Letters of Recommendation
Medical students are often in a quandary about whom they should ask for letters of recommendation. Letters are an important part of the residency application and give program directors the opportunity to see how the applicant is regarded by faculty members that have worked with the applicant in clinical and research settings.
Medical students often ask how many letters they should have from pediatric faculty and preceptors. Most pediatric residency training programs require three letters of recommendation. At least one letter should be from a pediatric faculty member. Other letters should be from faculty members who have directly observed your clinical work and can favorably write about your clinical skills. These letters may come from other pediatric faculty members or faculty from any other clinical department. For students who have done additional community work or research, a fourth letter documenting those activities enhances the application. The core three letters, however, should come from faculty who can relate personal experience with the candidate's clinical work.
Residency candidates should have an established relationship with an advisor who is a core member of his or her pediatric faculty. It is important to choose someone who is very experienced in the application process. Advisors can guide the process of obtaining letters of recommendation; they are sometimes familiar with other students' experiences and may have a sense of the quality of letters offered by their faculty colleagues. This can be a huge benefit.
Good letters of recommendation are important to program directors. Data from the 2014 National Resident Matching Program® (NRMP®) Program Director Survey indicate that 77% of Pediatric program directors who responded to the Survey cited letters of recommendation as a factor used to determine which applicants to interview. Pediatric program directors also assigned a mean importance rating of 3.8/5.0 to letters of recommendation as a factor considered when deciding how to rank applicants.
Asking for a Letter
Many students have difficulty requesting letters from faculty; but there are a specific set of principles and steps in the guide below that students can utilize to make it a positive experience for both the student and faculty member.
A Step-by-Step Guide
Be respectful at all times.
Make a face-to-face request or call the faculty member. If there is no answer, leave a voicemail or a message detailing your request and advising that an e-mail request will follow.
Send a follow-up e-mail. The first line should state that you tried to contact the faculty member and left a detailed message.
It is important to ask the faculty member if the person can write you a strong letter based on clinical skills. If the faculty member says that he or she can only write a somewhat strong letter, ask someone else. Of course, if that is still your best evaluation, stay with that person.
You must provide your letter writer with all necessary information, e.g., the Electronic Residency Application Service (ERAS) face sheet (which has an alphanumeric code that must be used to upload your letter to ERAS), your CV, and your personal statement, even if they are still in draft form.
Some faculty members will want to sit down with you in order to learn something about your interests. This will enable him or her to address your short- and long-term goals in the letter. Accept this opportunity.
Medical students have the option of waiving access to their letters. While you have the right to read your letters, this is generally not recommended. The ERAS "face sheet" has a selection marked "waived" or "did not waive" the right to read the letter before submission. Persons reading that letter who see that a candidate did not waive access may put less faith in the letter. Some faculty members may share a copy or discuss the details even if you have waived access. This is, of course, quite individualized.
Request your pediatric letters from core faculty members who have observed your direct clinical work with patients.
Pediatric department chairs may be very helpful in the application process; many have detailed understanding of other schools and their training programs. However, unless the residency program absolutely requires a chairperson's letter, it is not wise to request a letter from the chair if he or she has not directly observed your clinical work.
Strong letters can distinguish an application that otherwise would not stand out. Letters from clinicians, preferably pediatricians who have seen you in action and can detail your clinical work, are best. And finally, discussing your potential future plans with your letter writers is a great way to help your letter writer support you in achieving your goals.
The Personal Statement
The personal statement needs to be personal, positive, and honest. The content should reflect individual qualities, experiences, and special interests that enable the reader to assess, to some degree, the likelihood of a mutually successful Match outcome.
The residency programs have the applicant's transcript, along with a dean's letter (Medical Student Performance Evaluation or MSPE) and letters of recommendation. The personal statement enables the applicant to add a new dimension to the application, to persuade those who read it that the applicant will be an asset to the program and a desirable house officer who will "fit in," and reflects special qualities and interests that separate the applicant from his/her peers.
To save time and improve the quality of the piece, consider starting with an outline. The statement should flow well. It should be organized -- with a beginning, a middle, and an end. It should be grammatically correct and spell-checked or proofread by multiple individuals, perhaps even those outside the field of medicine. However, the essay should always reflect the character and personality of the writer. Typically, if possible, you should try to limit your statement to one page. The following list suggests points to be considered in the personal statement:
Interest in the field of pediatrics
Personal credentials and strengths that the applicant brings to the field of pediatrics
Experiences that demonstrate relevant personal qualities (e.g., motivation, leadership, reliability, integrity)
If there is a transgression on the medical school record, consider commenting on what was learned from the experience rather than offering excuses for it. How has the writer corrected any deficiencies? You will want to discuss this issue with your advisor prior to including it.
Professional plans after residency
Unique experience in medical school (or in pediatrics) that cemented the desire to pursue the field (e.g., an experiential vignette that describes a patient interaction).
Interests outside of medicine that lend insight into the applicant's personality
Content that is highly personal (e.g., discussions of a divorce), may be "too much information." Stories of family medical challenges, however, can be quite influential and instructive.
Evidence of Flexibility and Openness to New Ideas
Narratives relating experiences or attitudinal shifts that reflect personal growth during medical school. How have you grown?
An interesting life experience or accomplishment (were you an Eagle Scout, a competitive athlete, a musician, a bone marrow donor?)
Curriculum Vitae (CV)
Your CV should reflect your activities and accomplishments related to your chosen career path (in this case – pediatrics). Highlight your experiences during undergraduate and medical school with brief descriptions if space allows. These experiences that often cannot be reiterated on the personal statement often will provide fruitful conversation at residency interview days, so be prepared to speak about them in detail. Seek the advice of a mentor/advisor and/or Student Affairs Office (or comparable) at your medical school to help establish and review CVs. You can include items from college or before medical school such as past research experiences or activities in which you have strong demonstration of leadership.
Check out this wonderful resource for both CVs and personal statements.
A personal statement should present a clear, honest, and concise summary of the applicant's innate qualities. It should lend insight into one's personality, experiences and passions. A well written statement will take time. Ask for honest feedback from friends, advisors, and at least one person who has strong editing skills. The same approach should be taken with the CV.