Who to Ask
LoRs should come from attending physicians that you’ve worked with in clerkships or other clinical settings. Because you will likely choose to waive your right to view your letters, choosing wisely is important. Recommendations from physicians in your chosen specialty may carry a lot of weight in most cases, but someone who knows you well in another specialty may better serve your overall application than someone who doesn’t know you as well in your chosen specialty. When considering a qualified letter writer outside of your specialty, it may be wise to consider the similarity of their field compared to that which you are applying (e.g., general surgery relates more to urology than pediatrics). Note that LoRs from non-faculty (e.g., a physician you shadowed in the community) carry little to no weight and will likely not support your overall application.
It is wise to review the websites of programs to which you plan to apply. Their pages should have information on their letter requirements, preferences, and what writer specialties carry the most weight. Lastly, many fields are beginning to require standardized letter formats, be sure to check with your specialty’s national association for guidance regarding the field’s LoR norms.
When to Ask
Remember that attendings are very busy and hold various, overlapping commitments. Begin to think about who you might be able to request a LoR from beginning in your third year as you go through clerkships. You may consider asking an attending near the end of a particular clerkship, though know that this may require you to keep this person up-to-date on your medical school journey if your request comes far before the ERAS deadline. If you know the specialty you will be applying to at the beginning of a clerkship, you may choose to let the attending know of your intent early on and follow up at the end of your rotation with a formal request. However, you can make the request at any time leading up to the ERAS application timeline.
When you do have recommenders identified, be sure to allow these attendings sufficient time to prepare and write your letter, should they agree to. Ask for letters no later than one month prior to the ERAS deadline.
How to Ask
It’s advisable to request LoRs in person, and you may consider scheduling a meeting with the attending to discuss your motivation for your chosen specialty and why their recommendation would be invaluable to your application. If you know the attending well and/or are currently in a clerkship rotation with them, you may ask for a meeting in person. However, if you don’t see this individual regularly, you can request a meeting via email. Be prepared to provide your updated CV and personal statement. If you are feeling nervous, try and realize that, though this is unique and intimidating for you, this is a yearly routine for many attending physicians and they often consider this to be a part of their job.