Getting Into Residency: Put a Ring On It

Many of you already know about the Insider Medical Admissions' Guru on the Go© video shorts - a free, stop-motion animation series that provides critical advice in under one minute for medical school and residency applicants. I received some great feedback last year after rolling these out, including a nod from the NRMP® itself. Check out this brand new getting into residency video called "Put a Ring on It." Also, take a peek at the Insider Medical Admissions Guru page for more shorts.

Getting Strong Medical School and Residency Letters of Recommendation, Continued

This is my second blog entry  regarding actions you can take immediately to help you obtain strong letters of recommendation (LORs). The first entry describes two initial strategies for improving your medical school letter of recommendation process. (Much of the guidance in both blog entries is critical for residency applicants as well, so feel free to read on if you are a medical student.)  Today I’ll pursue the LOR topic further, specifically advising you how to positively influence the content of your LORs.

As a Harvard Assistant Residency Director, I bore witness to how weak – or even mediocre – LORs had the potential to bomb an otherwise competitive candidacy. Once you’ve followed directions and asked the right people (see my previous entry), it’s time to influence the content of your letters by making the job of letter writing easy.

 Let's Give Them Something to Talk About -Bonnie Raitt 

When pre-meds, residents, nurses, and physician colleagues asked me to write them LORs when I was Assistant Residency Director, the first thing I requested was that they send me background information to make my letter robust…and my job easier. Accordingly, I strongly recommend you create a “LOR packet,” which can include the following:

1. A brief, well-written cover letter defining all of your important accomplishments
2. Your curriculum vitae (CV)
3. Your personal statement in its final form
4. Your transcripts.

With regard to the cover letter, keep it streamlined. No one will skip the beach or her two-year old’s birthday party to read your exhaustive biography, so you want to thank the writer and highlight your pre-professional achievements in one page. The point of the cover letter is to supplement a letter writer’s knowledge of your candidacy and offer flattering content for inclusion. A professor may know that you made the only A in an organic chemistry class, but her LOR will be more complete, and she will demonstrate a more intimate familiarity with you if she knows enough to write that you volunteer regularly at a homeless shelter.

With regard to the CV and personal statement, these make useful supplements to the LOR packet only if they are in professional and final form. Don’t include rough drafts, as poorly organized background information leaves your writer the impression that you are a disorganized person. Also, only include the transcript if it bolsters your candidacy, demonstrating academic achievement. Don’t shoot yourself in the foot if you have some bad grades or an incomplete you’d rather not showcase.

Bottom line: An applicant who offered me a list of her accomplishments in a tidy, accessible package was more likely to get a strong, comprehensive letter that was submitted promptly. She also distinguished herself from the majority of candidates who requested letters without demonstrating a comparably sophisticated understanding of the demands this process made on my time. If you can make a letter writer's job easier, your forethought is likely to pay dividends in the letter your receive. This is not a court of law, so the savvy applicant can take subtle advantage of her ability to "lead the witness."

Signed, Sealed, Delivered - I'm Yours - Stevie Wonder

In addition to making your writer’s life easier with a LOR packet, you can improve your writer’s attitude and speed by making the process of submitting your letter easy: Ensure that you don’t leave your letter writer to figure out where to send the completed LOR.

Your medical school recommenders have several options for submitting their letters to the American Medical College Application Service (AMCAS). You want to make the process as convenient as possible for the writers, and different faculty members may have different preferences, so offer each writer all feasible alternatives. If your letter writer plans to send the letter by postal service, provide her with a pre-addressed, stamped envelope. There is no worse party foul than asking someone to pick up the tab for the letter she is writing you as a favor.

Below are the options. Note that your AAMC ID and AMCAS Letter ID (found on your Letter Request Form) are required, regardless of the means of submission:

1. AMCAS Letter Writer Application: This site enables letter writers to upload documents to AMCAS securely.

2. Interfolio: AMCAS can receive letters sent to Interfolio if the applicant is an Interfolio user or if the faculty member’s institution/organization uses the program.

3. Traditional post (i.e. snail mail):
AMCAS, attn: AMCAS Letters
AAMC Medical School Application Services
P.O. Box 18958
Washington, DC 20036

4. VirtualEvals (VE): VE is available to members of the National Association of Advisors for the Health Professions (NAAHP).

A savvy applicant recognizes that even the way in which one asks for a LOR has the potential to leave a favorable impression on the writer if performed tactfully. The candidate who submits organized materials, provides supplementary information about her extracurriculars ("I knew she was a star in my chemistry class; I had no idea she also captained the tennis team and coordinated medical interpreters at the community clinic, too!"), and demonstrates the foresight to provide a stamped, pre-addressed envelope or explicit directions on how to submit a letter online can turn even the most overburdened professor into an enthusiastic supporter.

International Medical Graduate Performance in the 2014 Match

Many of you already know that the ECFMG® (Educational Commission for Foreign Medical Graduates) is a certifying, advocate organization for International Medical Graduates. Each year, the ECFMG publishes data on International Medical Graduate performance in the Match.

ECFMG posted their results recently:  In 2014 53.0% of U.S. citizen IMGs obtained first year positions through the Match. Of those IMGs who were not U.S. citizens, 49.5 % matched (Source: ECFMG®).

Considering this reality, it's important for current IMGs to approach the application process by ensuring they apply broadly to residency programs.