I speak to a few lucky medical school and residency applicants who are asked to write their own letters of recommendation. If you have this opportunity, first, realize that it is not unethical to write your own letter if you’re asked to do so. If you’d like to explore the scruples of this issue, take a look at this New York Times ethicist column about this topic.
The mistake I see candidates make in these situations is that applicants don’t write strong enough letters for themselves because they feel awkward about showcasing their accomplishments fully. If you have the opportunity to write your own letter, craft a glowing one. Be effusive and full-throated in your remarks about yourself. Remember that the letter-writer can choose to tone down the recommendation if she doesn’t agree. But if she does, you’ve utilized an opportunity fully and bolstered your candidacy tremendously.