ERAS Support Services for Applicants

Letters of Recommendation (LoRs)

About LoRs

Applicants are urged to submit LoRs that are meaningful in content. Strong LoRs are an essential part of your medical residency application. Your LoRs should give the residency program director a clear picture of your current skills and clinical ability, in addition to your personal characteristics such as professionalism, leadership, and interpersonal skills both in the patient setting as well as with hospital staff. Submitting LoRs that are substantive in content will ultimately provide the residency training program director with information pertinent to the residency recruitment and selection process.

You should select your letter writers carefully. The letter writer should be a physician who is familiar with your clinical abilities and knowledge, as well as your work ethic and interpersonal skills with patients and colleagues. You should consider asking for LoRs from clerkship directors, medical school faculty, and colleagues in the specialty to which you are applying. Some U.S. residency training programs may request that one of the LoRs be written by the department chair in that program’s specialty at your medical school. You should contact each program for its LoR requirements.

Ideally, you should meet with the letter writers and discuss specific instructions before the letter is composed and submitted. You should inform them about your educational goals and to which specialty or specialties you plan to apply. The letter writers should also be provided with a copy of your resume for reference purposes.

LoRs should be written on professional letterhead and signed by your letter writers. Professional letterhead can be the letterhead of the institution where the letter writer is employed or the letter writer’s personal letterhead. Professional letterhead is used to establish identity and to give program directors confidence that the letter is from a reputable source. Program directors may contact your letter writers directly to confirm the content of the LoR, particularly if they are interested in inviting you for an interview. It is for this reason that ERAS Support Services suggests contact information be provided in the letterhead or in the content of the letter. If, for some reason, a program director would not be able to contact a particular letter writer, then you should not use that letter. By following these guidelines, you will present program directors with a complete and professional document in support of your residency application.

It is your responsibility to follow up with letter writers to ensure that LoRs are ready in time to be sent to ERAS Support Services to meet program deadlines.

If an LoR is not written in English, it must be accompanied by an official English translation; that is, an English translation prepared by and certified to be correct by a medical school official (for example, a Dean or Registrar), a government official (for example, a Consular Officer), or a professional translation service. The translation must appear on official stationery and must bear the original signature and title of the medical school official, government official, or representative of the translation service. If the translation service is a private company, the letterhead stationery must identify the company as a translation service.

A Note About Specialty-specific LoRs: If a letter writer has recommended you for a position in a specific specialty, it is not advisable to use that LoR to apply for positions in other specialties. To help ensure accuracy in attaching such specialty-specific LoRs, ERAS Support Services at ECFMG conducts a review of the content of your LoRs. If we determine that there is a discrepancy between the specialty to which you are applying and the specialty for which you are being recommended in the content of your LoR, a notification will be sent to the e-mail address in your MyERAS application. If an LoR is determined to have a discrepancy, it will not be uploaded to your application until we receive direct instructions from you, as outlined in the e-mail notification.

If your goal is to secure a training position in any specialty, you should inform your letter writer of this when you meet to discuss specific instructions and should request a general letter applicable to all specialties.

Submitting LoRs

LoRs can be submitted to ERAS Support Services at ECFMG via a number of electronic methods: Applicants can submit LoRs if they have not waived their right to view the LoRs via ECFMG’s On-line Applicant Status and Information Systems (OASIS); letter writers can submit LoRs via the Letter Writer Portal (LWP); and medical schools can submit LoRs via the ECFMG Medical School Web Portal (EMSWP). Applicants, letter writers, and medical schools also can submit LoRs to ERAS Support Services via mail or courier service for scanning. See below for details on each method.

Via ECFMG’s On-line Applicant Status and Information System (OASIS)
Applicants can upload LoRs if they have not waived their right to view the LoRs to ERAS Support Services via OASIS. Whether to waive your right to see your LoR is a matter strictly between you and the letter writer. If you already have some LoRs, you obviously did not waive your right to see them. In that case, submit the LoR electronically via OASIS or via mail or courier service for scanning. Documents submitted through OASIS will take one to two weeks to process, while paper documents submitted for scanning will take four to six weeks to process.

If you would like to waive your right to view an LoR and still have it uploaded electronically on your behalf, you can submit an electronic request to your letter writer using OASIS. See Letter Writer Portal Requests for more information.

Via ECFMG ERAS Letter Writer Portal (LWP)
The ECFMG ERAS Letter Writer Portal (LWP) provides letter of recommendation writers with the ability to upload LoRs directly to ERAS Support Services at ECFMG on behalf of an applicant. In order for a letter writer to upload an LoR on your behalf using LWP, you must send an electronic request to the letter writer using OASIS.

LoRs uploaded through LWP will take one to two weeks to process. Applicants can track the status of their LoR requests from the request home page in OASIS. LoRs submitted electronically through LWP do not require the AAMC’s Letter Request Form or a DSF. For more information, see Letter Writer Portal Requests.

Via ECFMG Medical School Web Portal (EMSWP)
Through the ECFMG Medical School Web Portal (EMSWP), international medical schools can submit supporting documents electronically, including LoRs, on behalf of their students/graduates who participate in ERAS. ERAS Support Services attaches and uploads these documents to the ERAS PostOffice typically within one to two business days of their receipt at ECFMG. A DSF is not required for documents submitted electronically to ECFMG. Receipt of documents submitted electronically by medical schools can be tracked in the ERAS Support Services Document Tracking System, which you can access via ECFMG’s OASIS.

Via Mail or Courier Service for Scanning
LoRs mailed to ERAS Support Services for scanning must be accompanied by the AAMC’s Letter Request Form and a completed DSF. Send these documents to the appropriate address, as indicated on the DSF. Please note that paper documents submitted for scanning will take four to six weeks to process.

Whether to waive your right to see your LoR is a matter strictly between you and the letter writer. If you already have some LoRs, you obviously did not waive your right to see them. In that case, submit the original LoR electronically via OASIS or via mail or courier service for scanning. Retain a photocopy of the LoR for your records. Documents submitted to ECFMG for the ERAS 2013 season will not be returned. If you waive your right to see your LoRs and the letter writer will be submitting the LoR via mail or courier, provide the letter writer with a completed AAMC Letter Request Form and a completed DSF so that he/she can send the LoR directly to ECFMG in a sealed envelope from the institution.

IMPORTANT NOTE: Submission of any falsified or altered document to ECFMG is an example of irregular behavior. A determination by ECFMG that an individual engaged in irregular behavior may be sufficient cause to bar an individual from ECFMG Certification or revoke an ECFMG Certificate or take other appropriate action. ECFMG will send notice of a determination of irregular behavior to residency program directors, among others. See ECFMG Policies and Procedures Regarding Irregular Behavior.

Assigning LoRs to Programs

In order for your LoRs to be available to programs, you must finalize your LoR Authors and assign the letters to programs in MyERAS. You can assign a maximum of four LoRs to each program. For more detailed instructions, refer to the MyERAS Documents Tab Tutorial.

Repeat Applicants

If you participated in the ERAS 2012 season, you are not required to resubmit any LoR that was transmitted to the ERAS PostOffice for ERAS 2012. Note that this only applies to LoRs that were transmitted to the ERAS PostOffice in the previous season. If you submitted an LoR but did not reserve a slot for the LoR in MyERAS during ERAS 2012, that LoR was not transmitted to the ERAS PostOffice and will not be available for reuse for ERAS 2013. See ERAS 2013 Repeat Applicants for instructions on how to reuse LoRs.

If the content of your LoR has changed, submit the modified LoR. If you submit a modified LoR, and you have already selected to reuse the previously uploaded LoR, both versions will be made available to programs in the MyERAS PostOffice.

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