ERAS Letter of Recommendation: The Ultimate Guide and Samples

Read two successful ERAS letters of recommendation that helped our MD experts secure their dream residencies, and learn everything about this crucial application component. The process of ERAS, including preparing your personal statement, or interview responses, can be daunting, but we've got you covered – we share tips on creating a knockout ERAS letter of recommendation.

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How Important is the ERAS Letter of Recommendation?

As you start to prepare for your residency application , keep in mind that the letter of recommendation can showcase your attributes that may otherwise be impossible to include in your application, such as your teamwork skills, leadership abilities, professionalism, and dedication to patient care. It provides a unique perspective on your strengths and potential as observed by those who have worked closely with you.

The letter of recommendation allows residency programs to understand how other professionals view you, get an idea of your work ethic, and your ability to contribute to the field of medicine in your chosen medical specialty . A strong letter of recommendation can be the deciding factor between receiving an interview invitation or not and even which candidate a program ranks higher when faced with two equally qualified applicants.

How to Get a Strong ERAS Letter of Recommendation

Your letter writers are only able to craft a recommendation based on their experiences with you , so make that experience an amazing one. Give your best effort in everything you do. If you enter a class, clerkship, volunteer, or research activity with this mindset, you will stand out to possible letter writers.

At the beginning of any clerkship, job, volunteer or research activity, sit down with your supervisor, discuss expectations and aim to exceed them. Regularly seek feedback and maintain a positive relationship to facilitate future recommendation requests.

Who should be your recommendation letter writers?

Your letters should give a comprehensive and holistic insight into who you are as a student, person, and future doctor in that specialty. With that said, your writers can include pre-clinical professors, research advisors, volunteer or extracurricular managers or advisors, clinical clerkship attendings, or department heads. Your letter writers should be individuals who you have worked or interacted with and who can speak to your character, work ethic, and aptitude.

“I took advantage of my clinical rotations and was sure to identify the great letter writers prior to the start of the rotation. After identifying these letter writers, I was sure to perform well and discussed my desire for a strong letter of recommendation (LOR) at the mid-way point of the rotation.” – Dr. Terrell D. Coring, PharmD, MD, Medstar/Georgetown Washington Hospital Center - Internal Medicine

You should have at least one letter from a mentor, attending you worked with, or department chair in your specialty of choice, as most programs will require at least one letter that supports your suitability for the specialty you are pursuing. Some programs might also require a letter from someone outside the field of medicine. Be sure to look up the program specific requirements on their website.

“Most specialties require that you get at least one letter from someone in that specialty. I had letters from two different specialties, but I felt like this was useful in the end because one highlighted my passion for my chosen field and the other highlighted a strong work ethic. if you don't have a letter from your chosen specialty, I would discuss with faculty from that department potentially they could write you a non-clinical letter, but ideally you should pursue a rotation and ask for a letter.” – Dr. Monica Taneja, MD

Should recommendation letters be addressed to specific residency programs?

No, letters of recommendation should be standardized. Addressing letters to specific residency programs would result in your letter writers needing to prepare multiple letters. This is not feasible.

How to Ask for an ERAS Letter of Recommendation

When possible, you should ask for your letter of recommendation in person. If you are asking someone you are currently working with, simply ask to speak with them after your duties for the day are completed.

“I identified my main sub-i attendings at the beginning of the rotation. On our first day, usually attendings sit down with students to discuss expectations, and I used this time to also let them know that I would like them to write a letter for me. Attendings are generally familiar with this process, so everyone I asked was receptive and willing to write. I think being upfront with the fact that you want a letter helps them focus on your performance through the rotation versus asking them at the end.” – Dr. Monica Taneja, MD

Whether your ask in-person or request your letter via email, the approach is the same. Ask specifically, “Would you be willing to write a strong letter of recommendation for residency on my behalf?”

Below are samples of how to ask for a reference letter in person and via email:

When requesting a letter, you should always let your writer know that you will provide them with supplemental materials to aid them in their writing. You should provide them with your residency personal statement , residency CV or resume, a short biography to fill in any gaps in your background or accomplishments, USMLE or COMLEX scores, medical school transcript, and ERAS letter request form.

When to Ask for an ERAS Letter of Recommendation

The earlier you ask, the better. You want to give your letter writers ample time to compose your letter as they are busy professionals and need the proper time to prepare it. You also do not want them to feel rushed in needing to complete your letter.

At a minimum, you should request your letters 2 months prior to the submission deadline.

You do NOT have to wait until you are preparing your ERAS application to ask for letters of recommendation. Feel free to ask while you are working with that individual, during your classes, clerkships, volunteer, or research activities. In fact, a recent Program Director Survey shows that LORS in your specialty are the number 2 factor that determines whether you will be invited for an interview!

“I decided to ask for my letters of recommendations during my 4th year sub-I’s. I think sub-I’s are a great time to ask for letters of recommendation because you have already chosen the specialty you are going into and you are usually at the peak of medical school. It's really a great time for someone to see you working at your hardest with the highest level of knowledge that you have … I think the best thing you can do is work hard. You want them to talk about your quality and ability to work as an intern, so be up to date on your knowledge and integrate well into the team.” – Dr. Monica Taneja, MD, Harvard South Shore – Psychiatry

How to Enter Your Letters of Recommendation into ERAS

ERAS Letter of Recommendation: Thank You Notes

It is important to thank your letter writers for taking the time to write a letter on your behalf. You should thank them once you have received notification that your letter has been uploaded to ERAS.

Sample ERAS Letters of Recommendation

Now, let's take a look at two sample residency letters of recommendation. Pay attention to how well the two letters complement each other and create a holistic portrayal of the applicant.

FAQs

You typically need 3-4 letters, but check each program’s specific requirements.

2. How do I get a strong letter of recommendation?

Perform well in your roles, exceed expectations, and build strong relationships with your mentors.

3. Who do I ask for an ERAS letter of recommendation?

Ask individuals who know you well, such as pre-clinical professors, research advisors, clinical attendings, or department heads.

4. Who should I avoid asking for a letter of recommendation?

Avoid individuals you barely know or who seem hesitant to write you a letter.

5. How do I ask for a letter of recommendation?

Ask in-person if possible, provide your CV and personal statement, and clearly state your request.

6. When do I ask for a letter of recommendation?

Request letters at least 2 months before the submission deadline.

7. How do I submit my letters of recommendation to ERAS?

Your writers will upload the letters using the ERAS portal and a specific letter ID; you’ll receive an email confirmation once uploaded.

8. How long should my letters of recommendation be?

Your letters should be no longer than one page.

To your success,

Your friends at BeMo

BeMo Academic Consulting

Sources: NRMP Program Director Survey