A letter of recommendation is a document written about the applicant by a previous employer, professor, or anyone working in close contact with the applicant. This one document is supposed to describe you, your qualities, and your abilities — all in less than a few paragraphs. It can be an enormous determining factor in getting the job position, being accepted to a university, or matching your number one residency program. Although this is great in theory, obtaining letters of recommendation is both a burden to the applicant and the letters’ writers. As a rising fourth-year medical student starting residency applications, I find myself laden with the same anxiety I once felt as I applied to all my previous educational programs. These letters have been a crucial part of applications for undergraduate universities, medical schools, residency programs, and even jobs. But in reality, how is this one brief document an accurate representation of who you are?
With residency applications for the 2022 cycle right around the corner, medical students are scrambling to ask their preceptors for letters of recommendation. There is a huge emphasis on the importance of obtaining strong letters to match your desired specialty. These letters increase the workload on the writer and applicant. Since most rotations are only one month with the same physician, it is difficult to trust that this person knows you well enough to write about your qualities. Additionally, physicians knowing students for a transitory time makes it challenging to address the non-generic assets. Likewise, physicians work with numerous students making recollection of an individual’s strengths problematic. Often a big roadblock, especially for non-tech-savvy individuals, is the upload process. Most application sites are not user-friendly and deter physicians from easily accessing and successfully uploading these letters.
It becomes a “strategic game” of who you think would write the best letter on the applicant end. The game does not end there because the physician must also agree. There is the unrelenting anxiety of not seeing what is written or emphasized about you — the fear of the unknown. When you request this letter, you waive your right to know what was included. You gamble with the chance that the letter may not help your application due to the lack of personalization and emphasis on little aspects that make you stand out. Not to mention the added tribulations of the COVID-19 pandemic reducing time spent interacting with preceptors. Some attendings are not even able to identify their students without the masks on. This has really put a harsh toll on interpersonal connections and non-verbal communication — all of which can make a difference in someone’s letter.
Physicians, as we know it, are busy enough with extensive documentation for medical records. Now imagine adding on writing numerous letters for their students. Sadly, this leads to a few outcomes, most of which are not ideal:
The physician says “no”
This is the most dreaded response; students are already anxious to ask and getting turned down is discouraging. Furthermore, now the student must find another physician they flourish with to, once again, put themselves out there and ask.
Generic letter of recommendation
A generic letter can really hinder an applicant, even if their performance was far from average. Often physicians do not deliberately make the letters broad, but with bustling schedules, these time-consuming letters can fail to highlight some of the attributes the applicant offers; the letter will miss the mark on accenting strong points.
Rare: strong letter
Some physicians can offer extra time to meet with the applicant and discuss what goes into the letter. This often leads to a stronger and more personalized document. However, it is not as common, and writers are not to be blamed for this — as they have other obligations and time restrictions.
Letters of recommendation do not only apply to medical school, but also most schooling and job applications; this is not a problem solely of medical students and doctors. The hopes are to decrease the emphasis on these letters of recommendation, especially when deciding such crucial parts of our lives — like residencies and jobs. There should be more time-effective alternatives and allow the assessment of the applicant while lessening the weight on both parties. Something as simple as replacing letters with a phone call or video chat can allow for a more detailed discussion of the applicant. Alternatively, students could be allowed to write their own strengths and attributes, to which the attendings can attest to and be a reference. Lastly, the goal would be to transition to a more effective means of learning about your applicants, which is less arduous and erroneous. After all is said and done, these quandaries of obtaining letters may not even be a detailed representation of who you truly are.
Catherine Tawfik is a medical student.
Image credit: Shutterstock.com
