LOR for Applying IM

[futuredr2kids]

Hey everyone! I'm getting ready to apply for IM this year and am confused about letters of recommendation. I have 1 from an outpatient endocrine attending, 2 from my core IM rotation attendings, and 1 from my advisor/FM attending who worked with me inpatient (so all 3rd year letters). I have been told they are all very strong letters. My school has required ICU and cards rotations for 4th year but no sub-I offered or required. I was able to get a sub-I at a university program I am interested in but it starts in October so I don't know if there would be much benefit to getting a letter that late. Everyone keeps saying a sub-I letter is really important but I just haven't lucked out on VSAS for a July or Aug rotation. I would be able to get either a cardiology, ICU, or ID LOR in before ERAS opens but I'm not sure if there is value to a 4th year LOR showing more competency vs. a strong 3rd year LOR from attendings I know well. Can anyone speak to the importance of a sub-I LOR? Would anyone who applied without a sub-I LOR be able to speak to their experience?

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[DoReMiFaSo]

Ah VSAS.. I still carry nonhealing wounds from fighting for spots on VSAS. Bitter memories lol.

Anyways, yes, I think I can speak on this. I am an incoming IM intern who completed 2 subIs. My subIs were both later than the opening date of applications. I learned from first hand experience that it is far more important to have all the letters in by Day1 of applications than to wait for that one shinny subI letter. Now, this is not to downplay the importance of doing subIs. If you happen to be good, your subI attending might offer to not only write you a letter but also to make calls on your behalf, the latter of which I find to be infinitely more valuable. Your subI attending just might know someone who is someone of significance at your most desired residency.

 

[futuredr2kids]

Ah VSAS.. I still carry nonhealing wounds from fighting for spots on VSAS. Bitter memories lol.

Anyways, yes, I think I can speak on this. I am an incoming IM intern who completed 2 subIs. My subIs were both later than the opening date of applications. I learned from first hand experience that it is far more important to have all the letters in by Day1 of applications than to wait for that one shinny subI letter. Now, this is not to downplay the importance of doing subIs. If you happen to be good, your subI attending might offer to not only write you a letter but also to make calls on your behalf, the latter of which I find to be infinitely more valuable. Your subI attending just might know someone who is someone of significance at your most desired residency.

Thanks for the insight. I think I'm pretty worried about not doing well on an away sub-I. I have been at community hospitals for all of my inpatient rotations and have been working directly with an attending for all of them so I'm worried that working with a team for the first time + working with a new hospital system will be too steep a learning curve for me to do well. I've worked really hard on all my rotations have honored all my evals but there's a part of me that is just nervous about aways backfiring.