Is a chair letter an absolute requirement?
thanks.
Maybe not your chairman, but I would say that a letter from a chairman is pretty much a must-do. There are plenty of applicants who do not have a department of otolaryngology at their school. Creighton is an example.
As a prior member of admissions committees, I'd say an average chairman's letter raises less questions than no chairman's letter at all. The reason: just about every chair knows every other chair. They know them by reputation, by previous letters, by department quality, by personality, and often as friends or former colleagues in residency or in the same department.
For example, purely hypothetically, if you interview at my program and you're from UTSW and you don't have a letter from Dr. Roland, I'm going to wonder why. Because, as a chairman, I know him. I know what he likes and doesn't like in residents. I talk to him at meetings. I know his department is very respectable. I know he usually supports his med students and why he's not supporting you would raise questions.
The question to really ask is which chairman will write you the best letter. Is it from the biggest name? The one who knows you best? The one that you know writes awesome letters? That really unfortunately boils down to a crap shoot. Personally, I'd take one from the chair who I think will write the best letter about me beyond just the cookie-cutter stuff whether that was from a home department or an outside one.
Chairman letters can really set you apart if written well. They are rarely negative and harmful, but if they are cookie-cutter, they are usually see-through and don't help much more than your current CV does.