In order for your supervising attending physician to willingly write you a strong LOR and recommend you to residency, follow these 4 simple steps:
1. Keep it a surprise
Your chances of securing a strong and timely LOR are significantly improved when your physician realizes that you’re not there solely for an LOR, so we recommend that you not even hint at wanting an LOR until you’ve earned it.
2. Begin earning your LOR
A superb clinical performance over a 4 to 8 week clinical rotation should be the sole reason why your supervising physician would want to recommend you to residency admission committees. To “earn your LOR”, you should act genuinely interested in the actual experience provided to you by the clinical rotation: put away your mobile phones during the rotation, show up early, leave late, be pleasant, communicate effectively, and avoid every item on the right column of our ACGME Core Competency chart (Examples of Resident Trouble).
3. Ask for a 5-minute mid-clinical performance feedback
Print the ACGME Core Competency chart; then share with your supervising attending and ask for an informal verbal performance feedback. Reassure him that this should only take ~5 minutes of his/her time. Take notes and make immediate adjustments to your performance as necessary. Do not ask for an LOR yet!
4. Ensure LOR content quality based on ACGME core competencies
Remind your supervising attending to look for an email with the subject: “URGENT: Please evaluate [your first & last name]” in their inbox sent by AmeriClerkships one day after your official clinical block end date. Then ask your attending: “On a scale of 1 to 5, 5 being ‘Honors‘ and 1 being ‘Deficient‘, how would you evaluate my clinical performance based on the 6 ACGME core competencies, and were you satisfied with my performance?”
- A rating of 4 or 5/5 and the attending being satisfied with your performance are excellent indicators that the content of an LOR written by this attending will be strong, and you should ask for an LOR. Surprise the attending and say: “Thank you very much for this amazing opportunity! Now that I know you were satisfied with my performance, may I have your support for this year’s Match and ask that you write me a Letter of Recommendation?”
- A rating of 1 to 3/5 or the attending NOT being satisfied with your performance are indicators that the content of an LOR written by this attending will be weak or damaging, and will most likely raise red-flags. At this point, you should ask if there was any way that these deficiencies could have been identified earlier, and what you should do to improve moving forward.