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Hey all! Congratulations to all those who matched!!

A question about reference letters--the class of 2022 is officially not getting visiting electives. Do you guys think that competitive/small programs will still expect 3 letters from attendings within the field? 

Thanks :)

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Think this depends on the specialty and your location. Generally smaller surgical specialties put more weight on references letters from within the department. Of course this is not always possible and that’s fine. 
 

let’s say you are doing urology electives and you are in a bigger academic centre, think it would look odd if you didn’t have 3 LORs from urology and it may suggest that you are “backing up” with something else and may raise questions. This is just the way it seems to be in these smaller surgical programs where people talk. 
 

take my advice with a grain of salt, but this is coming from someone who matched to a smaller surgical specialty this year and didn’t back up 

good luck ! 

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The short answer is every program is different.

 

The more constructive comment is the following:

Having 3 references from your specialty has never been a stated requirement, however you should do everything in your power to secure at least 3 references from your desired specialty. As someone who has been on the admission committee for a Top 3 competitive program for the last two years, not having three references from the specialty you are applying for puts you at a significant disadvantage. Sure there might be more leniency from the program in terms of their expectations, but you will be competing against others who will do everything in their power to make themselves the best applicant, and that includes securing references. Assuming the strength of the letter is equivalent (which obviously it won't be) here is a list of how I view who you should get references from:

1. Staff in desired specialty who has seen you in Clinical and Research Setting

2. Staff in desired specialty who has seen you in Clinical Setting

3. Staff in desired specialty who has seen you in Research Setting

4. Staff in other specialty who has seen you in Clinical and Research Setting

5. Staff in other specialty who has seen you in Clinical Setting

6. Staff in other specialty who has seen you in Research Setting

Obviously your interactions with these particular staff are important in deciding who you ask for a letter. What is unanimous for small programs is that the person who writes your reference letter matters. Someone that is on the adcom or is known to the adcom will be more beneficial to your application than someone in a peripheral community that no one has heard of.

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Thanks everyone! I appreciate it, and of course, it's best just to aim for 3 strong specialty letters and then settle if it's not possible. Just wanted some insights as to what to do if you never run into staff during an elective? I imagine this is still valuable since you still get face time w/ residents, but I simply just don't know how to work around this. 

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30 minutes ago, smeagol said:

Thanks everyone! I appreciate it, and of course, it's best just to aim for 3 strong specialty letters and then settle if it's not possible. Just wanted some insights as to what to do if you never run into staff during an elective? I imagine this is still valuable since you still get face time w/ residents, but I simply just don't know how to work around this. 

Even in busier services and locations, I found there was always some face time with staff.  

It's crucial to develop good relationships with all residents and staff from the beginning and also be aware of which staff seem to have a higher opinion of you and try to obtain as much time with them as possible.  Resident opinion can influence staff and sometimes residents will also be able to provide guidance.      

Most schools begin mostly with core rotations so this should give you a "warm-up" in understanding the system.  As mentioned above, research opportunities, if available, are important to pursue as early as possible as subsequent clinical cross-over will be easier.  

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