Letters of Recommendation

Background:

Letters of recommendation hold a special place in the ophthalmology residency application process. Since ophthalmology is an “early match” specialty, any formal evaluation about a student’s performance in the clinical half of medical school is not forwarded to residency selection committees until after interviews have been offered to candidates. Thus, the only invaluable commentary on a student’s performance during their clinical years is in the letters of recommenders. Additionally, it seems the field of ophthalmology is quite small with most of its practitioners acquainted with each other- thus a letter of recommendation from an ophthalmologist is imperative as a credible source of a student’s potential in the field.

Personal:

In speaking to my academic advisors about this process, expectations for letters reflect the above nuances with the three letters to complete one’s application to include one letter from a professor who can speak to a student’s clinical performance, one letter from an ophthalmologist who can comment on a student’s abilities as a clinical ophthalmologist and, perhaps specific to my case, ideally a letter from someone who can speak to a candidate’s ability as a research scientist.

Asking for a letter from my research mentor was perhaps the easiest prospect given our affable, long-standing relationship and his being familiar with the residency application process (having had several medical students before me). Slightly more difficult was asking the professor who instructed me during my internal medicine rotation for a letter as I knew him less well and we had last spoken 2 months prior. Nonetheless he also enthusiastically agreed to write my letter.

Asking for a letter from an ophthalmologist was perhaps my least favorite endeavor, perhaps because as a student you imagine it will color the perspective with which this person will then view you. That is, as a student interested in a field- you earnestly seek advice, perspective and training from members in that field and, in ophthalmology, the professors are almost all exceedingly kind and generous. In asking for a letter of recommendation from one of these doctors, you not only further burden them for their already scarce time but also risk being viewed as an opportunist. Mostly you fear that all of your honest efforts and any congeniality you had shown prior to asking for the letter will be now viewed as premeditated and feigned when, of course, it was not. I can personally attest that numerous other medical students in all disciplines suffer this same sense of guilt in asking for a letter of recommendation and I can only hope it is angst over a wholly imagined circumstance.

A final sense of grief surrounding letters of recommendation is their actual content. As students almost invariably waive their right to see these letters, they have no sense of what is being submitted with their application. This variable is particularly stressing given all the permutations affecting a letter: whether the writer recalls relevant interactions with the student about which they can write, a general tendency of the writer to be generous in their recommendations, whether a letter will reflect time constraints in the writer’s schedule or perhaps whether the writer simply is or is not gifted with words. All of these variables are somewhat independent of the quality of the student requesting the letter yet undoubtedly affect the final “product.”

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