A lot of people have good advice on studying for Step 1 and Step 2, succeeding during third year clerkships, and writing a strong personal statement  but not so much on asking for letters of recommendation. This is somewhat surprising, as residency directors across all specialties rank it as one of the most important parts of the ERAS application. And while it isn’t especially challenging to get a generic “good” letter, it can be to get a great one: a letter that paints a detailed picture of you and really makes your application stand out. As such, here are four pieces of advice to make the process less painful while also helping improve the quality of your letters.

1. Ask someone who knows you as a person and a medical student:

   While this may seem obvious, it’s the single most important rule of asking for a letter. It may be tempting to ask the head of interventional radiology at your school because she has 113 publications, but if she can’t write a detailed letter about you, then it doesn’t matter. When I sat on the admissions committee for my medical school, I read over 300 letters of recommendation. It’s immediately apparent when the author knows the applicant.  These letters don’t just let the reader truly get to know the applicant. If the writer is willing to take the time to write a detailed and personalized letter, it shows that the applicant is a candidate worth considering.

1. Schedule a formal time to ask for the letter of recommendation:

   A few days before the rotation ends, ask your potential letter-writer if they have a couple minutes at the end of the week to sit down and give feedback. This allows you to ask her in a private and more relaxed setting, instead of having to yell awkwardly across the hospital as the attending sprints away when rounds are over. It also gives you a sense of what kind of letter she will write for you. If you received detailed and positive feedback, the letter will likely reflect that. Conversely, if during this session she is more critical or does not have much to say, you may want to reconsider asking that person for a letter.   

1. Help them make the letter as detailed as possible:

   After the attending agrees, send them an updated CV and personal statement. If it’s still early in the application process and you haven’t written your personal statement yet, that’s fine, but even a short personal bio and why you chose that specialty can give the writer insight into who you are outside of the hospital.  Attendings appreciate this because it makes the letter easier to write for them and also adds a layer of personal detail.

1. Follow-up!:

   This may actually be the most difficult step. As the deadline for my letters approached and one writer had yet to submit his, I found myself in a tough position between making sure I met the deadline and not wanting to alienate a busy attending who was doing me a service. I finally sent an email and immediately received one back thanking me for the reminder. My writer submitted it the next day.

When the deadline for submission is approaching, send an email simply asking if they need any more information from you and reminding them of the due date. Just make sure you give them enough time (at least a week) to write a quality letter.

At the end of day, remember that these doctors were once in your shoes and had to ask for letters themselves. They have also probably written many letters before and almost all will write you one happily. However, following these four rules can both make the process easier and strengthen your application. If nothing else, it can help you from going in AFib every time you think about it.