Residency Letters of Recommendation: The Best for Success

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Residency Letters of Recommendation: The Best for Success




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Presentations text content in Residency Letters of Recommendation: The Best for Success

Slide1

ResidencyLetters of Recommendation: The Best for Success

Elise Everett, M.D.

Julie Lahiri, M.D.

Christa Zehle, M.D.

Slide2

Workshop objectives:

1. Participants

will understand the

purpose and importance

of

Letters of Recommendation (LORs)

in

the

residency application process.

2. Participants will be able to help students identify

appropriate faculty

from whom they should request LORs.

3. Participants will be able to identify

key elements and information

needed

to write a strong LOR for a medical student applying to

residency

.

4. The participant will learn how to address

declining a LOR request

and informing

a student if they will

need

to

address challenges

in

the LOR.

5. The participant will be informed of the

timeline

for residency

applications

and when and how to submit a letter.

Slide3

Importance?

A letter of recommendation is one of the most important factors programs use when selecting candidates for interviews and in ranking candidates!

Slide4

Slide5

Slide6

Purpose?Serve as the “expert testimony” that help residency programs make better informed decisions about applicants

Convey more than grades and numbers:

clinical judgment

interpersonal

skills

professional

attributes

a

ptitude for specialty they are pursuing

i

mportant information not gleaned from ERAS CV

technical abilities

Slide7

Type of Letter?

Providing students with a

strong

letter of recommendation is very important.

S

tudents waiving their right to see the LOR is strongly recommended.

Slide8

Who should write a LOR?

Someone who…

Knows the student well

Is able to describe the applicant’s attributes

Has observed the student in a clinical setting

Slide9

Who should write a LOR?

“Famous

versus “non-Famous

” Faculty

Programs requirements

Specialty versus non-Specialty Faculty

.

Slide10

What are the main

applicant elements

you should convey in your LOR?

Slide11

Elements

clinical aptitude

personality

and

professionalism

l

eadership roles and attributes

research experience

future goals

outlying

circumstances or

things requiring explanation

Slide12

Gather information:

Meet with the student

Review CV and personal statement

Request copies of evaluations

Request a photo (to jog memory)

Ask others!

How do you execute this?

Slide13

ReflectWhat would a program director like to hear?

What would make a great resident?

Compare students to others with whom you have worked (top %)

Be specific - think of stories that illustrate the student’s strengths

How do you execute this?

Slide14

How do you execute this?

Opening of letter

Body of letter

Closing

Slide15

Avoid pitfalls!

Do

not

reiterate

CV content

Not too short (1-2

pages is

ideal)

Over-generalizations; don’t be too general (i.e., ‘best student I ever had’)

Avoid

personal remarks

(i.e., age

, race/ethnicity, marital status, children, physical characteristics, political and religious affiliations, geographic

interests, or

other personal

attributes)

Typos

/ wrong

gender/ wrong name

Slide16

What are potential challenges

when writing an LOR?

Slide17

Challenges

Writing

many

unique

letters

The

a

verage

student

You are unfamiliar with the student

The student has unique challenges; i.e.,

Academically

Personally/professionally

Clinical challenges

Slide18

What are strategies for overcoming these challenges?

Slide19

Overcoming challenges

Meet with the

student

Share

a story about a personal interaction with

the applicant

Stick to what you can truthfully say about a student

Decline

-especially

if you

do not

have anything positive to

say or cannot write a

strong

letter of recommendation

Or…

I

nform

the student that you will need to discuss challenges that they

have

Slide20

Timeline and Process

Letter of Recommendation Portal (LoRP)

Enables LoR Authors and/or their designees to upload letters of recommendation (LoRs) to ERAS for distribution to training programs, at the request of applicants.

Applicants generate a Letter Request Form (LRF) for each LoR they are requesting and provide the author with the form

Authors and/or their designees use the unique Letter ID on each form to upload LoRs for applicants.

A designee may not be a member of the hospital in an advising role or a medical school staff member supporting the application process.

Slide21

Timeline and Process

Letter of Recommendation Portal (LoRP) Guidelines

You will need an

AAMC account

.

In order for a letter to be uploaded to the Portal:

File must be in a PDF format, cannot exceed 500KB, and cannot be password protected, encrypted and/or contain an electronic signature

File name cannot contain spaces or special characters (i.e. hyphens, slashes, period, etc.)

Page size must be 8.5 x 11 inches

Recommended that letters are written on a professional letterhead and signed by the author

Before uploading a letter, carefully review the letter for accuracy and grammatical errors.

Slide22

Timeline and Process

Standard Forms/Letter

of

Evaluation

Programs

may request standardized forms/letters in addition to or instead of a narrative

letter; if this occurs,

both documents should be uploaded as

one

single PDF file.

Otherwise

, the standardized form/letter should be uploaded alone

.

Slide23

Timeline and Process

Letters may be uploaded once the ERAS season opens in May/June.

Students may submit applications around September 15

th

.

A student’s application is considered complete when they have three letters of recommendation.

Programs view applications early in the process.

To ensure your student receives a fair review, ensure you have your letter of recommendation uploaded prior to the application submission date (preferably by September 1

st

).

Slide24

Small group work

Review your applicant scenario

As a group, think about how you would execute the LOR

Do you need additional resources?

What should you include in your LOR?

Outline a plan for writing this LOR to share with the large group

Slide25

Large group work

Small groups will report back to larger group

Discuss your plan for writing this LOR.

Discuss the challenges and how to overcome these challenges.

Slide26

Scenario 1

You have just finished a busy week on the inpatient service.

The senior medical student / acting intern asks if you would be willing to write them a

strong

letter of recommendation for residency in your specialty. The student is in their third week of the rotation and, although you didn’t work with them much or observe them do an H & P, you felt like they did a good job.

Slide27

Scenario 2

You have been asked to write a letter for an average applicant. How do you write a

strong

letter for an applicant who is average academically or clinically?

Slide28

Scenario 3

A medical student asked you to provide a

strong

letter of recommendation in your specialty on their behalf.

The student just completed their acting internship and seemed to struggle more than most students. They showed improvement each week, however, they seemed to perform below the level expected of a senior medical student. Your main concerns are with their clinical judgement and efficiency. They are very nice and interacted well with the team.

Slide29

Scenario 4

A fourth-year

medical student

applying

into your field

asked

you to write a

strong

LOR

on their behalf.

 They failed the USMLE Step 1 and had to retake the

exam for which they

received a

passing score

of

198.

 

They

did not receive honors in any of

their Foundations

or

Clinical

Clerkships due to lower exam scores, per

their report

However

, clinically all of the residents and faculty

with whom they worked report

that

the student functions

at an

honors-level,

easily

assimilates

into the

team, demonstrates

outstanding clinical

acumen, functions

at the level of an intern in

their

history taking, physical exam, oral presentations and note-writing, as well as

takes

ownership and responsibility for

their

patients. 

They are extremely

hard working, professional,

have very

strong

IPCS; moreover, the patients

love

them.

How do you address

their

low USMLE Step 1 score in a LOR?

Slide30

Scenario 5

A fourth-year medical

student

applying

into another

field asked

you to write

an LOR.

 

They have solid

Step 1 and 2 board scores (235, 247), received two honors grades in Foundations, and

honored

the Surgery Clerkship

.

During

their

rotation on your clerkship, several residents, nurses, and faculty expressed concerns about

their professionalism

They were often

late to clinical

work, wore headphones

and tuned out during group

sessions,

or left the floor for unclear reasons. 

They did not seem

engaged in your particular field of medicine

.

When you

attempted to discuss this with the student, they

accused the residents, nurses, and faculty of

discrimination.

 

The student is smart, with

strong technical

skills,

and is interested in anesthesia as a career choice. 

The student feels like they

demonstrated

strengths

on your rotation with a high shelf score and good comments about

their

technical

skills. They hope

you can write

a

strong letter of recommendation, understanding that the issues raised were not reflective of

their

abilities, but

discriminatory.

 

How

do you address the professionalism issues in writing a LOR for this student

?

Slide31

Resources

APGO faculty development meeting workshop:

Charting an accurate course for a successful journey: how to easily write

en

pointe letters of recommendation.

Star Hampton, M.D.,

Archana

Pradham

, M.D.,M.P.H., Samantha

Buery

-Joyner, M.D.

AAMC Careers in Medicine Website

Guidelines for Writing Letters of Recommendation

; Anita D. Taylor, M.A. Ed., Associate Professor & Director of Career Advising, Oregon Health & Science SOM

University

California San Francisco

http://meded.ucsf.edu/ume/writing-letters-recommendation-residency

Guidelines adapted from Gross Davis B. Writing Letters of Recommendation. In: Tools for Teaching (1993). 1st Ed. San Francisco, CA:

Jossey

-Bass; 1993:407-412.

Slide32

Thank you!

Elise Everett, M.D.

Associate Professor of Gynecologic Oncology, Vice Chair for Education

Elise.Everett@uvmhealth.org

Julie Lahiri, M.D.

Associate Professor of Vascular Surgery, Program Director General Surgery Residency at UVM Medical Center

Julie.Lahiri@uvmhealth.org

Christa Zehle, M.D.

Associate Dean for Students & Associate Professor of Pediatrics

Christa.Zehle@med.uvm.edu

Slide33


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