Faculty Development Resources
Writing Letters of Reference
Information about writing the letter
Writing the Letter
A. Introduction
- Explain how long, how well, and under what circumstances (Clerkship Director, Teaching Attending, etc) you have come to know the student. Why are you qualified to comment on him or her?
B. Body
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In the body of the letter, describe the specific strengths of the person. Give the recipients of the letter information about the aspects of student performance THEY care about. Include those special features that will interest them.
Address aspects of the student's performance you know first-hand. Eye-witness accounts are more convincing than hearsay. Support your generalizations with SPECIFIC details or anecdotes, but also acknowledge other achievements, academic ability, and other activities (volunteering, serving on committees, awards)
Conveying the personality of the applicant is also important. For example, it might help the student for the program to know before the interview that a applicant may be more knowledgeable than the soft-spoken characteristic would indicate, or that an applicant has a good sense of humor even under stressful situations. That way when the applicant appears, the interviewer may already feel like they know the person, and allow for any "quirks" specific to that person. Help the reader to imagine the student as you describe them. A purely general description is not useful.
"Reading Between the Lines”
Most programs can "read between the lines" in your letters. That gives you freedom to say some things in a way that the applicant sees your nice comments, but the person reading the letter sees a potential problem. For instance, saying the person "does everything that is asked of them" could also read that the person doesn't self-motivate. If there is a weakness it can be stated with a positive, such as "...knowledge base steadily growing and no doubt it will be superior with more experience."
C. Conclusion
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The last paragraph states that you believe the person has the qualities (can be specific with these) to be an asset to the program/facility they are applying to, and that you support their application/candidacy fully. End the letter with a summary paragraph recapping your main points; if possible, compare the student with others you have known. I always state, "For further support of the application, feel free to contact me".
Alternate Letter Format: The ACGME Competencies.
ACGME has identified six residency competency areas: Patient Care, Interpersonal Skills and Communication, Practice-based Learning and Improvement, Systems-based Practice, Professionalism and Medical Knowledge. More and more, these competencies are being accepted as the gold standard for all of medical education.
You might find that the competencies provide a convenient way to organize your student reference letters. While you may not be able to comment on all of the competencies, you most probably have experience with the student’s abilities in patient care, communication, medical knowledge and professionalism. System-based Practice and practice Based learning are harder, but if the student has asked questions about health care costs or made suggestions to improve health care delivery, that falls under the systems-based practice rubric. Students who have worked to improve their own clinical practice were demonstrating the Practice-based Learning and Improvement competency.
