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Getting a letter when you work with multiple preceptors in a rotation

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I am trying to set up my 4th year electives, and I am wondering if anyone can offer some advice regarding getting reference letters.

In many rotations, you get to work with multiple preceptors. Or, if you work with a preceptor primarily, you do not get a lot of face-to-face time with the preceptor, but rather work a lot with the residents. How likely it is then to get a good reference letter?

Also, if in a particular rotation, you work on shifts with different preceptors, but all preceptors send feedback to a lead person to summarize feedback and provide evaluations, is it a good approach to ask that lead person to provide a CaRMS letter, even if you have never worked directly with that person?

Thank you!

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In rotations with multiple preceptors, it can be super difficult to get a strong letter due to minimal exposure. A few tips:

1. Try to identify early on in the rotation (first 3-4 days) who you would like to work with again. Identify who makes the schedule for the rotation, and approach them to help set you up for more days with your chosen preceptor. Most places have either an admin person or a resident who does the scheduling depending on place/specialty.

2. Ensure that, on the days you do have with a potential letter writer, you are showing up well prepared and ready to wow. Make sure you've done your reading, have a prepared topic/s in mind for discussion/pimping, and be enthusiastic/teachable/not annoying.

3. People talk, especially within departments. Letter writers will solicit information from other people who have worked with you. People circulate lists of strong clerks around the department to "keep an eye out" come CaRMS time. Make sure you don't slack off on days when you're working with others. One approach I used on multiple-preceptor rotations with daily evaluations was to save a copy of my evals before handing them in and providing these to my letter writers.

4. To your final question, I personally would not solicit a letter from someone I did not work directly with. Letters of reference are different from evaluations and can be intensely personal. A letter from someone you haven't worked with will at best be mediocre. Some places are willing to do a "departmental" letter of reference and have multiple preceptors sign on, but these are not common and I wouldn't go around asking for them (they should be offered). Again, I would suggest what I wrote in 3. which is to save your dailies and provide them to your letter writer so they can use evals from other preceptors as reference/corroboration.

I can't really speak to the situation where you don't work with a preceptor directly, but I would say that they get feedback on you from residents/other staff. Perhaps some medicine gunners can chime in?



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