Thursday 31 March 2011

On asking for LOR

Strong LOR versus LOR
Letters of recommendation are an important aspect of any IMG application. The task for any applicant is to secure not just good LORs but strong letters which vouch for the applicant. If you are going to work in a hospital or a clinic make sure you are clear about what you want out of it at the end. This is true especially is you are involved in patient care.

Hospital based USCE is valuable
The most sought after letters are from clinical faculty at university or university affiliated hospitals. A LOR on a university letter head is going to be viewed positively. To secure a USCE or observer-ship spot in a reputed hospital is tough but you have to do a lot of networking and develop connections. Read about USCE and observer-ships here. 

Place for clinic based USCE
Letters from physicians in private practice also have a place especially if they are a large community practice and the applicant is interested in applying to family medicine.For clinical sciences like internal medicine or family medicine, it is good to have some clinic and hospital based experience. This way you can have a broad range of referees who can write letters for you. 

Perfect Phrases for Letters of Recommendation (Perfect Phrases Series)

Buzz words create a stir
Sometimes, faculty will let you review their recommendation before mailing it in. Though this is not publicized much, it still happens and will be very much in favor of the applicant. This way, the applicant has some input and is able to ask the letter writer to mention specific 'buzz' words  that are key to a strong application.

Provide input for your letter
If you are directly involved in history taking, talking to patients and physical exam, outlining a plan of care, make sure this is mentioned in the letter. This shows that the referee had an opportunity to observe your interactions with the patient

To waive or not to waive.
Most applicant will be faced with a referee who chooses to send in your letter with no input from the applicant, since they waived the right to see the letter. According to ERAS, such letters are given more weight by program directors and faculty as they are supposed to represent an unbiased view of the applicant.

State your need for strong letter in begining.
The key is to ask the attending upfront if they would consider writing a strong LOR for you, so that they know what YOU want out of this. It is not good enough to write just a recommendation letter, it should be an impressive one. You should ask for a strong, solid recommendation. It is better to clear that up in the beginning, rather than assuming that they will, and end up getting a generic letter that does not look impressive at all.

How to ask for LOR
1. Be specific in asking for a letter of recommendation, do not beat around the bush or be indirect. Doing so the referee will know for sure they have a letter to write
2. If they have no time or are busy, ask if you can draft a preliminary letter which they can revise and sign as needed
3. If you are having issues with getting in touch with them via email, there is no problem in calling their office on the phone and reminding them of the time sensitive nature of the task.
4. refrain from haggling them too much but if they are still not responding, ask if they can still do it, if not, you can spend that time looking for a new referee.

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  1. but if its with psychiatrist then you do only to he treats patients with therapy?
    what should be done in that case as an observer?
    how can i ask for a letter of recommendation?

  2. Even listening in on a conversation between a psychiatrist and a patient will be considered as a USCE especially if you are applying for a residency in psych. Before you begin the rotation, discuss with the attending what is expected of you and be clear about what you want in return (LOR). Be enthusiastic, do not interrupt his interview with patient, ask questions later, and show up on time!
    You should ask directly, " Dr. __ would you be able to write a letter of recommendation for me? I am interested in psychiatry and this letter will help me for my interviews in this field"

  3. Dear Dr. Droidor,

    LOR or research from psychiatry helps to apply for IM or Neurology?

    Or is just a waist of time?

  4. Dear Dr.Droid,

    I want to apply for IM or Neurology... but I have the chance to get great LOR and research of pshychiatry.... it is useful to do it or is just a waist of time?

  5. LOR from another field may be useful. MAke sure you get LORS from neurology folks too. In fact a well rounded application can have referees from varied backgrounds. Good luck!

  6. my attending whom i did a month of clinical rotation with wrote me a letter of recommendation which i did not waived my right to see. the letter sounds generic. is it ok if i ask him to revise the letter? is there a proper way of asking that?

    2012 applicant

  7. yes. it is perfectly alright to ask him to revise your letter. after all it is going to make a big difference to you in your life. The best way to ask them would be like " Dr YY, i was reading through you LOR and it sounds good, thank you for writing it but could we add few more things or could we word it in this way such that my application becomes stronger for __ field?" be polite but know what you want out of it finally.
    good luck!

  8. Dear Dr. Droidor,

    I'm doing an observership and planning to apply for next year's match. When should I ask the attending for LOR? before ERAS application?

    Also, it sounds pretty weird to ask for LOR? What can she write into her letter? That I observed really well? I'm new in this country and have some speaking problems which I hope to get over soon. So, she can't comment on my good interpersonal relations. I'm very desperate about these issues. Please help me...

  9. no it is better to ask at the outset so the the referee knows what you expect at the end of your rotation. Do not be shy in being clear about your need of a letter. You can always be direct and ask " would you consider writing a letter of recommendation for me at the end of the rotation?"
    though it may sound weird, it is not in reality. so dont worry about it. She can write stuff like you interacted with patients under supervision. You were keen and observent, asked right questions, have a keen interest in (speciality of your choice) etc etc

  10. Dear Dr.Droidor,

    Im an IMG, writing my STEPS now. I have got into a research which involes doctors in India and a neonatologist in the USA. But it mainly involves biomedical engineering staff. My work right now is in INDIA. I dont know if I would be allowed to ro required to work on this in the USA. Will working on this be of any help for me? Will the LOR by such people work? I was thinking it would make my CV look impressive at the least, or netwoking with those doctors get me some observership. I dont know if Im right. Please let me know your opinion. Thanks

    1. Hello Dr. Shekhar, this kind of work will certainly make your CV more well rounded. Can you get a LOR from your collaborators in USA at the end of this? This will help tremendously, I have personally used a non physician LOR and that is a well accepted alternative as well. You are correct in thinking that it will make your CV more accomplished and networking opportunity is always a plus.

    2. Dear Dr.Droider,
      I am an IMG interested in applying for Int medicine,Paed and Family medicine. I have a good research opportunity in Radiology. Will it be any help?

    3. it depends on a few factors. If you are using this as a filler to keep your CV rolling and updated then it will be useful. Doing research in radiology in itself will not have an adverse impact on your application to IM, FM or peds. Just be ready to answer why you did what you did and you will be okay.


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