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Jefferson Medical College Alpha Omega Alpha Guide to the Clinical Years

Letters of Recommendation

Most residency programs require three letters of recommendation on your behalf. You are allowed to submit up to four evaluations for each program. The general rule of thumb is to get a letter if you did well in a rotation and established a good relationship with an attending. Resident letters, even from a chief resident are generally not acceptable. Some programs require at least one, if not two letters from an attending in the field you wish to enter – check with your specialty advisor or the Dean’s Office. Some tips for getting letters:

  1. If an attending offers to write you a letter – say, “Yes, please!” You do not have to use every letter you get. In fact, you can pick and choose which letters to send to each residency program you apply. This means you can get ten letters and pick any four or the same four for each program to which you apply.
  2. Letters are due before October 10th of fourth year. This is the last day that the registrar will scan your letters into the ERAS database so that you can use them to apply. A good policy is to let the physicians writing your letters know that you need the letter in the registrar's hands by October 1st, so you have some wiggle room.
  3. Letters from third year are good to have, but not a prerequisite. The more letters you get third year, the more relaxed the beginning of fourth year will be. The letter writer can send the letter to the registrar to store in your file. If you can't get a letter third year, don't panic. You have plenty of time in the beginning of fourth year. Also, attendings expect you to ask for letters on your fourth year rotations.
  4. Try to ask for a letter at the end of a rotation or as soon as you get a grade back if you are unsure how your final evaluation will turn out. The fresher you are in the mind of the attending writing your letter, the better the letter will be.
  5. Give your letter writer a copy of your CV and cover letter for ERAS (available at http://www.aamc.org/students/eras/resources/start.htm). Waive your right to view the letter. It’s just one of those things. Don’t worry about the AAMC ID# on the cover letter; you will receive this fourth year. Include an addressed, stamped envelope for your letter writer to return the letter. The letters should be directed to the Office of the Registrar, c/o Sheryl High, 1015 Walnut St., Suite G-22, Philadelphia, PA 19107.
  6. Medicine electives tend to be better opportunities to get letters than Sub-Is for those going into Internal Medicine. For surgery, however, Sub-Is might be a better opportunity to meet an attending and shine. Ask students in the years ahead of you who are good attendings to meet for the field you wish to enter.
  7. Don't worry if your letter is from a younger attending as opposed to the chairman of the department. If the younger attending knows you better, it will be a better letter. However, if the chairman knows you, it never hurts to ask.
  8. If you are going into internal medicine, you will need a "chairman's letter" from Dr. Caruso in the Department of Internal Medicine. This counts as one of your three letters for some programs and everyone gets one from Dr. Caruso.
  9. Letters from researchers can also be good letters if a researcher MD knows you well; however, they probably will not be able to comment on your clinical skills ability. You can offer to go to office hours with them one day so they can get a sense of your clinical prowess, or do a clinical elective with them. If this is not feasible, a research letter is still okay but balance it out with three clinical letters.
Last revised: 9/07

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