How to Rock Your Letters of Recommendation

By Elizabeth McKinnon 


Friends, it never ends. Yesterday you were asking your college professors and the family practitioner you shadowed for recommendation letters for medical school. Today, you’re about to step into a new role as a budding resident, and one of the most important aspects of your application has to be taken care of.  Letters of recommendation (LOR) are extremely important, and no one knows that better than a 4th year student on the interview trail.

Obtaining good recommendation letters is key to having an application that fleshes out who you are. Until now, you’ve been listed as a series of numbers, letter grades, and board scores. And while this specific data matters, ultimately your chances of being chosen for an interview will be better if you are well-reflected in your letters. A good recommendation adds your humanity to your application.


So in order to better help you, I’ve complied my top 5 tips for getting great letters of recommendation. You don’t have to follow these to a T, but these are general guidelines that will help you get the LOR you want.



1) Getting noticed means getting stand out!


You'll spend a whole calendar year in the hospital doing clinical rotations, and there's no better way to increase your knowledge by doing the hands-on stuff. I cannot begin to tell you how important it is to not only commit yourself to the learning available to you, but also to study hard during these years, as if there is a test every day. This will allow you to grow as a student, and you will be super-prepared if an attending asks you a question. It's definitely okay to not know an answer, but when your number is called to impress your higher-ups, are you up gonna belt out the tune or bottle it all up?

This is the foundation for getting yourself out there when it comes to asking for letters of recommendation. A doctor would be hard-pressed to write a letter for you if he or she knows nothing about your skill set, your talents, and your basic abilities that would make you a good physician. So be at your best and you'll never have to wonder if you gave it your all.

This other piece of advice when it comes to getting noticed is somewhat less important, but it could very well work in your favor if executed properly. Now, those of us who spent a little bit of time in theatrics know how important it is to stand out amongst your fellow starlets. When it comes to "nailing the audition", you want to be able to gain a certain amount of notoriety but without coming across as a showoff or a know-it-all. This ultimately will help you get noticed among your real-world "starlets" (the medical team), and this is a true way to make yourself known amongst a group. Perhaps you have a similar sense of humor as your attending, or you have something in common with him or her. It can be as simple as telling a funny joke or mentioning that you also took a trip to Australia last summer. Whatever it takes, find something you can talk about that's not medicine-related. Doctors are humans, too. In my experience, it's the things you exude in addition to clinical persona that make the biggest impression.

So don't be afraid to be the rockstar, the jokester, the history buff, or the girl who wears her pink scrubs on Tuesdays "just because". Always keep it professional, but don't be afraid to be yourself!


2) The early bird gets the worm...but the late worm gets to live!

This rather colorful intro is just my way of saying that doing things early has it's perks, but being "too early" has drawbacks as well.

A lot of people always want to know “when is a good time to ask for letters of recommendation?” And the answer is "early, but not too early". How do you figure? Ask too early and you run the risk of the writer forgetting. Ask too late and you may not receive the letter in time to be helpful towards your application.

For the grand majority of attendings and clerkship directors, this isn't their first rodeo. They've participated in the residency match themselves, but they've also helped dozens of eager medical graduates get into the programs of their choice. And since no one is an island, they've been on the business end of asking for letters themselves! The moral of this is that they very much expect medical students to ask them for letters of recommendation. It's a necessary part of the process that happens year after year without the least bit of change.

With this assurance, go into every rotation knowing that you might ask for a letter. Be it your first or last rotation in your clinical schedule, leave the door open so that you not only motivate yourself, but that you also leave the door open should anything fall by the wayside with another writer (more about that later).

To throw yet another variable in, the time frame will have to be left up to you and the preceptor. In many instances, the opportunity to present your case will be on the writer's time. For instance, I've been on rotations where the director said during our orientation that he would be happy to write letters. I've also been on ones where the director wanted to meet with me individually on the last day of the rotation to discuss my evaluations and board scores before he said yes to writing a letter. So plan it accordingly and don't get down if they make you wait in a long line, ask to be contacted closer to the application opening, or insist that you speak directly with the secretary about any letter matters. Everyone has their own style.

Whatever the case may be, always be prepared. Collect email addresses, office phone numbers, pager numbers, and any other contact information you may need to contact your letter writers down the road.

Lastly, if you're ever at a complete loss for when to ask, just go ahead and do it as soon as possible, but be prepared to revisit the request if the writer wants to discuss it at a later date.


3) By failing to prepare, you are preparing to fail.


When you are preparing to ask for a letter of recommendation, always bring the following things with you:

  • A Current Photograph (not a selfie, a candid, or something out of focus or unprofessional...and for goodness sake no "duckface"!)
  • Your latest CV (with most current contact information)
  • Your unofficial transcript with board scores
  • Your Personal Statement (even if it is still a work in progress)
  • Your AMCAS ID number (if available)

Check and double check that your address, emails, phone numbers, and any other information is up to date, clear, and correct. Don't have your personal statement done yet? A rough draft will do if there is still a good amount of time before your application goes out. You can always email them an updated copy. Don't have your AMCAS ID? Also okay. Sometimes you won't have this until the ERAS opens in mid-July. The number will also be on the official request form you will give your letter writer when you officiate them as letter writers on your application.

Preparedness is key, folks!


4) we have liftoff?

I rarely advise others to stay scripted, but this phrase you must say is a very important one. It has been passed down to me and is now being read by the next generation.

So now you've set a time and date to talk. That day is today. You're in your preceptor's office, looking around at diplomas and family pictures while he or she takes a quick phone call.

Take a deep breath. Everyone needs help sometimes. Your career is a completely normal and logical thing to ruminate over and you're making an excellent decision by being here right now.

When the doctor turns his or her attention to you, it's now the time to ask for a letter of recommendation. But you must use these two words to describe what you need!

"Can you write me a strong, positive letter of recommendation?"

This shows that you are making an informed request and that your level of understanding of what a letter of recommendation is… is clear in your mind. For the purposes of your residency application, your letters must be strong and positive.

So there it is! We have liftoff! Good for you!

But alas, there is always a need to prepare for their answer.

If the answer is YES, well done!

If the answer is No, then do not think of it as a drawback. Think of it as another hurdle you've cleared. A good attending will let you know if they cannot provide a strong, positive letter of recommendation. And they will most likely give you a reason (he hasn't spent enough time with you, he is very busy, he thinks you should seek letters in your specialty of choice, etc). Whatever the case, consider it a good thing if he is honest with you about why he cannot provide a letter. You want letters that are going to be helpful to your application, not ones that won't be as personal or show you in the brightest light.

I was rejected for a letter once from an attending I really liked. It stung, but at least he was honest with me. He could write me a positive letter, but it wouldn't be strong. And if I had begged and said that was okay, maybe my circumstances during the match process wouldn't be as good. So like I said, consider it a good thing when they shoot you down.

Now that you've been given the green light, hand over your materials you have prepared and remember to double-check your contact information. Make sure that you have the current emails and phone numbers of your writer and the secretary or office manager.

And remember to say thank you! It's totally fine to send an email or a handwritten thank you note for their time. It'll make them feel appreciated, and in the event they haven't uploaded yet, it will jog their memory to do so.


5) Y'all come back now!

The last bit of advice I have is to follow up with your letter writers. You should at least contact them when the ERAS application opens and you have to send the Letter Request forms to them. But this should not be the first contact after asking for the letter. Definitely get in touch with them beforehand and thank them for helping you out. But as always, do not be a pest. Remember, they may be busy with other responsibilities and may not work on your letter until they have time. Do not worry. Just keep up the communication and it will get done.


Another good way to keep in touch is to keep your letter writers updated with how things are going with residency interviews. They want to hear from you! I send mine updates about once every one or two months. I just sent them a quick message to let them know how things are going and I thank them again for the invaluable aid to my application. Don’t be a stranger!


Dr. Barone and I wish you the best during your clinical years!


#2 Folasayo Adeniyi 2016-07-17 21:02
Thanks Dr. Barone, you are the best!
#1 Zhenshen 2016-07-17 16:15
Thank you for this article! How do you distinguish between positive and strong letters? What does the letter need to have to be considered strong?
Category: LOR

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