Medicine, Navigating Medical School, Trainee Advice

How to Get an AMAZING Letter of Recommendation for Residency

A key component of your residency application is the letter of recommendation. Once residency programs have screened applicants on the basis of Step scores and clerkship grades, there remain only a few ways for residency hopefuls to standout. As a result, an amazing letter of recommendation for residency can help differentiate you from other equally qualified applicants.

When I interviewed for residency, interviewers often commented on the strength of my letters of recommendation. I’m grateful for the advice I’ve received over the years regarding getting amazing letters. Now, I want to share that advice with you!

In this post, I will outline some strategies that I believe helped me to land AMAZING letters of recommendation for residency!

Do work worthy of an amazing letter of recommendation

When it comes to getting an amazing letter of recommendation for residency, you set yourself up for success by doing amazing work. Your letter writers can only write based on their experiences working with you. Be consistent in your preclinical courses and clerkship rotations. Put in effort above and beyond what is asked. If you always put your best foot forward, your letters of recommendation for residency will reflect that.

Protip: At the beginning of a research project, clerkship rotation, or sub-I, discuss expectations with the principal investigator or supervising attending. Being proactive about understanding expectations will ensure that you’re both on the same page about what counts as excellent work.

Ask for letters of recommendation early

The best time to ask for a letter of recommendation is now. Students often wait until they’re working on their applications to ask for a letter of recommendation for residency. But, more likely than not, that’s too late. You want your letter writer to write your letter of recommendation for residency immediately after, or during, your work with that person. Whether you’re asking for a letter from a research mentor, supervising attending, or academic advisor, the closer your request is to your actual shared experience, the more content the writer will remember and be able to write about.

Protip: You can start asking for letters of recommendation for residency as early as your preclinical years! The earlier you ask, the more practice you get with building relationships with potential letter writers. Even if you’re still deciding which specialty is for you, it doesn’t hurt to have letters of recommendation readily available. You might need them for internships, dual degree programs, or scholarship applications anyway! Before applying to residency, I needed letters of recommendation for my business school application, so I was glad that I asked for letters of recommendation early on in medical school.

Ask for letters of recommendation often

Not only should you ask for letters early, but you should also ask for them often. Your residency application will likely require three to four letters of recommendation. That means that you should have AT LEAST 5-6 letters of recommendation written on your behalf. Why have more letters of recommendation than you need? You don’t always get to read your letters of recommendation before they are submitted, so it’s a smart strategy to have multiple letters available in case some are stronger than others. When you have more letters that you need, you can vary which letters of recommendation you send to each program, as needed. Let me provide an example.

When I applied to residency, some of my letter writers let me read small portions of their recommendation letters in advance. I was grateful that they allowed this AND that I asked for more letters than I needed – five in total. Unfortunately, some of the letters of recommendation were a little bland. In my opinion, I don’t think the mediocre letter quality had anything to do with my work, efforts, or interactions with the writer. Rather, in hindsight, some of the people from who I requested letters were probably too busy to write a strong letter. So in the end, I was glad that I had other options of letters to choose from.

Protip: Ask for as many recommendation letters as you can to give yourself options!

Asking for letters in different specialties

Specialty uncertainty is another reason to have more letters of recommendation for residency than you need. Before I settled on psychiatry as my specialty of choice, I considered obstetrics and gynecology and anesthesiology. I requested letters of recommendation from attendings in these fields as soon as I finished working with them, at least one year before I applied to residency. Generally, you will want at least one internal medicine letter and then 2-3 letters from those in your specialty of choice. To be honest, I only had one letter of recommendation from a psychiatrist because I decided on psychiatry in the 9th inning. But ideally, you want at least two letters from someone in the specialty to which you are applying.

Protip: Many schools offer a storage office or virtual complication process for you to have letters of recommendation stored on your behalf during college and even after you graduate. Additionally, you can start storing recommendation letters in the NRMP portal as soon as you get a certificate for your application cycle.

Find the great letter writers

As I mentioned before, sometimes you can get a bad letter of recommendation from someone with whom you worked well. Don’t take it personally. It’s important to remember that writing isn’t everyone’s strong suit. Moreover, some people will simply be too busy to write you a strong letter of recommendation for residency.

It’s okay and even expected that you specifically ask a potential letter writer the following question: “Would you be willing to write a strong letter of recommendation for residency on my behalf?” By using this specific verbiage you do two things. First, you set up the expectation that you want a strong letter. Secondly, you provide the person you’re asking a graceful chance to bow out in case they do not think they would write a strong letter for you. Consider this question a win-win filter for both you and the potential letter writer.

Protip: Don’t be afraid to ask around! Ask upperclassmen and even advisors who the great letter writers are. I know that when I applied to residency, one of my mentors gave me the “inside scoop” as to who the best letter writer was in the department. This tip was GOLD because that person’s letter of recommendation was mentioned positively in every single residency interview I did.

How to ask for a letter of recommendation for medical school

Ask for letters of recommendation in person

When possible, it’s a great idea to ask for letters of recommendation in person. You want to see the person’s initial reaction to the request. If the person you ask enthusiastically responds to writing a letter, you’ll know it by their body language and word choice. Someone who is happy to advocate for you will likely smile and quickly offer words of encouragement and support. On the other hand, someone is less likely to write you a strong, convincing letter of recommendation for residency if they seem shocked (raised eyebrows) or hesitant (pauses or stutters in response) about the request.

If you are unable to ask for a letter of recommendation in person, remember to still use specific wording about wanting a strong letter. And be sure to read between the lines of the reply.

“Would you be willing to write a strong letter of recommendation for residency on my behalf?”

Have diversity in your letter writers

When it comes to choosing who should write your letter of recommendation for residency, diversity is key. Students often aim for the world-renown researcher or the chair of the department. However, it’s more important that you choose letter writers who know you, your work, and your potential. If that person happens to be a big wig, even better. Each letter writer does not need to be able to address your personal interests, your work, and your potential. But as a whole, the letters of recommendation that you include in your residency application should help the admission committee learn about you as a person and future doctor, not just as a student.


Choose letter writers who know you, your work, and your potential.


Materials to provide your letter writer

Once a supervisor or mentor agrees to write a letter, you should soon after provide a copy of your personal statement and resume or CV. If you haven’t written the formal personal statement for residency as yet, you should at least have a short letter of intent that explains why you are interested in your chosen specialty. It’s also helpful to write a short biography to help the letter writer fill in any gaps regarding your background and accomplishments. These documents will help the writer formulate a letter of recommendation that mentions specific attributes related to your goals.

Finally, feel free to include other relevant information that you would like the letter writer to include. For instance, if you worked in the lab with a researcher, feel free to share a memory from the lab that stood out to you. Or, you could mention a time when a labmate recognized your contribution. Tidbits like this can help your letter writer include as many specific examples of your greatness as possible. Lastly, feel free to list any attributes or strengths about yourself that you would like the letter writer to include. Below are direct examples from recent letter of recommendation requests I sent:

  • ” It would be great if you could touch upon my potential as a leader in the field of medicine.”
  • ” I hope that I made an impression during the Sub-I and my clerkship rotation that would allow you to attest to my clinical skills and decision making, professionalism, patient rapport, and leadership potential as a future psychiatrist.”

Summary

Having an amazing letter of recommendation for residency is a great way to stand out from the crowd. As the residency application process becomes increasingly competitive across all specialties, having someone who knows you well strongly advocate on your behalf can be of great help. Let me know in the comments which of these tips you found most helpful. And if there are any other words of advice that you’d like to share, please leave a comment below as well!

Good luck!! And be sure to check out the rest of my med school content in the Navigating Medical School section of my blog!

Dr. Atasha Jordan is an Ivy League-trained psychiatry resident and businesswoman. Learn more about Dr. Jordan here. Feel free to say hello and be sure to subscribe to the newsletter for updates!