well
  - It is from a relevant specialty
  - It is from later in the year
  - You are offered a letter
  - Scheduling and timing of specialty choice can prohibit you from getting enough 4th year LOR’s.
- It is recommended to request at least one letter of recommendation from your 3rd year. You may need it to round out or complete your application. Having an extra letter or two on file is suggested.
- Do not ask 1st or 2nd year faculty, no matter how well you did or how much they love you. Programs want to know about your clinical performance.
Specialty vs. non-Specialty Faculty?
- Usually the majority of your LOR’s will come from your 4th year work in the specialty you are pursing.
- However, not all LOR’s need to be from your specialty. Other valuable LOR’s may come from:
  - Other relevant specialties, i.e. Pediatrics for Family or vice versa
  - Where you performed very well.
- Again, programs have different requirements. For example,
  - A surgical program may require one non-surgical LOR.
  - EM programs often require all EM LOR’s or a standardized SLOR
“Famous” vs. “non-Famous” Faculty
- “Famous” faculty are those physicians who are well known, in their field or region, or who hold important positions, such as department chair.
- A LOR from a “famous” faculty member can be extremely helpful, but only if they know you well. If not, it will be obvious and the LOR will carry little weight.
Senior vs. Junior Faculty
- Both are perfectly acceptable however, a letter from a senior faculty member who knows you well can carry more weight. However, having worked with your letter writer personally is the most important factor
- No residents! There are rare exceptions, i.e. some Ortho programs require a letter from a chief resident.
LOR from an Away rotation?
- Faculty from away rotations, especially in your specialty can be very helpful.
- This letter can illustrate how well you perform outside your home institution and is an unbiased evaluation and comparison to other students.
- A letter from a faculty member in the program or region a student is applying can be helpful.
- Remember, you do not have to send this letter to all programs. You can send it just to that away site or to the region of the country where you did the rotation.
Other important issues and exceptions…
- Never family members!

When to Ask

The earlier the better. Be sure to give your letter writers adequate time, about 4-6 weeks, to write your LOR.
- Depending on your programs, you should aim to have your LOR’s submitted by mid-September.
During 3rd and 4th year?
- Majority of LOR’s come from 4th year work; however LOR’s from the work of your 3rd year are also good and may be needed to complete your application.
When during a rotation?
- It is best to ask at the start of the rotation, especially for 4th years. You can let the attending know you will be requesting a LOR as early as the first day.
- You can also wait to get to know the faculty and let them get to know you before asking. You would then ask in the middle or towards the end.
- If you decide to wait, ask faculty soon after the rotation ends. They will have your performance fresh in their mind and can write a stronger LOR. Do this even if you will not need the letter right away.
- If needed, you can go back and ask a 3rd year attending, but the longer you wait after you have finished the rotation, the more difficult it will be for them to write the letter
- Always remind your letter writer at the end of the rotation.

How to Ask

Ask directly and in person (see “how do I ensure a strong LoR?” section).
We recommend meeting with your letter writer, in person, to discuss your career goals, strengths and interests. It will help him/her compose a more personal LOR.
- Address generic versus specialty specific LOR’s
- Discuss career goals & strengths
Make appointment – meet face-to-face if possible, or over the phone if not
Give adequate time – suggested advance notice is 4-6 weeks
- Provide a deadline to submit LOR by (mid-September)
Some may offer you a LOR. Respond to this offer ASAP.
Say thank you!

How Do I Ensure a Strong LOR?

It is extremely important when requesting a LOR to ask your letter writer if they can write you a strong letter. There are a couple ways to ask:
- “Can you write me a strong letter of recommendation?”
- “Do you know me well enough to write a strong letter?”
- “Would you feel comfortable writing a strong letter?”
Know yourself. Did you do well on this rotation? Did you perform your best for this attending?
Read body language and be aware of any discomfort
If faculty makes any excuse, look elsewhere for a LOR

What information should I provide to my letter writer?

When ERAS opens, for the next application cycle, you will be able to add your Letter Writer's name (LoR Author) into your MyERAS Application. Once you have entered your LoR Author's name, you will be able to provide your letter writer with an ERAS "Letter Request Form". This form provides the LoR Author with instructions on how to upload your letter into the ERAS LoRPP as well as a unique identifier which each of your LoR Author's will need in order to upload your letter.
- Until ERAS/SF opens, please ask your letter writer to write the letter now and hold it until you can provide them with the ERAS Letter Request Form.
- Letters can only be uploaded once the ERAS system opens for the
  upcoming application cycle.
- SF Ophthalmolgy Letters of reference can now be uploaded by authors directly to an applicant’s SF Match account via the SF Match Letter Writer Portal. The SF Match LOR Portal allows applicants to send online requests for letters of reference and authors to upload letters directly into applicants’ accounts. Medical schools will no longer upload reference letters for applicants. For additional information, please visit the SF website at http://www.sfmatch.org or login to your SF Match account.
- Military Match
  Students have the following options for submitting military application materials:
  1. Students can complete application and upload materials to MODS from military network computer while on away rotation(s)
  2. Students can also request to have application materials sent, in an encrypted file, to the designated military email address
To ensure your letter of recommendation includes all the necessary information and gets sent to the right location, we suggest you give the attached LoR instructions to your letter writers at all Drexel clinical sites along with the ERAS/SF Letter of Recommendation Request Form.
It is strongly recommended that you waive your right to see the LOR.
- This makes your letter confidential and the letter is then considered more strongly by residency programs.
- This must be indicated on the ERAS Letter Request Form before sending it to your letter writer.
Your CV (Link to CV site)
Additional documents may be requested
- Personal Statement (Link to P.S. site)
- Copies of Evaluations
- Transcripts if requested
Provide and discuss a list of experiences and qualities you would like highlighted
Tell your letter writer if you would like the letter to be specialty specific (you will be an excellent Ob/Gyn) or general (you will make an excellent resident)
- This is very important if you are undecided, applying to more than one specialty or to prelims/transitional years.
LOR’s should focus on your direct clinical interactions with the faculty member, not your whole medical school career or life story. So only give what is relevant.
Give a reasonable deadline and adequate advanced notice (4-6 weeks)
Follow up with email summarizing meeting. This also serves as a good reminder.
Thank you note & follow up

How many letters will I need?

The number of LOR’s that you will need will vary by student and program. While most will only need three, you may need more depending on your specialty, if you are applying to more than one specialty or prelims/transitional years, etc. This information is program specific. It is extremely important to check with the programs directly.

Most residency programs will ask for 3 to 4 LOR’s.
- A maximum of four (4) LOR’s can be sent to any given program via ERAS
- The exact number is program specific.
- If you send more than the requested number, the program may indiscriminately discard one LOR.
- So check with each individual program!
Some specialties will request a chairman’s letter (in the specialty to which you are applying). The Chair letter counts as one of your LOR’s.
The majority of your LOR’s should be from faculty within your chosen specialty (2 of 3)
Request extra LOR’s...
- In case some faculty members end up not being able to write the letter
- For applying to different specialties or prelims
- For specific programs (i.e. where you did an away rotation)
- For specific regions of the country
You will be able to assign different LOR to different programs, so you may have or need 5 or more letters on ERAS, even though you are only sending 3 to each program.

Chairman Letter

A letter from the Chair of the department is required for some specialties. Most common are medicine and surgery. Check with your programs.
Only request a Chair letter if it is required or if you have worked with the Chair.

MSPE

Known as the Medical Student Performance Evaluation (MSPE)
An MSPE will be written for each student.
- Information to write your MSPE will be taken from the Student Portfolio
MSPE’s DO NOT count as LOR’s
All MSPE’s will be uploaded together on Oct 1.
You can and are expected to review this letter. Make sure you do this as soon as your letter is ready for review!

Where do LOR’s get sent and how?

All ERAS LoR’s must be submitted electronically by your letter writer using the ERAS Letter of Recommendation Portal (LoRP): https://www.aamc.org/services/eras/282520/lor_portal.html)

If requesting a letter before ERAS opens, we suggest that you ask your letter writer to write the letter now and to hold it until ERAS opens. Once ERAS has opened for your class, you can provide your letter writer with the ERAS "Letter Request Form" that you will print from your MyERAS application.
SF Ophthalmolgy Letters of reference can now be uploaded by authors directly to an applicant’s SF Match account via the SF Match Letter Writer Portal. The SF Match LOR Portal allows applicants to send online requests for letters of reference and authors to upload letters directly into applicants’ accounts. Medical schools will no longer upload reference letters for applicants. For additional information, please visit the SF website at http://www.sfmatch.org or login to your SF Match account.
Military Match: Students can also request to have LoR's sent, in an encrypted file, to the designated military email address by Marie Hartman in the Office of Student Affairs & Career Advising(OSACA). To have application materials sent a student must:
Information regarding Military LoRs:

Military letter instructions will vary by branch and will be provided by student. Letters of recommendation will either be mailed directly to program or sent to Marie Hartman in the Office of Student Affairs & Career Advising to forward to the designated military email.

Please watch your email for the more information and the official ERAS announcement.

Tracking your LOR’s? (How do I check to see if my LOR’s have been received?)

When ERAS opens, you will be able to track your letters in MyERAS.
Additional information about tracking will be covered in future ERAS communications and sessions.

Early Match (SF Match-Central Application Service-CAS)

Letters of reference
Three (3) letters of reference are required for review by the programs. No more, no less. It is
recommended that residency applicants provide one letter from a core rotation.

Letter writers have the option to provide a reference letter or complete the Ophthalmology Standardized Form instead. Applicants should inform letter writers of this option

NEW to CAS (2017-2018): Introduction of Standardized Letter of Recommendation Form
You now have the option of requesting letter writers to use a standardized letter of
recommendation form. This is a 3- page standard form which they fill out and submit in place of
a traditional written letter. Again, this may be used in place of a traditional letter of
recommendation, but NOT in addition to a traditional letter.
Medical schools will be able to upload medical school transcript and MSPE as soon as the applicant registers for the SF match and submits his/her online Central Application Service (CAS) application form.
Your documents should be requested as follows:
- Letters of recommendation/Ophthalmolgy can now be uploaded by authors directly to an applicant’s SF Match account via the SF Match Letter Writer Portal. The SF Match LOR Portal allows applicants to send online requests for letters of reference and authors to upload letters directly into applicants’ accounts. Medical schools will no longer upload reference letters for applicants. For additional information, please visit the SF website at http://www.sfmatch.org or login to your SF Match account.
- Letters of recommendation for your preliminary year position should be processed through ERAS. This may mean in some cases, that you request your letter writer to upload one letter into the ERAS LoR Portal to support your preliminary year application and one to be uploaded into the SF Match Letter Writer Poral to support your Ophthalmology application.
NOTE: Letter writers can address their letters to either “Dear Program Director” or “Dear Review Committee”.
Please refer to the Early Match Guide for more information or visit www.sfmatch.org

How do I choose which ones to use?

Based on performance in rotation
- Better Performance usually results in a stronger LOR
Based on Specialty Choice
- At least 2 of 3-4 LOR’s should be from your specialty
Student Underground…Beware!
- Other students are probably where you will get much of your information, but that is not always reliable!
- Most students waive their right to see their LOR so they may not be the most reliable source.
- Other students can certainly be helpful in identifying supportive faculty.

TIPS

Ask early
Follow up, send reminders
Send Thank You Notes. Also please let your letter writers know where you Matched.

Requesting Letters of Recommendation for your Residency Application