Secure strong endorsements from the right recommenders with strategic planning and professional communication.
Someone who knows you well, can speak to your clinical abilities, has observed your growth, and carries weight in the medical community. Quality trumps title every time.
Strength
Institutional weight
Best When
Strong clinical performance in their department
Avoid If
If minimal interaction or generic letter likely
Strength
Detailed project knowledge
Best When
Significant research contribution with publications
Avoid If
If research is minor part of application
Strength
Direct observation of skills
Best When
Worked closely for 4+ weeks with excellent performance
Avoid If
If only worked nights/weekends with minimal interaction
Strength
Understanding of residency readiness
Best When
Away rotation or special program participation
Avoid If
If from your home institution (conflict of interest)
Letter writer asks you to write it yourself
Shows lack of investment and knowledge
Solution: Politely decline and find another writer
Vague commitment ('I'll try to get to it')
High risk of late or missing letter
Solution: Seek more enthusiastic writer
No recent interaction (>2 years)
Letter will lack specific, current examples
Solution: Reconnect first or choose someone more recent
Suggests a committee letter
Generic and impersonal
Solution: Request individual letter or find alternative
Mentions they're writing many letters
Your letter may be generic or delayed
Solution: Provide exceptional packet and follow up regularly