Letters of recommendation (LOR) are exceptionally important part of the medical residency applicant package. Many IMG applicants seek US letters of recommendation for application to programs. However, given the fact that US LORs are difficult to obtain for those who are not in the system, many applicants have to make do with what they get.
If this were the case, then would it not be ideal to know which specialties prefer LORs from specialty specific referees and which fields are less discerning as far as letters are concerned? To answer this question, data was procured from the program directors survey NRMP 2010, compiled and analyzed for the LOR specific query. The results were tabulated and are represented in Fig 1.
|Fig. 1 Relative importance programs place on LORs from specific specialty|
The percentage of programs citing specialty specific letters of recommendation was normalized using a min-max formula to nominate a value of one and 0 to the most and least specific respectively. As you can see, Internal medicine and pediatric programs were least concerned about who wrote the letter. On the other hand, IMG friendly programs in psychiatry and family medicine were more critical and wanted more specialty specific LORs. On the higher end of this spectrum were neurology and pathology and emergency medicine was highest at one.
The implication of this is two-fold
- If you are applying to pediatrics or internal medicine, it should not matter much as to where your LOR comes from. It could be from a general practitioner, a specialist, a radiologist or even a scientist because these programs did not place much weight on the LOR being specialty specific.
- If you are applying to subjects like family medicine, psychiatry, neurology or pathology make sure you have at least 1 or 2 letters or recommendation from physicians who are practicing in that field. Do not use a letters of recommendation exclusively from specialties like cardiologist or internist if you are applying or interested in the above fields.
Keep this advise in mind when you are doing your observership or USCE because the goal of such enterprise is to obtain a stellar letter of recommendation and to make connections who can vouch for your performance and character and ultimately help you obtain an interview. Thus if you focus on obtaining the right kind of letter of recommendation whether you choose to waive it or not, it may make things a little easier for you when it comes to improving your interview chances using the LOR!.