Worried about getting reference letters

[SlowMedStudent]

I'm a CC3 planning to apply to FM. I'm halfway through my core rotations. I didn't bother trying for reference letters in the first 3 blocks since I figured I was too "green", which in retrospect was a mistake, since these were the blocks were I actually had nice preceptors I got to work with everyday. And I got to play my strengths during those rotations. But I was just trying to adjust to clerkship at that point. I wouldn't say I was superb, but they recognized my hard work and gave good feedback.

My plan was to start asking for reference letters in the fourth rotation. Unfortunately it turned out to be a pretty brutal rotation with a couple of preceptors I did not vibe with. I had hopes for my current rotation, but it doesn't look like it's going to pan out either since I've had a couple of mess ups with the preceptor I spent the most time with (e.g. not being able to answer bread and butter type of questions after we had already talked about it).

Talking to my classmates about getting letters make me anxious. People were already asking for letters in block 2. I read that you need to like ask 10 people and maybe get 5 back, to build a buffer instead of counting only 3 referees to all submit their stuff on time...which makes sense. Realistically there won't be a lot of opportunities to get letters in my later rotations, since they are mostly surgery and peri-op- totally not where my strengths or interests are.

I have my fam med rotation coming up, so I'm really hoping to get a letter there. We have 7 electives at my school, but I'm thinking what are the chances of me actually getting the electives that work in my favour/vibing with the preceptor/get enough time with one/do well enough?

I know I sound overly anxious for someone applying to FM, but I can't help but to feel worried. I'm pretty average at best in terms of clinical/procedural skills. It won't be easy to find people who are impressed with me. I guess I'm looking for reassurance or suggestions.

 

[mdlifecrisis]

You can ask for reference letters retrospectively, just shoot them an e-mail (just remind them of who you are: send them your eval, a small summary of some of the things you did during the rotation, CV, photo)!

Don't stress about it too much, most of us our average, that's actually how "average" works. 

 

[SlowMedStudent]

5 minutes ago, mdlifecrisis said:

You can ask for reference letters retrospectively, just shoot them an e-mail (just remind them of who you are: send them your eval, a small summary of some of the things you did during the rotation, CV, photo)!

Don't stress about it too much, most of us our average, that's actually how "average" works. 

 

Thanks for the suggestion. Should I email them now or wait until I am applying for carms? It'll be a year since I worked with them by that point.

[mdlifecrisis]

7 minutes ago, SlowMedStudent said:

Thanks for the suggestion. Should I email them now or wait until I am applying for carms? It'll be a year since I worked with them by that point.

I would e-mail them now, and then you can send them a reminder when you get closer to the CaRMS date.

[indefatigable]

22 minutes ago, SlowMedStudent said:

Thanks for the suggestion. Should I email them now or wait until I am applying for carms? It'll be a year since I worked with them by that point.

Email them now and send in an official request as soon as you can (i.e .the summer) - you will be fresher in their mind.  Plus,  you can then request the letters from CaRMS, before you submit, and use the strongest ones for your applications - given the new CaRMS realities it's best to not leave anything to chance (your competition will be doing the same).

[SlowMedStudent]

22 minutes ago, indefatigable said:

Email them now and send in an official request as soon as you can (i.e .the summer) - you will be fresher in their mind.  Plus,  you can then request the letters from CaRMS, before you submit, and use the strongest ones for your applications - given the new CaRMS realities it's best to not leave anything to chance (your competition will be doing the same).

Applications open November...Reference letters are due in Feb. You are suggesting I make my official request in the summer? Is that what people normally do?

I see your point about requesting to see the letters from CaRMs before submitting. How much time does it normally take to get to see your letters? Any for making sure your referees actually submit early enough for you to do this, aside from asking super early?

[shikimate]

So from what I've observed, what happens usually with preceptor is once you ask for their letter and they agree, they put your name down on a list of students they have to write letters for, and make note of things to talk about (eg particular strength, memorable story etc). Then comes CARMS time usually they have a template where they insert the relevant points (unless you are really special and they really wanna say something positive or negative about you). So if you ask now while they still remember you, it gives them more time to be prepared than asking this fall when they've forgotten about you.

But I mean you have 7 electives so I can't imagine you bomb them all and not be able to produce 3-4 letters from them. I mean do you really need more than 4-5 letters for FM? I can imagine for something super competitive you want as many as you can and use ones with big names or local names, but I doubt FM really cares that much? 

[indefatigable]

Just now, SlowMedStudent said:

Applications open November...Reference letters are due in Feb. You are suggesting I make my official request in the summer? Is that what people normally do?

I see your point about requesting to see the letters from CaRMs before submitting. How much time does it normally take to get to see your letters? Any for making sure your referees actually submit early enough for you to do this, aside from asking super early?

Actually I'd make your official request now with your email.  It looks like CaRMS allows this 

https://carms.zendesk.com/hc/en-us/articles/115004111786-Can-my-referee-send-a-reference-letter-before-a-match-opens-

It's supposed to be 30 days to get your letters - but it can be more if it's busy.

Honestly - t's better for your referee to write now as they might forget you later.  

[bearded frog]

Are you asking if you should be asking for letters in every clerkship block and you haven't even done your core rotation in your desired specialty? It happens, but generally people don't look to core rotations as opportunities for letters, because people are usually learning the specialty and getting the hang of things, and not excelling. It's good for networking especially if you know what you want to do, meet the staff and residents, and find someone you like in FM to approach for a selective. Most letters will be from electives 4th year rotations at your own school where you have the basics down and can demonstrate improved performance so that you can get a good letter, I don't think most of my classmates and myself worried too much about letters during core rotations.

[Persephone]

9 hours ago, bearded frog said:

Are you asking if you should be asking for letters in every clerkship block and you haven't even done your core rotation in your desired specialty? It happens, but generally people don't look to core rotations as opportunities for letters, because people are usually learning the specialty and getting the hang of things, and not excelling. It's good for networking especially if you know what you want to do, meet the staff and residents, and find someone you like in FM to approach for a selective. Most letters will be from electives 4th year rotations at your own school where you have the basics down and can demonstrate improved performance so that you can get a good letter, I don't think most of my classmates and myself worried too much about letters during core rotations.

I don't know if this is entirely true! I know lots of people who got letters from core rotations this past year, including from cores that weren't their desired specialty (but related enough to be relevant). Maybe that was because of COVID putting us on a break for 3 months and needing to make up for lost time (and also being at a 3 year school). I agree electives can be a good place to get letters from, but sometimes you get better exposure to one preceptor on a longer core than on a typical 2 week elective and that can be more useful. But I agree with most of the responses here. Just send an email now and then again when CaRMS opens. When CaRMS opens you can send them the eval they wrote for you and your CV.

[bearded frog]

2 hours ago, Persephone said:

I know lots of people who got letters from core rotations this past year, including from cores that weren't their desired specialty (but related enough to be relevant).

If you have a good experience in your core and get feedback that you were above average or working at the level of a resident etc, I would definitely ask for a letter!

Just in my experience as a pediatric resident at least, even the peds gunners coming through are miles ahead when they come back for a 4th year elective vs during their core, and I worry people are looking at letter volume over letter quality. If your preceptor says they can write a "strong" letter of recommendation then fair enough, but don't just get one because you think you should that will be mediocre. Most programs limit how many letters you can submit and you want all (usually three) to be the strongest possible.

[Persephone]

2 hours ago, bearded frog said:

If you have a good experience in your core and get feedback that you were above average or working at the level of a resident etc, I would definitely ask for a letter!

Just in my experience as a pediatric resident at least, even the peds gunners coming through are miles ahead when they come back for a 4th year elective vs during their core, and I worry people are looking at letter volume over letter quality. If your preceptor says they can write a "strong" letter of recommendation then fair enough, but don't just get one because you think you should that will be mediocre. Most programs limit how many letters you can submit and you want all (usually three) to be the strongest possible.

Sure yeah, if you're in a four year program that makes sense to do. My psych core was about a month before CaRMS opened so that was about as strong as I was gonna get haha. I also don't think there's harm in practising asking for letters and then not requesting them when the time comes, just to have some references requested if things don't go the way you hoped with preceptors later on. But yes, in principle, I agree.

[bearded frog]

17 minutes ago, Persephone said:

Sure yeah, if you're in a four year program that makes sense to do. My psych core was about a month before CaRMS opened so that was about as strong as I was gonna get haha. I also don't think there's harm in practising asking for letters and then not requesting them when the time comes, just to have some references requested if things don't go the way you hoped with preceptors later on. But yes, in principle, I agree.

Yes... this obviously doesn't apply if you're core is after electives ha. Basically what I'm saying is you want to find the right balance between early enough that you have enough for CaRMS but late enough that you've established yourself that you can actually get good feedback in your letters!

[qwerty879]

On 5/20/2021 at 7:28 PM, SlowMedStudent said:

Applications open November...Reference letters are due in Feb. You are suggesting I make my official request in the summer? Is that what people normally do?

I see your point about requesting to see the letters from CaRMs before submitting. How much time does it normally take to get to see your letters? Any for making sure your referees actually submit early enough for you to do this, aside from asking super early?

Quote

 

Actually I'd make your official request now with your email.  It looks like CaRMS allows this 

https://carms.zendesk.com/hc/en-us/articles/115004111786-Can-my-referee-send-a-reference-letter-before-a-match-opens-

It's supposed to be 30 days to get your letters - but it can be more if it's busy.

 

 

Is getting reference letters early and requesting them all through CaRMS to review them before the application deadline going to become the new strategy?

[bearded frog]

2 hours ago, qwerty879 said:

 

Is getting reference letters early and requesting them all through CaRMS to review them before the application deadline going to become the new strategy?

It has always been possible, and recommended if you're asking for the letter significantly before the application period opens, as the letters may be better if they're more "fresh" and they haven't forgotten about you.

[Understandable]

On 5/22/2021 at 2:47 PM, bearded frog said:

It has always been possible, and recommended if you're asking for the letter significantly before the application period opens, as the letters may be better if they're more "fresh" and they haven't forgotten about you.

This, AND I think there is a requirement about recency of experience with the preceptor and/or date of the letter. Check on these things, because I think you may need to have rotated with them within the past 1-2 years and the letter must be dated during the year of application I believe. 

Good rule would be to ask for a letter during the last day feedback session with the doctor, keep in touch with them (maybe 1-2 emails reminding them of good experience and that you'd be in touch for reference comes Carms time), and then ask formally through Carms portal with some details from the rotation (pts you bonded with or procedures you were complimented on etc.) when it opens.

[indefatigable]

22 minutes ago, Understandable said:

This, AND I think there is a requirement about recency of experience with the preceptor and/or date of the letter. Check on these things, because I think you may need to have rotated with them within the past 1-2 years and the letter must be dated during the year of application I believe. 

Good rule would be to ask for a letter during the last day feedback session with the doctor, keep in touch with them (maybe 1-2 emails reminding them of good experience and that you'd be in touch for reference comes Carms time), and then ask formally through Carms portal with some details from the rotation (pts you bonded with or procedures you were complimented on etc.) when it opens.

Good point - some programs do put date requirements on letters (not the vast majority though).  The strictest I ever saw as within 6 months of the application date (one competitive program) - some other programs within 1 or 2 years.

The goal is to get a letters as soon as possible, but not too soon - a year in advance is probably safe 99% of the time.