This document provides guidance on writing effective letters of recommendation. It discusses the importance of writing recommendation letters that are helpful to both the applicant and selection committee. The key points made include gathering relevant information about the applicant and position, having a structured format with an opening paragraph about your qualifications, supporting paragraphs with specific examples and evidence about the applicant's qualifications, and a closing summary statement. Common pitfalls to avoid are also outlined, such as writing letters without knowing the applicant well or criteria of the position. The goal is to write organized, substantive letters that highlight how applicants meet expectations.

1. Writing a Helpful Letter of
Recommendation
Jeff Harrison, MD
Department of Family Medicine
Faculty Development

2. Really????
• How hard can it be to write a letter of recommendation
• After all….. we are highly educated
• You would be surprised at the frequency of unhelpful letters we see

3. My Qualifications
• 18 years of reading letter of recommendation for residency applicants
• 15 years of reading letters of recommendation for medical school
applicants
• Writing multiple letters of recommendation for medical students,
residents and faculty

4. Goals
• Learners will attain knowledge regarding key component's of a helpful
letter of recommendation
• Learner’s will gain skills in crafting an effective letter of
recommendations
• L:earner’s will recognize common errors made by letter writer’s

5. LOR Fundamentals
• Statement of support to help the candidate +
• Present a well documented evaluation of the candidate for the
selection committee +/-
• Address a specific purpose – academic, character, leader, teacher +/-
• Written in a defined structure – have a plan +/-

6. You are asked to write a letter of
recommendation -now what?
• Do I know the candidate?
• Is information available regarding the position specifications?
• Am I an appropriate information source?
• Is the time frame reasonable?
• Can I write a supportive letter?
• If your answer is NO to any of these then proceed slowly

7. 3 Kinds of Letter’s
• Easy: you know the candidate well and think very highly of them
• Not as Easy: you know the candidate and have no issues with their
performance
• Really Easy: you don’t them well or have reservations about
performance

8. You have accepted the challenge
• Try and meet with candidate unless you know them well and are very
familiar with the selection process
• Get their CV
• Ask for the detailed specifications put forth by the selection
committee – criteria and format

9. Building the LLOR
• Headings
• Opening Paragraph
• Supporting Paragraphs
• Summation and closing

10. Heading
Generic greeting vs specific:
• Dear Dr. xxxxx
• Dear Program Director
• Dear Selection Committee
Identifying information for candidate:
• AAMC #
• NRMP #
• DOB

11. Opening Paragraph – more about you
• Intent of letter
• Your relationship to the candidate
• Length of association and setting
• Your qualifications to make an assessment

12. Examples
• I am writing in support of Donald Trump who is applying to your
medical school.
• I have known Mr. Trump for 2 years; he has shadowed me in my busy
clinical practice during holiday breaks and summer vacations.
• I am an Associate Professor in the DFM at UNMC and have precepted
innumerable student and residents over the past 8 years; as such I
feel qualified to assess Mr. Trumps qualifications.

13. Supporting Evidence – about the candidate
• Address the selection criteria
• Need to provide supporting evidence for your claims – examples
• Need more than just superlatives
• This is not Lake Woebegone – all cannot be above average

14. Supporting Evidence II
• If you can’t honestly say this candidate is in the top 5% of all
students/residents – then don’t
• You can say they are well qualified to meet the expectations of the
position. “demonstrated the qualities to be a successful medical
student”

15. Supporting Evidence - specific
• Academic: scores, boards, research
• Service: volunteer, leadership, time
• Teaching: evaluations, recognition
• Leadership: elected positions, appointed positions, outcomes

16. Academic Examples
• Dr. Sanders has exhibited outstanding medical knowledge as
evidenced by scoring in the top 5% of all family medicine residents on
the national In-Training examination in each of the past 3 years.
• Dr. Clinton has demonstrated superior scholarly work during
residency. She was recognized as having the top poster presentation
at the Department of Family Medicine annual residency research
symposium and again at the NAFP Annual Scientific Assembly.

17. Service Examples
• Student Cruz has demonstrated strong commitment to community
service as evidenced by his ongoing performance as the physician
recruiter for the SHARING Clinic. This is a nationally recognized
student run clinic that helps meet the needs of Omaha’s large un-
insured population. The role of physician recruiter requires diligence,
persistence and commitment to providing outstanding oversight for
this group of patients.

18. Teaching
• Dr. Kasich has demonstrated outstanding teaching skills during his
residency and would be a valued asset to your fellowship. His
supervisory evaluations routinely note his strength as a teacher. He
was in fact, voted resident teacher of the year by his peers.

19. Leadership
• Mr. Carson has been a proven and successful leader during is medical
school training. He was elected President of the Family Medicine
Interest Group during his M2 year. This is one of the largest student
organizations on campus. He led the organization and
implementation of a highly successful residency fair as well as
numerous procedural workshops.

20. Summary Paragraph
• Global assessment - use your superlatives
• Meet the criteria for position as outlined above
• Willingness to answer questions
• Thanks for consideration
• Waived right to see letter

21. Several Last Comments
• Format
• Length

22. Make Miss Jenkins Happy
• Written on letter head
• Spell checked
• Organized
• Font and type size – NEVER HAND WRITTEN
• Prose
• Proof read

23. Why do I care about Miss Jenkin’s 35 years
later?
• Sloppy letters suggest a lack of support for your candidate
• Hard to read letters are hard to read
• Your own credibility in your institution

24. Length
Goldilocks Rule:
• Not too long, not to short, just right
1-2 pages should be your target
• Too short says you don’t know or really don’t care
• Too long loses the reader
• Check expectations (ERAS no more than 1 page)

25. Do’s
• Ensure you should write this LOR
• Gather data: CV, criteria
• Structure:
1. Opening - about you
2. Supporting - evidence of qualification
3. Summary – global and re-iteration of qualification
4. Length and format

26. Don’t’ s
• Write letters for those you don’t know or like
• Write without knowing the criteria being evaluated
• Make claims that can’t be substantiated
• Wait until the last minute

27. Summary
• Most of us will be asked to write a letter or recommendation for a
student, resident or colleague – we need to make it helpful for the
applicant and selection committee
• Gathering a little data and following a structure makes this a fairly
simple process
• Keep your good letters on file – the format can be recycled

28. Your Turn – choose one and share
• Write an opening sentence or two for a pre medical student who has
shadowed you in clinic.
• Write a supporting statement for a resident applying for a Sports
Medicine Fellowship that requires teaching residents and students.
• Write a supporting statement for your colleague who is going up for
promotion to Associate Professor – teaching focus.