Asking for reference letters from EM electives with lots of preceptors

[mew]

I'm applying EM this year and was able to get 3 EM electives (7 weeks total). The issue is that my schedules have not been ideal- on my current elective I don't work with the same staff more than twice, and I've heard from other students that they're facing similar scheduling challenges at other sites. I know one of the criteria in the new standardized reference letters is the amount of time spent with the candidate/how many shifts worked together. How many shifts should I be working with someone before I can consider asking for a strong letter? Also, is it appropriate to ask to switch into shifts with your preferred preceptor and/or ask to pick up extra shifts?

[frenchpress]

3 hours ago, mew said:

I'm applying EM this year and was able to get 3 EM electives (7 weeks total). The issue is that my schedules have not been ideal- on my current elective I don't work with the same staff more than twice, and I've heard from other students that they're facing similar scheduling challenges at other sites. I know one of the criteria in the new standardized reference letters is the amount of time spent with the candidate/how many shifts worked together. How many shifts should I be working with someone before I can consider asking for a strong letter? Also, is it appropriate to ask to switch into shifts with your preferred preceptor and/or ask to pick up extra shifts?

Common issue. In my experience two is the minimum number of shifts to ask for a reference, obviously more is better. It can help to let them know early that you’re going to want a letter from the rotation, and then they can also talk to others who have worked with you. Sometimes if you can get shifts with whoever is evaluating you for your elective then that’s a good person to ask for the letter, because they will be reading the feedback from everyone and can comment more broadly. Whether it’s appropriate to ask to switch shifts will depend on the site - it has been at many departments I’ve worked in, although not all. 

[jb24]

This is expected for an EM rotation. I would just make it explicitly clear to every attending you work with that you are really interested in EM. That way, if things go well, and you get those good vibes from the staff, I would ask for a letter.

Some rotations have a system for this where one writer will kind of consolidate the feedback into a strong letter.

Another thing is to talk to the EM residents there, and get an idea of who might be a good letter writer. Good luck, and you got this.

[Arztin]

People understand this perfectly. If you do well, 2 shifts can be good enough for a good LOR.

[confusedmedstudent2022]

On electives it might be trickier, but for the core rotation, my classmates interested in emerg requested the staff schedule from the ER clerkship admin and asked to switch shifts with other classmates who aren't interested in ER.