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An Offer You Can’t Refuse

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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.

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DO vs. MD

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Thinking about a medical school application for 2018, I’ve had a few industrious pre-meds ask me about DO school. There was an excellent article in the New York Times a few years ago about what doctors of osteopathy do and how their admissions criteria are different from allopathic schools’. It’s here and worth a read.

The topic of DO schools is an enormous one. A few quick points many candidates don’t know about DOs:

1. Many doctors of osteopathy practice medicine just like allopathic doctors do. I do per diem emergency shifts at Kaiser and work with many DOs. Candidly, I usually do not know which colleagues have osteopathic degrees and which have allopathic ones unless I see a prescription blank or a signed computer note.

2. If applying to osteopathic school, candidates are generally better off with at least one (strong) letter of recommendation from a DO supervisor.

3. Osteopaths currently take the COMLEX for their board tests, instead of the USMLE. If an osteopathic medical student wants to enter an allopathic residency, s/he may need to take the USMLE in addition to the COMLEX. On the other hand, there are many allopathic residencies that accept the COMLEX. Also, there is talk that in the future (when exactly is unclear, however) there may be just one board test that both groups take.

4. The osteopathic Match occurs before the NRMP Match, a fact that can be difficult for osteopaths applying to both types of residencies. If those applicants are successful in the osteopathic Match, they cannot enter an allopathic residency. If, on the other hand, they wait and enter the NRMP Match, they run the risk of simply not matching.

Again, this topic is complicated and nuanced, but the DO option is a great one for some applicants.

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Inaccuracies in Medical Student Grades Translate into Residency Application Strategy

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Here’s an interesting article by Dr. Pauline Chen on medical student grades. In reading the article, residency applicants should reflect on how important the content of their letters of recommendation is, especially in the setting of medical school grades that may be inflated or simply inaccurate. The 2016 NRMP Program Director Survey supports the importance of letters, as well, with statistics. Make sure your letters are very strong; remember that mediocre letters should not be a part of your residency package.

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Writing Your Own Residency or Medical School Letter of Recommendation: Is it Ethical?

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It’s not infrequent that an applicant tells me that a letter of recommendation (LOR) writer has asked the candidate to draft his/her own letter because the writer is “too busy.” I notice that medical school and residency applicants are a bit sheepish as they tell me about this arrangement. Have no fear: You are not doing anything unethical. (Here is an old piece by the New York Times ethicist Ariel Kaminer regarding this exact topic.)

If a faculty member asks you to write your own letter, not only should you do it, but you should do it with zeal. Make sure you showcase the accomplishments that distinguish you from other candidates and highlight traits that are important for your future career path. Use honest – but bold – adjectives to describe your best qualities.

Remember that the letter writer has final say, so even a busy faculty member might modify the letter. Keeping this fact in mind might alleviate your (unnecessary) guilt and should encourage you to write the strongest letter you can. (It’s harder to go from outstanding to mediocre than from outstanding to excellent.)

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Get a Better Letter

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After over a decade of reading medical school and residency letters of recommendation (LOR), I can tell you that the biggest error I see in the LOR process occurs when applicants settle for mediocre letters. In other words, they know that a supervisor/faculty member/attending isn’t going to write them a strong letter, but they fill the LOR slot with the middling endorsement anyway.

Please take a look at my most recent Student Doctor Network article, “Get a Better Letter” for concrete ideas on how to approach the letter of recommendation process.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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