Match Strategy

The number of interviews you need depends on your profile — not a magic number. This article explains what the data really says and how interview quality matters more than quantity, especially if you’re a strong communicator.

→ Read the full article at: www.missionresidency.com/match-q-and-a/how-many-interviews-do-imgs-need

Step 3 can help you get interviews in some situations, but doing it too early can backfire. This article explains how Step 3 fits into your Match plan depending on your red flags, visa needs, and whether you’ve done hands-on clinical work.

→ Read the full article at: www.missionresidency.com/match-q-and-a/step3-before-usce

Residency Letters of Recommendation (LOR) Strategy Guide

✅ Quick Summary: What You’ll Learn Below

• How many LORs you need and which types are most effective

• Step-by-step instructions for requesting and submitting letters in MyERAS

• What it means to waive your right to view the letter and why it matters

• How to recognize the difference between a strong and weak letter

• What to do if a preceptor asks you to write your own letter

• The most common mistakes applicants make with LORs

• When to start asking for letters so you’re not too late

• Why letters from hospital-affiliated attendings are more valuable

• A ready-to-use prompt you can give ChatGPT if you’re drafting a letter yourself

Welcome to your one-stop guide for understanding, requesting, and optimizing your Letters of Recommendation (LORs) for the ERAS application process.

✨ Why LORs Matter

Letters of Recommendation are one of the most influential components of your ERAS application. According to the NRMP Program Director Survey, LORs consistently rank among the top 5 factors used to select applicants for interviews. A strong letter not only confirms your competence but also humanizes you in a way that scores and CVs cannot.

✍️ How Many Letters Should You Have?

• ERAS allows you to assign up to 4 LORs per program.

• Most applicants aim for 3 strong letters, with a 4th as a bonus or backup.

• Try to include at least 1 specialty-specific LOR from a U.S. attending physician affiliated with a teaching hospital.

🔧 How to Request and Submit LORs (Step-by-Step)

1. Identify Your Writers

Choose physicians who:

• Supervised you directly

• Know your work ethic and clinical skills

• Are affiliated with teaching hospitals (more weight)

2. Politely Request the LOR

Ask in person or via email. Example: “Would you feel comfortable writing me a strong letter of recommendation for residency?”

3. Create a LOR Request in ERAS

• Log in to your MyERAS account.

• Go to the Documents tab, then Letters of Recommendation.

• Click Add New and enter your recommender’s details.

4. Decide: Waive or Not Waive Your Right

More on this below ↓

5. Upload the Letter Request Form

• Once created, download and send the unique ERAS Letter Request Form to your recommender.

• They will use this to upload their letter via the ERAS Letter Portal.

6. Assign LORs to Programs

• You can assign specific LORs to individual programs once your letters are uploaded.

• Tip: You don’t need all LORs uploaded to submit ERAS; you can assign them later.

🧵 Should I Waive My Right to See the LOR?

✅ YES (Waive) — Strongly Recommended

• Programs tend to trust waived letters more.

• Waived letters suggest honesty and allow writers to speak candidly.

• Most advisors and experts agree: waiving your right is the default best choice.

❌ NO (Don’t Waive)

• May raise red flags or suggest a lack of trust

• Only advisable if you genuinely believe the writer may submit a weak letter

✏️ What Makes a Strong Letter?

Great LORs include:

• A clear relationship: who the writer is, how they know you

• Clinical examples showing skills in action

• Comments on professionalism, communication, reliability

• Comparison to peers (e.g., "top 5% of students I've worked with")

• A story of growth or resilience under pressure

• A confident closing endorsement

Pro Tip: Teaching hospital letterhead > private clinic letterhead. Even a short, strong letter from a hospital carries more weight than a generic one from a private office.

🔍 Special Case: When They Ask You to Write Your Own Letter

This happens more often than you think. If a recommender says, "You write it and I’ll sign it," here’s what to do:

Step 1: Accept the Offer (Gratefully)

This is your chance to control the narrative—use it wisely.

Step 2: Gather Key Info

• Rotation details: setting, specialty, dates

• Specific cases or stories you were involved in

• 2–3 strengths or qualities you demonstrated

• Writer’s full title and hospital affiliation

Step 3: Prompt ChatGPT Like a Pro

You can say:

"Write a one-page ERAS letter of recommendation from a U.S. internal medicine attending physician. This student worked with me during a 4-week inpatient hospital rotation. Highlight their clinical reasoning, professionalism, and communication. Include a comparison line (top 5%), and a story of how they handled a difficult patient encounter with maturity and empathy. Close with a strong recommendation."

This lets you start with a quality draft that you can polish to match your recommender’s tone.

Step 4: Final Touches

• Match your writer’s voice/tone (not too flowery or robotic)

• Ensure facts are accurate

• Let your writer revise and approve before uploading

❓ Common Mistakes to Avoid

• Asking too late

• Choosing big-name doctors who barely know you

• Not following up with reminders or deadlines

• Submitting unassigned letters

• Forgetting to waive access (when you meant to)

📆 When to Start Asking for LORs

• Ideally, 2–3 weeks into a rotation

• Final deadline: before August to ensure writers have time

✨ Final Advice

• Strong letters don’t require perfect English; they require authentic praise and detail.

• Make it easy for your writer: give them a bullet list of accomplishments, CV, personal statement, and the ERAS request form.

• Thank them personally after submission. Gratitude goes a long way.

Ready to write or request your letter? Head to your MyERAS portal and take the first step. Need help drafting one? We’ll walk you through it step-by-step in our [LOR Writing Worksheet].

💬 Ultimate ChatGPT Prompt for Writing Your Own Letter of Recommendation (LOR)

Prompt:

Play the role of a U.S. attending physician affiliated with a teaching hospital. Your goal is to write a one-page ERAS Letter of Recommendation for a medical residency applicant in {insert specialty here} who completed a 4-week clinical rotation with you. This letter will be used as part of their official ERAS residency application.

You are writing in your own professional voice as a physician—knowledgeable, warm, and honest. Avoid robotic or overly generic writing. Do not use em dashes, semicolons, or stiff AI-style phrases. Keep it natural and human. The letter should sound like something a real doctor would write for a student they respected, even if they didn’t work with them every single day.

Structure the letter as follows:

1) Introduction

• Who you are (briefly), your role, and how you know the applicant

• The rotation setting, duration, and how closely you worked with them

2) Clinical and Interpersonal Strengths

• Specific examples of the applicant’s clinical skills, judgment, curiosity, or communication

• A sentence or two on how they compared to their peers (e.g., “top 5% of trainees I’ve worked with”)

3) Personal Story

Include a brief story that humanizes the student

• Optionally, include something the student shared about their background or family that helps explain their drive, resilience, or values

  • Examples: “As I got to know {insert student name here}, I learned that many of her strengths stem from her experience raising two children while preparing for her USMLEs…”

  • Or: “As the son of a farmer, he brought a grounded, no-nonsense work ethic to every patient interaction.”

4) Closing Recommendation

• A confident, clear endorsement (e.g., “I strongly recommend them for a categorical position in {insert specialty here}.”)

5) Before you generate the letter, ask me a few questions to personalize it further.

Pretend I’m the student, and you’re trying to write the best possible letter on my behalf. Ask me questions like:

• Is there anything you shared with your preceptor about your background or family that helps explain who you are?

• Were there any standout patient encounters or situations that show your strengths in action?

• What 2–3 qualities would you most want your letter writer to highlight?

Once I answer those, write the full letter in 3–5 paragraphs, keeping it to a single page. Use the tone of a supportive, realistic, and experienced attending—not dramatic or overdone, and not vague or templated.

Important style rules: Do not use em dashes (—), semicolons, ellipses, or overly dramatic transitions like “what stood out even more was…” or “something many students struggle to do.” Avoid generic phrases like “I had the pleasure of,” “a deep interest in,” or “any program would be lucky to have them.” Use clear, plain, conversational language. Vary sentence length. The goal is to sound like a real attending doctor writing this in 10–15 minutes—not a perfect essay or performance review.

Sure! Here’s a Sample of an LOR . . .

To Whom It May Concern,

I had the pleasure of supervising Dr. Ayesha R***** during her four-week internal medicine rotation at North Valley University Hospital, a tertiary academic teaching center. As her attending physician on our inpatient service, I worked with her closely during morning rounds, patient handoffs, and daily case discussions. She also took part regularly in our teaching curriculum, which includes morning report, noon conference, and faculty-led didactics.

Dr. R***** quickly stood out as one of the most engaged visiting students we’ve had this academic year. Her clinical thinking was clear and well-structured, and she often asked thoughtful questions that led to deeper group discussion. She was dependable, respectful, and consistently delivered well-prepared patient presentations. I would place her in the top 10 percent of students I’ve worked with over the past ten years.

One moment that stood out was her care for a patient with uncontrolled diabetes and limited English. She took the initiative to involve the interpreter, pharmacy, and social work to build a care plan that was actually realistic for the patient’s situation. Her level of empathy and follow-through left a strong impression on both our team and the patient’s family.

As I got to know her, I also learned more about her background. She’s the oldest of five children in an immigrant household and helped raise her younger siblings while preparing for medical school and the USMLEs. I believe that personal history explains a lot about her poise, maturity, and ability to manage multiple demands without losing focus.

I strongly recommend Dr. R***** for a categorical position in internal medicine. She has the right mindset, skillset, and character to thrive in residency. I would be happy to work with her again in the future.

Sincerely,

Dr. James T********

Attending Physician, Internal Medicine

North Valley University Hospital

james.t*******@northvalley.edu | (555) 123‑****