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.