Work in Progress: Writing letters of recommendations

Residency application season is officially starting!

As of September 1, 2009, medical students can now apply to ACGME-accredited residency programs. This also means that EM faculty are hurrying to finish their Standardized Letters of Recommendations (SLORs). This is what I'm working on all week.

I love the fact that the Council of Residency Directors (CORD) organization created a standardized form. Having read applications, it makes it SO much easier to compare students. See CORD website for form.

Two-page SLOR form (click to enlarge image)

For students applying into EM, I highly recommend reading the template form so that you at least know what you are being evaluated on. It gives you a sense of what residency programs are looking for. In blue are my personal thoughts on some questions:

How long have you known the applicant? If the answer is less than 4 weeks, I wonder how well the letter writer knows the student.

Indicate what % of students rotating in your Emergency Department received the following grades last academic year: This is a crucial piece of information. When I was a student, I didn't even think of the fact that there might be a range of honors rates. Some rotations have a honors rate as low as 7% and others as high as 60%! Having the distribution of grades on paper gives application readers a better sense of the student's grade. For instance, a passing grade in a 60% honors/30% high pass rotation actually places the student in the bottom 10% of students for the year in the EM rotation!

• Total # students last year:
• Honors %
• High Pass %
• Pass %
• Low Pass %
• Fail %

Work ethic, willingness to assume responsibility. Coming into residency, I personally don't expect students to know much about medicine and EM. So, I try to look for teachability and potential to become a great emergency physician. I find that work ethic directly correlates with this. Anyone who isn't scored as Outstanding makes me a little wary.

• Outstanding (top 10%)
  
• Excellent (top 1/3)
  
• Very Good (middle 1/3)
  
• Good (lower 1/3)
  

Compared to other EM residency candidates you have recommended as such last academic year, this candidate is ranked as: This is nice piece of information about the letter writer habits. In the age of grade inflation and hyperboles, this allows readers to see if a writer only gives "Outstanding" global assessment rankings or a distribution of rankings. If the former, an "Outstanding" score on the applicant's SLOR holds a little less weight in isolation.

• Outstanding (top 10%)
  
• Excellent (top 1/3)
  
• Very Good (middle 1/3)
  
• Good (lower 1/3)
• Provide # Recommended as such (for each ranking) last academic year