Letters of Recommendation

Faculty Letters of Recommendation

Programs will generally request three or four letters of recommendation from faculty members as part of your application package. Select three or four faculty members who know you and ask each one to write a letter of recommendation for you. The ideal letter is written by a senior faculty member who knows you well, whose field is in the specialty to which you are applying, and who is known at the program to which you are applying. A letter from the ideal may not be feasible for all four letters.  Use your judgment and request letters from a group of authors that best meet this criteria. You can obtain advice about these choices from your advisor and the Associate Dean for Medical Student Affairs. A copy of your biographic sketch, a written statement of your career goals and a brief reminder of your contact with them will help the faculty prepare quality letters on your behalf. Letters of recommendation are sent by the faculty member directly to the residency program for NON-ERAS Programs. For ERAS Programs, letters will be uploaded by the faculty member directly into the ERAS system. For NON-ERAS Programs, be sure to provide the faculty member with a list of persons and addresses to whom they should send the letter of recommendation.  

These letters can be very valuable to program directors looking for some distinguishing characteristics among the many applications they receive.  After reading through this manual, everyone will know how to write a good CV and personal statement.  Quality letters of reference strengthen your application.

The following outline of thoughts on letters of reference was developed by the Department of Family Medicine with contributions from medical students at the University of Washington in Seattle.  Though the procedures and timelines have changed over the past 30 years, this advice is still completely pertinent.  (Leversee, Clayton and Lew, Reducing Match Anxiety, University of Washington, Department of Family Medicine, 1981.)

IMPORTANT "Your letters of reference often become an important reflection of your academic performance and serve as an important source of information about your non-cognitive qualities.

Number of Letters
Most residency programs request three letters of reference. Sometimes they specify certain departments or rotations from which the letters should originate; be sure to follow directions from the program brochure. Occasionally, a letter from a person not involved in the profession of medicine will be requested. Do not send more letters than are requested unless you have one that is especially dazzling. Some selection committees suspect "the thicker the application, the thicker the student." Some programs review only the first letters to arrive up to the number they request and subsequent letters are ignored. Therefore, it is in your best interest to follow the "N + 1 Rule," i.e., if "N" is the number of letters requested, send no less than "N," but send no more than "N + 1."

Letters should be uploaded/mailed to programs in August and September. So, start soon and avoid procrastination. Common reasons to procrastinate include:

- "I don't know anyone well enough to ask for a letter."

- "I hate asking for letters...I'll wait until August."

- "I did well on surgery but that was six months ago...they won't remember me..."

- "Dr. Scholarmann is on sabbatical and I'll just wait until she gets back."

- "I'm an average student so I'll just get a two liner from one of my attendings later on...a quick phone call will solve that problem when the time comes."

- "I'll dazzle them on my next rotation and get the best letter yet."

It is common courtesy to make arrangements for obtaining letters as soon as possible.  You may begin now by requesting letters from previous rotations. Postponing a letter request until you have completed a specific rotation of particular interest may be indicated.  Try to allow at least 1 month from the time you request a letter until it must arrive at its destination.  Bear in mind that faculty is often out of town or may have multiple letters to write.

Requesting a Letter
In most instances, you will request a letter from a rotation in which you did well, that relates to your chosen field, or was specifically requested by the program brochure. When possible, choose someone who knows you well over someone who does not. Choose someone who can judge your clinical skills and intentions as well as your personal qualities. Choosing at least one person who is likely to be recognized by the program is also a good idea. Also, make it easy for the person preparing your letter by providing a CV and a copy of your personal statement. Make a brief appointment with the letter writer to review your resume personally and to provide additional personal information, particularly if you can remind him or her of some specific event or situation in which you performed well on his or her rotation."

ERAS Requirements

Each letter writer must receive the following from you: a LoR request form printed from the ERAS website showing your letter ID number. Authors upload letters into the ERAS system. ERAS policy for the Class of 2016 prohibits upload by the student's school on behalf of an author.  ERAS Policy information:  incudes this document  which helps describe this new requirement to authors. 

FERPA Release Form
Complete the FERPA Form to authorize faculty and staff access to your educational record at Vanderbilt University. Complete this form by July 1st and return to the Student Records Office in 303 Light Hall.

Chairperson's Letter

Many hospitals request letters of evaluation from the chairperson of the department (chief of service) of the specialty in which you are applying. These letters usually reflect the department's composite assessment of its experience with you. Most department chairpersons will ask that you schedule an interview with them and provide them with a copy of your personal statement and/or CV before they will write a letter for you. Once you know where you want the chairperson's letter sent, submit the list to the chairperson's office.

Medical Student Performance Evaluation (MSPE)

MSPE, formerly known as the Dean's Letter. Note: NOT one of your LoRs. 

Advice from Previous Students

Certain programs will ask for letters from third-year clerkships. Some will ask for letters from peers (i.e. chief letters). Check the programs’ websites for specific details, and call if you have any questions. Also check on the MyERAS website and talk to the application coordinator in the office of student affairs to see if specific letter-writers have turned in their letters—some may need “encouragement” (i.e. gentle prodding multiple times) before they finally complete them. It is a good idea to start asking for letters EARLY, i.e. May or June. Sending a “Thank you” note can often remind letter writers that they should probably finish those letters. Some get different letters for their transitional or preliminary year, but it is not always necessary. Some also get letters from various attending physicians with whom they worked while on away rotations. Be cautious as that may indicate to other institutions that you are interested in that program. You have the option to send specific letters to each program and it can really help you if the letter is from a school you are seriously considering, if that person is nationally known (and obviously writes you a great letter), etc.