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How to Write a Letter of Intent to Residency Programs?
2024 Guide to Residency Letters of Intent

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How to Write a Letter of Intent to Residency Programs? 2024 Guide to Residency Letters of Intent

It is a common practice to send Letters of Intent to express your strong interest and commitment to a specific program, enhancing your chances of matching there. In this blog, we will discuss how to write a Letter of Intent, the best time to send these letters, and the best practices to make your Letters of Intent stand out.

What is the difference between a Letter of Intent and a Letter of Interest?

A Letter of Interest is typically drafted at the beginning of the Match season to your top choice residency programs. It includes the reasons that interest you to train at the program and to convince them to extend an interview invite. It may include your unique qualities, experiences, and skills which would be viewed as an asset to the residency program.

A Letter of Intent on the other hand is drafted at the end of the Match season in an attempt to convince your top program to rank you highly by proving that you will be a good fit for them.

How many Letters of Intent should you send? How many programs should you write a Letter of Intent to?

It is advisable to write only one letter of intent to your top choice residency program, stating that they are your “Number one”.

However, it is common practice to write a letter of intent to the top few programs (arbitrary number) stating that you will be ranking them “highly”. There are mixed views regarding the same, as it may prove to be a double edge sword. On one hand, it may inform the program that you will rank them highly compared to other programs on your list. In contrast, the program will not be aware of their place in your Rank Order List. It could vary from 3rd place in a candidate who has received 7 interviews to 10th place in a candidate who has received 25. It also carries the disadvantage of informing the Program Directors that they are not your number one choice for residency, leading to the question, “why not number one?”.

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Who should you write the Letter of Intent to?

You can write a Letter of Intent to residency programs you are interested in ranking highly. A letter of intent is commonly written to the Program Director (PD) of the desired residency program. It is a good practice to CC the Program Coordinator (PC) to ensure the message is conveyed and not lost in the sea of emails. However, you can also send the letter of intent to the faculty and the residents you interacted with on interview day. It is advisable to use the same email address registered in ERAS.

When to write the Letter of Intent?

Each residency program has varying timelines as to when they conclude their interviews for the Match season. Most of the programs complete interviewing applicants by mid-January to early February. Given that the Rank Order List (ROL) opens on February 1 (NRMP Match 2024), it would be ideal to send the letter of intent by the end of January or early February. 

What should you include in your Letter of Intent?

A letter of intent should be personalized to the residency program. It can include the reasons why you would be a good fit for the program, how the program would help you achieve your future goals, and how you can effectively contribute to the program.

It can also include a gist of an interesting conversation you had with the Program Director or faculty to add a personal touch to the letter.

It is appropriate to mention to the program that they are your “Number one” choice, assuming you will be writing only one such letter. You can also consider mentioning significant changes that have occurred in your curriculum vitae (CV), such as publications, conference presentations, and awards which can add to your existing credentials.

What should you exclude from your Letter of Intent?

It would be unnecessary to mention your USMLE Step scores and reiterate your ERAS CV as residency programs already have access to this information.

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Letter of Intent Sample | General Surgery Applicant

Dear Dr. XYZ (Program Director),

I hope you are doing well.

This is Max Smith, a General Surgery residency applicant from QRS School of Medicine, Brazil. As the Match season comes to an end, I can firmly say that ABC (Name of the Institution) is my first option for residency. I’d like to provide a few persuasive reasons for my choice.

Having previously completed my residency in General Surgery at a tertiary care hospital in Brazil, I am accustomed to the high volume of patients and long working hours. This hands-on experience has directly translated into providing quality care for my patients and I believe that it will help me in adapting to your fast-paced residency schedule. The excellent General Surgery training at your institute will help me attain excellent surgical skills which will be useful for a career as a Trauma surgeon.

My research in medical school focused on resuscitative strategies in trauma and I have presented them at various national conferences. If given the opportunity to train here, I would like to expand on my research by working under the guidance of Dr. Scott who has published groundbreaking research on the same.

I appeared for the Step 3 USMLE exam in early February and awaiting the results. This is to enable me for an H-1B visa sponsored by your residency program. The favorable work atmosphere and resident camaraderie are the motivating factors in my decision to rank ABC first among all my programs. I am motivated to train under your supervision and look forward to the Match.

Thank you for your time and consideration.

Warm Regards,
Max Smith
(AAMC ID)

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A critique of the above Letter of Intent:

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Final takes on Letters of Intent

A good letter of intent can prove beneficial in a candidate’s effort to match at their residency program of choice. Some consider hand-written letters to be more valuable than an email, however, it carries the disadvantage of not reaching the destination on time. Be it via traditional mail or email, content is king, and your words will describe your purpose. As program directors and program coordinators tend to be busy during this time of the Match season, it is common to not receive a reply. This should not be considered negative and efforts to spam their inbox should not be made. Be respectful, genuine, and honest in your letter and your intentions will shine through.

I hope this blog helps you navigate through your letter of intent and I wish you match at your number one program!

If you need any help editing your letter of intent, check out our risk-free editing service (get your money back if you are not satisfied). Click HERE to learn more.

Good luck!

By Dr.Vikyath Satish

An International Medical Graduate from KIMS Bangalore, India and Internal Medicine Resident.

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