Dear Program Director: Deciphering Letters of Recommendation

Saudek, Kris; Saudek, David; Treat, Robert; Bartz, Peter J.; Weigert, Rachel; Weisgerber, Michael

doi:10.4300/jgme-d-17-00712.1

Cited by 43 publications

(39 citation statements)

References 23 publications

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“…Mark Nehler, MD I n this issue of the Journal of Graduate Medical Education, Saudek et al 1 shed light on the issue of letters of recommendation in graduate medical education. A survey of pediatrics residency and fellowship directors posed questions regarding the content and impact of recommendation letters as part of the application process.…”

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confidence: 99%

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Letters of Recommendation: How Do They Fit Into the Modern Application?

Nehler

2018

Journal of Graduate Medical Education

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“…In summary, Saudek et al 1 have drawn our attention to letters of recommendation as an important aspect of the application process. Letters of recommendation are difficult to score and to quantify as an input in evaluating candidates.…”

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Letters of Recommendation: How Do They Fit Into the Modern Application?

Nehler

2018

Journal of Graduate Medical Education

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“…Although there is existing literature examining LORs, the current study adds to this in several respects. Most studies to date have looked at trainees in the United States medical training system (10,11,17), while the current study examined letters from across Canada, thus adding the experience of another country and enriching the data pool. This study also highlights the relationship between letter quality and letter writer, leading to opportunity for possible faculty development with a goal of improving letter quality.…”

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confidence: 99%

Reference letters for subspecialty medicine residency positions: Are they valuable for decision-making? Results from a Canadian mixed method study.

Chopra

Joneja

Sandhu

et al. 2020

Preprint

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Background The letter of recommendation is currently an integral part of applicant selection for residency programs. Internal medicine residents will spend much time and expense completing sub-specialty away electives to obtain a letter of recommendation. The purpose of this study was 1) to examine a large sample of reference letters in order to define essential components of a high-quality letter, and 2) to elucidate the relationship between quality of reference letter and the letter writer. Methods We conducted a two-phase mixed methods study. In phase one, a large sample of letters of recommendation was examined using an audit tool as a coding framework. A 5-point composite endpoint of high-quality letter components was subsequently developed. In phase two, program director letters were compared to non-program director home institution and elective letters based on inclusion of components of the 5-point composite endpoint using Chi square testing. Results 715 letters were examined (398 non-program director home institution letters, 201 program director letters, and 116 elective letters). High-quality letter components were: nature of relationship, duration of relationship, In Training Evaluation Report information, research involvement and comments on areas for improvement. Program director letters had a significantly higher proportion (10.4%) of all 5 high-quality components, compared to 0% in both non-program director home institution letters and elective letters (p < 0.001). A significantly higher proportion of program director letters had 4–5 high-quality components (62.5%) compared to 2% of non-program director home institution letters and 0% of elective letters (p < 0.0001). Conclusions Letters of recommendation from elective rotations are of the poorest quality and such rotations should not be pursued for the sole purpose of obtaining a letter. The low quality of elective letters leads to the recommendation that writers should decline to write them, programs should not require them and trainees should not request them. Program directors write the highest quality letters and should be a resource for faculty development. Clinical supervisors can use the 5-point composite endpoint as a guide when writing letters for applicants.

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“…An LOR can confirm information about an applicant's competence, but it is also uniquely able to provide employers with information about an applicant's personal strengths and characteristics that apply to the desired position and in comparison with other applicants. [1][2][3][4] Choosing the writer is key. While the academic rank of the writer holds importance, especially for academic positions, the most important attribute is that the writer is knowledgeable and can speak positively about the candidate's integrity, capacity, knowledge, and experience as these attributes apply to the desired position.…”

Section: What Is Knownmentioning

confidence: 99%