Non-US medical students should not make the mistake of waiving their rights to see traditional LORs: There are conflicting reports on whether waiving of FERPA rights to see an LOR will actually make a statistically significant difference in how a writer assesses a medical student. Additionally most writers incorrectly recommend that an LOR be waived to improve chances of an interview, where in fact the purpose of waiving FERPA on an LOR is to help the writer speak more truthfully, and based on over 2000 LORs analyzed by AmeriClerkships, waived LORs are no less or more positive, since they are written in prose and are therefore highly subjective. Waived (or unwaived) LORs can actually decrease chances of securing interviews, if they’re fundamentally problematic (see below).
Since AmeriClerkships serves residency candidates with more complicated personal or academic histories (e.g. unmatched US and international medical graduates, and visiting international medical students vs. traditional US medical student), the traditional LORs (versus Standardized Letter of Evaluation used by ER programs) they seek carry a much higher purpose as well as risks, as the traditional LORs can be used:
- For residency candidates to learn from, and improve upon deficiencies
- For Advisors to use for acculturation and improvement, similar to post-clinical evaluations
- To immediately send their entire residency application package to residency programs that do not participate in ERAS or NRMP, or those with off-cycle or last minute vacancies requiring up to date LORs
- To increase writer accountability and transparency by lessening the chance of writer delays or temptation of copy/pasting from a previously written LOR
- To decrease errors (grammatical, wrong person uploads, wrong names, incorrect dates or specialty of interest, just to name a few)
- To show respect for the writer’s time by not constantly calling them to send their LOR to various offices
The above is typically not the case for US medical school seniors, who’s LORs are typically written by their clinical clerkship supervisors who have been US residency trained, are in the same parent institution as their medical school, written within months of the end date of an experience, and typically by GME faculty or teaching hospital attending physicians and academicians. So AmeriClerkships recommends that its Members:
- Only ask US practicing MDs or DOs who supervised them during US clinical experiences to write US medical residency LORs
- Begin earning their LOR, and requesting that the writer train and evaluated based on ACGME core competencies
- Ask for LORs only towards the end of a clinical block
- If the writer agrees, ask if you asking for a copy will change the way he/she was planning on writing your LOR; if the answer is “No”, then ask for a copy. If “Yes”, then ask them to “please explain so you can learn from the process”.
- Do not keep asking if the writer does not want to share a copy of your LOR with you; simply accept his/her decision, but ask them to educate you on why, outside the common misconception that ‘waived LORs alone’ increase chances of securing interviews.
In our experience, physicians write positive character reference letters regardless of the waived status of an LOR; however character references are typically generic, so most need training on making LORs less subjective by instead evaluating your clinical performance based on ACGME core competencies – which most-all writers welcome, and will agree that it is a good idea for you to see your LOR and provide feedback. Therefore we strongly recommend that you not waive your right to your LORs.
See our full analysis of pros and cons of waiving your rights to see your LORs.