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Letters of Recommendation (LoRs)
About LoRs

Applicants are urged to submit LoRs that are meaningful in content. Strong LoRs are an essential part of your medical residency application. Your LoRs should give the residency program director a clear picture of your current skills and clinical ability, in addition to your personal characteristics such as professionalism, leadership, and interpersonal skills both in the patient setting as well as with hospital staff. Submitting LoRs that are substantive in content will ultimately provide the residency training program director with information pertinent to the residency recruitment and selection process.

You should select your letter writers carefully. The letter writer should be a physician who is familiar with your clinical abilities and knowledge, as well as your work ethic and interpersonal skills with patients and colleagues. You should consider asking for LoRs from clerkship directors, medical school faculty, and colleagues in the specialty to which you are applying. Some U.S. residency training programs may request that one of the LoRs be written by the department chair in that program’s specialty at your medical school. You should contact each program for its LoR requirements.

Ideally, you should meet with the letter writers and discuss specific instructions before the letter is composed and submitted. You should inform them about your educational goals and to which specialty or specialties you plan to apply. The letter writers should also be provided with a copy of your resume for reference purposes.

Program Directors may contact your letter writers directly to confirm the detailed discussion written in the LoR, particularly if they are interested in inviting you for an interview. It is for this reason that ERAS Support Services suggests contact information be provided in the letterhead or in the content of the letter. If for some reason a Program Director would not be able to contact a particular letter writer, then you should not use that letter.

It is your responsibility to follow up with letter writers to ensure that LoRs are ready in time to be sent to ERAS Support Services to meet program deadlines.

A Note About Specialty-specific LoRs: If a letter writer has recommended you for a position in a specific specialty, it is not advisable to use that LoR to apply for positions in other specialties. To help ensure accuracy in attaching such specialty-specific LoRs, ERAS Support Services at ECFMG conducts a review of the content of your LoRs. If we determine that there is a mismatch between the specialty to which you are applying and the specialty for which you are being recommended in the content of your LoR, a notification will be sent to the e-mail address in your MyERAS application. If an LoR is determined to be a mismatch, it will not be uploaded to your application until we receive direct instructions from you, as outlined in the e-mail notification.

If your goal is to secure a training position in any specialty, you should inform your letter writer of this when you meet to discuss specific instructions and should request a general letter applicable to all specialties.

Submitting LoRs

As stated in ECFMG’s Original Document Policy, all LoRs submitted as part of an ERAS application must be original documents. If you cannot supply an original LoR, ERAS Support Services will not delay the processing of your ERAS application. However, the document will be annotated, as described in the Original Document Policy. See the Original Document Policy for additional requirements.

If an LoR is not written in English, it must be accompanied by an official English translation; that is, an English translation prepared by and certified to be correct by a medical school official (for example, a Dean or Registrar), a government official (for example, a Consular Officer), or a professional translation service. The translation must appear on official stationery and must bear the original signature and title of the medical school official, government official, or representative of the translation service. If the translation service is a private company, the letterhead stationery must identify the company as a translation service.

LoRs can be submitted to ERAS Support Services at ECFMG via mail or courier service for scanning or electronically via the ECFMG Medical School Web Portal (EMSWP).

Via Mail or Courier
LoRs mailed to ERAS Support Services for scanning must be accompanied by the AAMC’s Request for Letter of Recommendation/Cover Sheet and a completed DSF. Send these documents to the appropriate address, as indicated on the DSF.

Whether to waive your right to see your LoRs is a matter strictly between you and the letter writer. If you already have some LoRs, you obviously did not waive your right to see them. In that case, mail the original LoR and retain a photocopy of the LoR for your records. If you do waive your right to see your LoRs, provide the letter writer with a completed AAMC Request for Letter of Recommendation/Cover Sheet and a completed DSF so that he/she can send the LoR directly to ECFMG in a sealed envelope from the institution.

IMPORTANT NOTE: If you waive your right to see an LoR, that letter will not be eligible for return through the Return of Document Service (RODS).

Via ECFMG Medical School Web Portal (EMSWP)
Through the ECFMG Medical School Web Portal (EMSWP), international medical schools can submit supporting documents electronically, including LoRs, on behalf of their students/graduates who participate in ERAS. ERAS Support Services attaches and uploads these documents to the ERAS PostOffice typically within two to three business days of their receipt at ECFMG. A DSF is not required for documents submitted electronically to ECFMG. Receipt of documents submitted electronically by medical schools can be tracked in the ERAS Support Services Document Tracking System, which you can access via ECFMG’s OASIS.

IMPORTANT NOTE: For ERAS 2012, ERAS Support Services at ECFMG expects to offer applicants the ability to send electronic requests for letters of recommendation (LoRs) directly to their letter writers. Letter writers will have the ability to upload LoRs directly to ERAS Support Services via a new Letter Writer Portal (LWP). LoRs uploaded through the LWP are expected to be processed within one to two weeks. Please monitor the ERAS Support Services section of the ECFMG website for additional information.

Assigning LoRs to Programs

In order for your LoRs to be available to programs, you must finalize your LoR Authors and assign the letters to programs in MyERAS. You can assign a maximum of four LoRs to each program. For more detailed instructions, refer to the MyERAS Documents Tab Tutorial.

Repeat Applicants

If you participated in the ERAS 2011 season, you are not required to resubmit any LoR that was transmitted to the ERAS PostOffice for ERAS 2011. Note that this only applies to LoRs that were transmitted to the ERAS PostOffice in the previous season. If you submitted an LoR but did not reserve a slot for the LoR in MyERAS during ERAS 2011, that LoR was not transmitted to the ERAS PostOffice and will not be available for reuse for ERAS 2012. See ERAS 2012 Repeat Applicants for instructions on how to reuse LoRs.

If the content of your LoR has changed, submit the modified LoR. If you submit a modified LoR, it will permanently replace the previously uploaded LoR. All documents mailed to ERAS Support Services for scanning should be accompanied by a completed DSF.

[last update: June 9, 2011]