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How to Write a Letter of Intent to Residency Programs?
2026 Guide to Residency Letters of Intent
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How to Write a Letter of Intent to Residency Programs? 2026 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.
Before we start, if you want my team to help you with your Letter of Intent, click here.
We also have detailed guides on 2026 ERAS Application Updates, how to write your personal statement, and 250+ residency interview questions.
Table of Contents
- What is the difference between a Letter of Intent and a Letter of Interest?
- How many Letters of Intent should you send? How many programs should you write a Letter of Intent to?
- Who should you write the Letter of Intent to?
- When to write the Letter of Intent?
- What should you include in your Letter of Intent?
- What should you exclude from your Letter of Intent?
- Letter of Intent Sample | General Surgery Applicant
- A critique of the above Letter of Intent
○ Pros
○ Areas of improvement - Final takes on Letters of Intent
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 (such as a recent clinical externship), 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?”.
Email of Intent Editing
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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 (check your NRMP portal for specific dates), 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 compared to candidates from even the top med schools in the US, 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.
Get FREE exclusive sample letters of intent for your residency application!
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:
Pros
- Simple language and easy readability.
- Specific to the residency program and specialty.
- Highlights the applicant’s goals for research and fellowship
- Incorporates previous experiences (here, home country residency) and presents it as a strength to the program (ability to handle large patient volumes and decision-making).
- Provides pertinent updates regarding the applicant (here, USMLE Step 3).
- Highlights that the Program is ranked ‘Number one’ on the Rank Order List.
Areas of improvement
- Repetition of certain aspects like previous residency might not be appropriate unless using it to highlight certain qualities or skills. If possible, avoid repetition of your CV.
- Here, one might argue that the letter of intent is very specific to Trauma Surgery when the applicant is applying for General Surgery. There are two schools of thought; On one hand, it would be a safe bet to highlight aspects pertinent to General Surgery rather than a specific area of General Surgery (Trauma Surgery in this example). Contrary to this, an increasing number of applicants who apply to the Match are focused on one or two aspects and elaborate on the same to display their depth and interest in their choice after residency. Note that this does not necessarily mean fellowships. This may include their path as a hospitalist, physician-scientist, academic medicine, etc.
- This letter of intent mentions that the research performed by Dr. Scott was ‘groundbreaking’. This sounds like a blanket statement and fails to explain the specifics of the research performed.
- Does not incorporate a personal experience about interview day interaction with the Program Director. This is optional and is at the discretion of the applicant. The advantage of including one would be to help the PD remember you beyond your ERAS photo amid a large pool of candidates.
- This letter is on the long side and could be made more concise.
For more details you can check our video “How to Write Residency Letters of Interest”
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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