Impressing: Letters of Recommendation

Letters of recommendation are very important. Over 70% of programs use them to help decide whom to interview.
Who to ask:

  • The minimum requirements for a letter writer are: someone who can comment on your clinical abilities AND who you know thinks you did a good job.
  • At least one letter should come from a family physician. The other letters can come from physicians in any specialty. Additional letters from family physicians or other physicians in primary care fields can help strengthen your application by indicating your commitment to family medicine.

When you request a letter:

  • Ask the individual if they would be willing to write you a “strong letter of recommendation.”
  • Give the letter writer plenty of time to get your letter in, at least one month.
  • Some letter writers may need gentle reminders about the letter. If a month has passed, send an email.

Number of letters:

  • You should have a minimum of three letters of recommendation – some programs will accept more.
  • Do not submit more letters of recommendation than a program accepts.
  • Rarely a letter writer will not come through with a letter. Be sure to request at least one back-up letter to prepare for this. Nothing is worse than only having two letters in your ERAS application and watching the days tick by. Ask 4-5 people for letters to ensure you will have the minimum number required.

To get great letters of recommendation:

  • Ask physicians who know you well for letters. You should ask for letters from physicians who have directly observed your clinical skills. Important things that residencies want to see in a letter include your clinical knowledge, your willingness to learn, your ability to work with other members of a team, and your ability to work with patients.
  • Provide your letter writers with your photograph and a copy of your personal statement and CV. The photo ensures that the letter writer is writing about whom they think they are writing. The CV and personal statement gives the letter writer more information about you that can help them round out your LOR.
  • Ask for letters as soon as possible. It’s easier for a letter writer to remember specific examples of your skills right after a clinical experience.
  • Be sure your letter writers indicate your interest in family medicine. A letter that states that you would be a great resident without naming the specialty could be viewed as a “generic” letter and perhaps a sign that you are applying to two specialties in the match.

Avoid these pitfalls:

  • Asking for a letter from the chair of the Department of Family Medicine. Do not ask the chair to write a letter unless this person can directly comment on your clinical skills OR the program requires this letter. These letters are often just a rehash of the rest of your application and do not add more information. It is better to have letters that comment on your abilities based on direct observation.
  • Letters that do not at all relate to family medicine. You may have demonstrated amazing surgical skills during your neurosurgery elective, however, most family medicine residencies will not be interested in your ability to perform a laminectomy. A letter from a neurosurgeon could be a good letter if it comments on your skills on the wards, in clinic, or on a team.

National Residency Match Program (2010). Results of the 2010 NRMP Program Director Survey.Retrieved from