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Letters of Recommendation: To ask or not to ask - that is the question?

Updated: Sep 28, 2021

Like Christmas, application time comes around once a year - and you need to make sure that you put yourself in a good position to be accepted. Letters of recommendation can make or break your application, here's how to think about who to ask

Who to Ask: The Ideal Reference

Ask a clinician in your specialty of choice

According to the several surveys, letters that carry the most weight are from Clinicians that programs know and respect. This includes experts in the specialty but also the Clinicians who are working in the program you are applying to. You will need at least one letter from a Clinician in the specialty. This is very important. Here are some tips to guide you in thinking through who you should ask

Once you have secured a letter from a clinician in your specialty of choice, prioritize quality of reference & credibility

Don’t forget about asking other credible references who think you are a superstar, no matter what specialty or research background they are from. The people you ask will depend on the program(s) that you are applying to and any unique attributes that you bring to the table. No Program Director would hold this against you and it may help “round out your application” in about 40% of programs. If you have done formal training in research and your research supervisor can attest to your scientific genius, ambition, and determination, then this is also helpful. Note that people who are not credible references may detract from your application (e.g., friends, relatives). Most importantly, remember to get the core references from the physicians in the specialty you are applying to - then you can think about broadening the net.

Follow instructions

Ensure that you follow the directions regarding reference letters outlined by each Program. This goes without saying.

Be strategic & communicate your intentions with your referees

If you are applying to several specialties, strategize on the specificity of your referee letters. You may decide to send certain letters of reference only to certain programs. It is essential in these cases that you make time to meet with your referees and talk with them about your career plans. You want to avoid general statements like “John is destined to become a superior academic surgeon” if you are also sending this reference to Internal Medicine programs.


Most admissions officers won't even review an ERAS® application until they have two letters of recommendation uploaded, no matter how outstanding all of the other elements may be. Prioritize this in your preparation.

Now that you know this, get all hands you need on deck and go get that rec!

#medicaleducation #medicine

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