Improving Your Medical Residency Application: Tips for Obtaining Optimal Letters of Recommendation

Matching to a residency program through the NRMP® (National Resident Matching Program) is a competitive endeavor. Even top-tier candidates can have difficulty getting PGY-1 (post graduate year one) positions in many specialties. Those that do match may not get their first or second choices, leaving them in suboptimal locations or programs. Consequently, the submission of an excellent residency application is crucial.

The Electronic Residency Application Service (ERAS®) is a centralized program that transmits applications, letters of recommendation (LOR) and other supporting credentials from the applicant to program directors using the Internet. Most residency programs now use ERAS®, although a few use individualized applications.

Some of the most useful residency application advice I can offer includes ensuring that your letters of recommendation are optimal, as these evaluations are one of the most critical aspects of applying to residency.

One way to do this is to choose the right person to author your LOR. A wish list for an evaluator would be the following:

a)S/he is senior faculty with a weighty title who is well known in his/her field.
b)S/he is in a specialty that is the field to which you are applying or a closely related one.
c)S/he has spent significant time with you.
d)S/he is an experienced letter-writer.
e)S/he has explicitly stated s/he will write you a strong LOR. It is important to directly ask any potential author, "Can you write me a very strong letter for residency?"

Of course all of these qualifications are not possible for all letter writers. But the more of these you can garner the better. With regard to (a), residency directors are human just like the rest of us: Receiving a LOR from an accomplished, known colleague will be weighed much more heavily than one from someone deemed less successful and unfamiliar. If you are better connected to someone without a title (for example, a resident), consider asking a more senior person who has a weightier title if s/he would consider writing a LOR with significant input from your closer contact.

To improve your residency candidacy fully, consider working with a professional. Because applicants can unknowingly undermine their chances of success with poorly compiled application materials and underdeveloped residency personal statements, a qualified, personalized residency admissions consultant provides a great advantage.

Residency consulting companies come in a variety of forms. Some are bigger businesses that focus on admissions to several types of graduate programs - not just medicine. Others are smaller and provide a medical focus, but have a pool of consultants of varying quality. Finally, elite companies offer both the medical focus and a highly experienced consultant who works one-on-one with clients. These professionals are ex-admissions officers from highly respected medical institutions. They have the inside knowledge of how residency admissions work, providing individualized guidance to optimize Residency application personal statement, ERAS® and interview skills.

When choosing a residency admissions consulting company, a candidate should verify the company's references and research its consultants. Elite companies that offer both the medical focus and a highly experienced consultant who works one-on-one with clients offer a large advantage for applicants, especially during these competitive times.