How many?

Aim for four letters if the number is not specified. Check program requirements on the ERAS and program websites.

Who should write the letters?

After you review the letter requirements for your programs, think about who can write a meaningful LoR about your abilities as a doctor rather than someone who will rehash your CV. Usually, one of the letters is from your residency program director. Others can be written by clinicians in general medicine or subspecialties with whom you have worked. If you have been involved in research or education projects, get LoRs from your project supervisor. Include at least one letter from a subspecialist in the specialty that you are applying for. 

When should I ask for the letter?

Asking for a letter while you are still working with a faculty member is best — and the earlier the better — as this allows them to pay more attention to your performance in real time and perhaps take note of specific strengths or examples. You can provide additional instructions on how to submit the LoR closer to the due date.

How do I ask for the letter?

First, don’t be afraid to ask! All faculty members at institutions with residency programs are accustomed to writing LoRs. You can email your request, but also offer to meet in person to discuss your career plans. Writers based outside of the U.S. may require more guidance. An international faculty member may be brief about your abilities, and this could be perceived more negatively than intended. Providing sample LoRs could be helpful.  

Here are some more helpful tips: 

• Ask if they feel they know you well enough to write a positive letter on your behalf

• Provide an updated copy of your CV and your personal statement to frame the LoR

• Consider noting specific areas on your CV that you would like highlighted

• Always remember to thank your letter writers, especially after you match, because they will be curious about the outcome! 

Fellowship interviews are often a bit more involved than residency interviews. The number of faculty members and trainees is much smaller in the fellowship program, and some fellows may stay on faculty after their fellowship. Therefore, faculty will be considering you as a potential future colleague and want to determine in the interview whether you will be a good fit.

Tips for acing the interview include: 

• Be engaged: Show your best side during the interview day. Make sure you are rested. Do not schedule interviews when you are post-call! Be social, put your phone away, and get to know the faculty, fellows, and other applicants.

• Practice and prepare: Many residency programs will offer mock interviews with experienced fellowship interviewers. Even if you do not have the opportunity to do a mock interview, prepare answers to commonly asked questions and practice delivering these answers out loud. 

Some interview topics to prepare for include:

• Talking about yourself

• Your strengths/weaknesses

• Describe a challenging patient interaction and how you resolved it

• Where you want to be in 5 to 10 years (You don’t have to be specific but you should have some sense of what you would like to do and how you will get there.) 

Make sure you know what questions interviewers are not allowed to ask (e.g., what other programs you applied to, age, gender, religion, sexual orientation, and family status). If any of these questions come up, try to make light of it and take the conversation in a different direction. Let your residency program director know if you are concerned about questions asked during your interview. 

• Know your interviewers: Many fellowships will give you the interview schedule ahead of time; make sure you read about the interviewers and their interests. If you know the program has a faculty member that might make a good mentor, make sure to contact the program well ahead of time to see if they can schedule an interview with that person. In addition to the division’s website, you can find useful information about interviewers on PubMed, LinkedIn, Doximity, Google, etc. This information will allow you to find some common points for discussion during the interview. 

• Ask questions: You should have read the program’s website in detail before the interview. Reviewing the website of the medical school or the medical center might also be helpful. You may find information on a relevant grant or multidisciplinary initiative. Prepare honest questions to help get to the essence of the type of curriculum the program offers (including clinical experiences you would like to learn more about, research mentorship, or non-clinical training opportunities).

• Interact with current fellows:They are on the front lines and can tell you more about call schedules, work hours, and other day-to-day questions than any of the faculty members. In addition, current fellows can give you the inside scoop on the program, the program director, and mentorship.

• Send thank you notes: Sending a thank-you note (via email or snail mail) is not required and may not be reciprocated. If your post-interview feelings are genuine, you can choose to send a quick note to express your ongoing interest in the program and you can include specific points, but do not cut and paste a generic thank you note. If there are been major updates to your application, let the program know.

• Post-interview communication:The official match policy is to discourage any communication from the program to the applicant after the day of the interview. Therefore, if you do not hear from the program, it does not necessarily indicate a lack of interest in you. However, fellowship programs are not prohibited from contacting you so you may get a call or an email, usually just to check if you have any additional questions. Programs cannot ask you how you are going to rank them. If you have concerns about a post-interview communication, discuss it with your residency program director who can help resolve the situation. 

During the interview season, register with NRMP to rank your programs. Don't forget to submit and certify your ranklist on NRMP by the deadline. Good luck!