LOR from a kid's pediatrician?

[Anxs4Residency]

This question is for a friend of mine. Please see if you
can help.

She has known a US practicing pediatrician very well, in the past
several years, as she (the doc) is her kid's pediatrician. Many programs insist
on having a recommendation letter from a US Physician. Other than
this, she does not know any. Her other LORs are from a foreign
school (she is an IMG). Do you think this local LOR will help? And if
yes, what should it say (generally speaking)? I think her case is
almost hopeless that she will find something (even though she is
an ECFMG-Certified MD); however, I'm trying my best to help. Thanks
a lot in advance for any constructive suggestions.

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[Winged Scapula]

The purpose of the LOR is to comment on one's suitableness for US residency. Unless she has an unusual relationship with her child's pediatrician, I cannot imagine how this physician could comment honestly and usefully on her suitability.

While programs may prefer LORS from US physicians, there are thousands of IMGs/FMGs in your friend's position. Most of them also do not have US LORs and many still suceed in obtaining a US residency position.

IMHO, a letter from a physician who is not in the position to evaluate your clinical skills and fund of knowledge is no different than a letter from a member of clergy, government official, etc. - all of which are generally deemed unacceptable.