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Letters of recommendation are required by all programs, and many will also ask that you submit a departmental (or Chair’s) letter as one of the submissions. Letters of recommendation allow programs to hear directly from people who have worked with you in patient care settings and who have observed your direct interaction with patients and other health care professionals. This information is very important for programs to have when reviewing your application.

Many students worry about whom to ask for letters. It is difficult to know early in the process from whom you will eventually be able to receive a letter or how many letters you will ultimately have to choose from. Therefore, it is reasonable to ask those whom you believe can give an honest evaluation of your performance, even if you are not sure that you will eventually need to use their letter. Because of the way ERAS works, letter writers will not know if their letter has been used in your application. Although it is not a good idea to non-selectively ask for letters from almost everyone with whom you have worked but will likely not use, you also do not need to select in advance only a small number of people to ask (or hope to ask). It is usually helpful to have a few more letters than you need; selecting the specific letters you actually use will come later in the process.

For those you do ask, it is important that you seek a LoR as soon as possible after completing a clinical rotation with that person. Letters generated soon after you work with someone are more individualized and contain more detailed content than those written months later (and remember that most faculty work with many students – the longer you wait to obtain a letter, the more “generic” they tend to be since the writer may be less able to recall specific details about you and will write more generalized comments). So if you know faculty you are planning to ask to write on your behalf, it would be good to approach them now.

When asking for letters, be honest with the potential author and ask them if they would feel comfortable writing on your behalf and would be willing to do so. Although most faculty are extremely happy to write for students, if there are concerns about their ability to write a supportive LoR, they will hopefully come up in those discussions.

It is also generally recommended that you waive your right to review your LoR. Although you certainly have this right, authors may hesitate to write completely objectively if they know you will be reading the letter, and programs may be given the perception that there might be issues you don’t want reflected in your LoR. If you feel strongly about not waiving you right to review your letters, you should discuss this with your advisor in the department of medicine.

Some students hesitate to ask for LoR because ERAS is not yet open and you do not yet have an ERAS identification number. However, writers can be asked to compose their letter and hold it, and many departments of medicine have a system in place to store LoR prior to the opening of ERAS so that letters can be completed shortly after working with a faculty member and sent to ERAS once registration has opened.

It is also important for you to discuss your letters with your advisor in the department of medicine. For example, although it is preferable that at least some of your letters come from more advanced training experiences (such as an acting or subinternship), it may be difficult to do this because of scheduling issues beyond your control. Plus, not all LoR need to be from clinical rotations, particularly if you have done other things (such as research or other types of work) that demonstrate qualities that are best related in a letter of recommendation. For these reasons, seeking advice from your departmental advisor about how to approach the makeup of the letters you include in your application is very important, although this will likely come later in the process. 

Your personal statement is your best opportunity to communicate with residency programs about yourself beyond your other application materials (such as your grades and examination scores) and before an interview. It can be an effective way to distinguish yourself from other applicants, point out what is unique about you, and serve as a basis of topics for interviewers to discuss with you. Residency programs really do read personal statements, and a strong one can be very helpful to programs who are reviewing your application.  Now is a good time to start thinking about what your personal statement might look like.

Many students find writing personal statements very intimidating and worry that they aren’t able to write something that is either creative or compelling. However, the purpose of a personal statement isn’t literary, but rather to express something about who you are as a person and potential medical resident. For example, what led you into medicine, and particularly into internal medicine? What motivates you on a day-to-day basis?  What are your hopes and dreams as a physician? What qualities do you have that would bring something unique to a clinical training program? There are many questions that, if looked at personally, often make writing a statement fairly straightforward.

It is also important that you receive feedback from others on your statement. Most departmental advisors can be immensely helpful with this, providing guidance on how to frame what you are thinking of writing, reviewing what you write, and making sure that the basics, such as spelling and grammar, are in order. Take advantage of the input of your advisors as they probably read many, many personal statements each year and can provide helpful feedback on what works and what could be improved in yours.

Building Your Curriculum Vitae