If you’re reading this, you’ve likely interviewed at several residency programs and are thinking about your residency match list! You probably took a huge sigh of relief after, thinking most of the hard work was done. Then you hear one of your friends mention an LOI, and the nerves come right back. What’s a letter of intent? Should I be sending a letter of intent to residency programs? If so, when? Look no further for the answer to these questions, as well as everything you need to know about writing a residency letter of intent!
A letter of intent is an optional document written by a residency applicant to a program that states you will be accepting an offer of admission should you receive one. These are typically sent in the form of an email. Sending an LOI to a program tells them that they are your #1 program – in fact, you should explicitly say so in your letter (more on content later). If you are applying to residency programs, you are telling the program that you are ranking them first on your rank list.
While a residency letter of intent is technically not a binding contract, you should not send one unless you are certain that the program you are sending it to is your top choice. If you don’t know which school or program is your top choice, or you have any doubt, by no means do you have to send one! It is perfectly okay and normal to forgo sending a letter of intent.
One big difference between a medical school letter of intent and a residency letter of intent is that residency program directors and admissions committee members typically talk to one another. Therefore, if you send an LOI to multiple residency programs, you may get caught. Then, programs will know you’re disingenuous and this might affect your entire match / ranking process negatively.
But what if a residency program told you not to send a LOI?
If you’re the person who’s been dreaming of one program and they ask for no more communication, don’t worry! There are other ways to show your dedication to the program. Your interview is a great time to express your enthusiasm, as well as in thank you emails to your interviewers (as long as they are allowed). Another great way to show your interest in the program is to ask lots of questions – during your interview as well as after. Residency programs oftentimes have social events before and after interview day. These socials are another great way to show your interest in a program. It’s important to be enthusiastic (but not overly enthusiastic) and engaged. This is a good time to learn more about the nitty-gritties of the program, including the residency culture.
Finally, you can gauge if a residency program is interested in you if they invite you for a second look weekend or second look visit. Note that not all residency programs offer this or accommodate this. If you are considering how to rank your top choices for your residency match list, then strongly consider attending a second look. During this visit, you can have coffee chats and meals and shadowing opportunities with current residents & faculty members – these are great times to show your enthusiasm for the residency program. If the program is truly your top choice, you can also set-up a meeting with the residency Program Director and tell him or her that the program is your top choice.
The content of your LOI is extremely important. That being said, it does not need to be a multi-page document or lengthy email. In fact, it shouldn’t be – nobody wants to read that! Instead, you should use this brief outline to structure your LOI, trying to keep it to no more than 2-3 paragraphs.
The first should clearly state that they are your top choice, and you are very excited about it! The next should be longer and go into detail as to why that program is your top choice. More specifically, why you are a good fit for the program. Does the program have strengths that align with your background and interests? You can also highlight what you discussed with your interviewers on interview day.
If location is a large reason for wanting to go to that program, that’s totally OK! However, this shouldn’t be the first thing you list. They want to feel wanted first and foremost for their program, not its location. After you go into detail about why you specifically are a good fit for their program, you can say something like, “finally, my family and friends are located in xxx city and I would love to stay close to them.” Or just state why you want to move there, even if you don’t have connections there!
Here is a letter of intent residency template you can follow and take a look at the example below!
Dear [Program Director],
Body Paragraph 1: Talk about Clinical Opportunities. Since residency is first and foremost focused on making you a great clinical physician, the first body paragraph should be unique aspects of the curriculum that appeal to you.
Body Paragraph 2: Can talk about additional opportunities that excite you. You can include research and leadership opportunities here.
Body Paragraph 3: Discuss the culture of the residency program. You can talk about location here if you want.
Conclusion: 1-2 sentences.
If you need help with editing your residency letter of intent, we have a letter of intent package!
Are you on the medical school admissions wait list of waiting for an interview?
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Your acceptance can be just one letter away…
Dear [Program Director],
I hope you’re doing well! I have now completed my psychiatry residency interviews. I wanted to reach out to you to let you know that I am excited to be ranking the [School or Program] Psychiatry Residency Program as my #1 program.
There are several compelling factors that draw me towards [Program/School], including clinical opportunities in my areas of interest, which include women’s mental health, addiction psychiatry, and community psychiatry. I am excited by the electives available, including the Survivors of Torture clinic, rotations at the Veterans Affairs, and Research elective. It is noteworthy that residents can begin exploring electives as early as the second year.
I am excited by the research opportunities and the ability to independently lead my own research project during the fourth year of residency. I am interested in pursuing psychodynamic research with trauma victims. I aspire to find new therapy modalities and approach to improve mental health treatment for trauma victims.
As discussed on my interview day [DATE] I was also taken by the obvious emphasis on resident wellness, as evidenced by the psychodynamic movie nights, weekly process groups, and the psychodynamic psychotherapy elective in third year. I enjoyed the camaraderie among faculty and residents. I am excited for journal clubs sponsored by various faculty members. After speaking with residents, it is clear that the program creates an environment for residents to learn and flourish. Finally, I would be thrilled to remain in [STATE/REGION] where my family lives.
For all of these reasons, I believe [SCHOOL/PROGRAM] is a wonderful fit for me and I would be honored to be a member of your residency class next year.
Thank you for your consideration. Please email me if you have additional questions about my application or candidacy.
Undergraduate
Princeton
Medical School
Stanford
Residency
Harvard, Emergency Medicine
Undergraduate
Johns Hopkins
Medical School
Stanford
Residency
Stanford, Pediatrics
You should send the letter as soon as you know that a program is definitely your number one choice. For early matching programs, applicants send a letter of intent around December. For all other residency programs, applicants send a letter of intent around January or early February. You may hear from the grapevine (other students or residents) when the rank list meetings are. We would recommend sending a residency letter of intent before the rank list meeting – that way they can incorporate your desire to attend during the rank list meeting. That being said, don’t feel rushed to send it at all. Once you do, there isn’t really any going back.
Who to send letter of intent to residency? You should definitely send the email to the program director as well as the program coordinator. After that, it is up to you if you want to include others, such as your interviewers or any other contacts you have connected with from the program. Sometimes, medical school students connected with the Associate Program Director or the chief residents during interview day. You can drop a line and let them know the program is your top choice school.
As far as how to address the email…
If you are sending it to your number one residency program, I would address it as: “Dear Dr. [program director] and the [name of program] [specialty] residency program,”
If you are sending it to your number one medical school, I would address it as: “Dear Dr. [dean of admissions] and the [name of school] medical school,”
As stated before, do NOT, by any means, send an LOI if your program explicitly states not to, or if you are unsure of your top program. Of course, if you send the email and then later decide you prefer a different program, it is within your right to either rank that program higher or accept an admission from that program instead of the one you sent the LOI too. However, it is very likely that in doing so, you will be burning a bridge with that program. If you later want to go to residency there, or seek employment there, people may remember you and decline. You never know who is talking to who! Therefore, if there is any doubt at all, it is safer to forgo the LOI altogether.
Do not send multiple residency letters of intent! In the same vein as the last paragraph, you never know who is talking to one another. Program directors and deans of admissions from different schools could very well be in contact with each other, and it would be better to not send any LOIs and take your chances than to send two and get neither program. On top of that, it is simply a dishonest thing to do, and honesty and integrity are characteristics that very doctor should strive to embody.
Don’t send soft residency letters of intent! If the last paragraph makes you anxious because you are scared to put all your eggs in one basket, this is understandable. However, fight the urge to send one LOI and some “you are one of my top programs” emails. Programs do know about LOIs, so if you are not explicitly stating in your letter that they are your top program but are instead saying they are one of your top programs, they’ll be able to read through the lines.
As we said in the above section “How to write a residency letter of intent,” there are other ways to show your enthusiasm a residency program.
There is a very delicate balance between sending an LOI vs sending no email vs keeping in touch with the residency directors. If you have questions about your residency match list and whether you should send a residency letter of intent, contact us below or send us an email at info@crackingmedadmissions.com.
Finally, don’t freak out if you don’t get a response! This could be for a multitude of reasons, and it does not mean the program is not interested in you. It is common for applicants to receive no response and end up going to that program, or to receive responses a month later. Try your best not to read into it. Along the same lines, don’t read too much into a response if you do get one. Even if they explicitly say you will be accepted or ranked to match in their response, you cannot trust this. Applicants are burned by such responses more commonly than you would think.
Bottom line – a residency letter of intent can be an extremely powerful tool. However, sending one is not always necessary or possible. Follow these blog post tips and you should be safe, whether you decide to send one or not. Good luck!
