Letters of Recommendation

​Letters of recommendation are an important part of your application package. Because they can be more descriptive, personal, and detailed than the Dean’s letter, they flesh out the portrait of your strengths. Ask your letter writers early and communicate your deadline to them. Give them at least a month to complete it. Provide them with your CV and personal statement.

AAMC's Careers in Medicine resource

​Who should write the letters?

Letters of recommendation (LOR) should come from the faculty who know you best and can speak most persuasively about your clinical and research strengths. When possible, include faculty who have observed you in your fourth year electives and clerkships where you functioned more independently. The grades from Summer B and Autumn A will not be in your MSPE, and thus their assessment of your work will add new information to your application.

At least one and probably two letters should come from a physician in your specialty area, but think of rounding out your application with letters from different specialties if those faculty members can speak persuasively about your ability to function as a house officer. Remember that the salient comments from your clerkship evaluations will be included in the MSPE so you may try to avoid the redundancy that will result if you ask the same faculty for LORs. See the Departmental Career Advisors Survey (PDF) for discipline-specific advice about whom you should get LOR’s from.

As you go through your clerkships, try to anticipate whom you can ask for recommendations. Work enough with this individual so they will possess the kind of firsthand experience that allows them to advocate for you. If your attending offers to write you a letter at the conclusion of your rotation, ask them to keep it in their file. You may also request that an attending write you a letter. (Some students prefer to wait to receive their grade before doing so.) If you ultimately decide to use these individuals, recontact them so they can update the letter with a current date and in the format required by ERAS for electronic submission.

DON’T wait to ask for letters until the end of your 3rd year. The letters will be stronger and more specific if you solicit them at the end of your rotations!


How many do letters do I need?

Most programs ask for three or four letters of recommendation. A recommendation from a faculty member in the program you are applying to can carry significant weight as may a letter from a faculty member who knows the residency director in that program. You can continue to add letters of recommendation to ERAS, even after your residency applications have gone out. This allows you to update your application with recommendations from your 4th year electives, Sub I’s and clerkships. ERAS allows you to store as many LOR’s as you wish and designate different letters for each program, but no more than four can be sent to any one program.

If you already have sent in the maximum of four letters to a given program, and want to add a more recent recommendation, you will have to withdraw one letter in order to add the new one.

Do I need a Chair’s letter?

Some programs require a letter from the UW chair of the corresponding department. Since chairs often don’t know medical students, they may rely on others’ evaluations of your performance in writing it, but they will usually ask you to come in for an interview. If they do, bring in your CV and personal statement. Check each residency that you are applying to in order to identify their particular requirements. For competitive specialties, we suggest that you get letters from senior faculty members who are well known in their field.


When should I ask for my letters?

If you haven’t done it earlier, you should be actively requesting letters of recommendation in June, July and August, as you move into your 4th year. Letter writers need at least 4-6 weeks of advance notice to complete a letter. Be sure to indicate a date by which the letters need to be completed. Letters should be uploaded to ERAS before September 15th.

Letters are accepted throughout the application process but many programs require you to have a minimum of 2 before they will schedule you for an interview.

How should I ask for letters?

It's best to ask the letter writer in person. Begin by saying, “I am applying for a residency in X specialty. Do you feel that you know me well enough to write me a strong letter of recommendation?” In this way, you have given them a graceful way to decline. If they give you a resounding yes, trust it. If they hesitate, and you are concerned that they are not being forthcoming, encourage them to be honest. A lukewarm letter will not help your application.

Once you have a positive response, follow up with an email confirming your conversation AND reiterating the deadline information. Attach a copy of your CV and your personal statement.

How do I know if a letter has been turned in?

A faculty’s agreeing to recommend you does not end your responsibility for this process. Once September begins, you will be able to see which letters have been uploaded. You should follow up with the writers who have not turned in their recommendation.

An example of a reminder e-mail:
“I am sending you a note to thank you again for agreeing to write me a letter of recommendation. I also wanted to let you know that your letter has not yet arrived and am looking forward to completing my application. The deadline for my letter submissions is __. Let me know if there is any additional information that you need from me. Thank you again for all of your help.”

Waive your right to see your letters of recommendation

The ERAS Cover Letter includes a statement indicating that you have waived your right to see your letters of recommendation. We encourage you to sign this waiver. Program directors may see a student’s decision not to waive as a red flag.