This is the second article in a series of two articles exploring how IMGs can get strong letters of recommendation (LOR) for the residency application. The first article explored strong vs weak letters of recommendation, who you should ask to write the letter for you and what information you should provide the letter writer with.
In this article, I will discuss more tips on getting good LOR and highlight when you should be asking for these letters.
1 Don’t just ask if the writer can write a LOR for you.
Ask if the writer could write a strong LOR for you. The way you ask for the letter can be as simple as “Are you able to write a strong letter of recommendation for me?” or “Do you feel that you know me well enough to be able to write a strong letter of recommendation?” If the response indicates that they may not be able to recommend you enthusiastically then respectfully consider asking another writer.
2 Set up a personal meeting with your letter writer before he/she writes the LOR.
You should make sure that you provide all of the information needed for the letter including a CV (a must), personal statement and deadline details (see the previous article for more details). Be clear about what your goals are and what specialty you are choosing.
3 For letter authors in the US:
It may be helpful for them to know specific programs you’re thinking of applying to. Or, you can ask if they have advice on which programs you should consider. They can guide you on which programs suit you best and they could (if you’re lucky) have some connections with program directors in various programs.
4 For letter authors outside of the US:
It is extremely important that you have good knowledge of what strong LORs look like so that you can inform the authors on what the conventions are. It may be helpful the writer to visit websites such as the UCSF guide for residency LOR writers or you can give them a print-out of the information.
5 When should you ask for the letter?
Medical students in US medical schools are often advised to give their writers at least 4-6 weeks to write the letter. They may even ask their attending physician to write a LOR for them as early as the first day of a clinical rotation. Some opt to wait to get to know faculty better before asking (ie. asking for the letter in the middle of a rotation or close to the end). IMGs should use their judgment about what makes sense for them.
Ideally, IMGs should have had all of their letters submitted by the first day application opens on ERAS. I started getting interview invitations on the first week after I submitted my application. It can work in your favor to have good LORs in place so that programs can see them as soon as they are able to.
6 Do the basics well:
This is an obvious point, but I need to mention it here. Work hard, stay up-do-date on your knowledge, contribute beyond what is expected, be a team player and treat everyone well. Take up opportunities to get involved in projects, posters and other academic pursuits. These can all help you get strong LOR.
7 Send a thank-you note: The letter writing process can be challenging for busy academic physicians who have many other responsibilities. Make sure you show your appreciation!
8 Tips from other sources (websites below were accessed on 7/2/16):
- discourages IMGs getting letters from overseas schools as “standards of international schools vary.”
- suggests ways IMGs may be able to obtain US clinical experience and get LORs.
- I disagree strongly with one point from this article when it says “[Residency programs] really look for letters from professors, residents, etc. who can attest to your abilities and future as a physician in the US”. In my opinion, you should avoid asking for a letter from a resident. They are too junior and their assessment would not be thought of highly by programs.
- LOR opinions (possibly written by a program director, although the identity of the author is unclear)
- generally good advice!