Question about appropriate LORs for application

[Kalyx]

Hello everyone,

I would greatly appreciate your opinion on the current scenario I'm in. I'm deciding between ENT, Gen Surg, and Emergency Medicine (aack! I know!) and am a bit stuck with regard to LORs should I decide to go for GS. I have one very strong LOR lined up from my third-year rotation, which I did at a community site. I was hoping to schedule a GS Sub-I for the summer both for the exposure and to get additional LORs, but I basically had to choose between an ENT rotation or a GS Sub-I and I went for the former feeling that I *had* to get exposure to ENT. My school has an unfortunate policy whereby we must complete Step 2 early on in 4th year, even if we did well on Step 1, so I cannot schedule any Sub-Is during that time.

If I were to choose Gen Surg, I would primarily be interested in community-based programs. Would it be acceptable to include 1 or 2 LORs from ENT surgeons? Or would that be a big red flag or weakness to my application? An alternative is to try simply "shadowing" a general surgeon for a week in September before I begin studying for Step 2 without signing up for an official rotation and hoping for a letter this way, but that of course is no guarantee. There is also an internal medicine doc who knows me extremely well and would write me a very strong LOR. Although his specialty background may not be not ideal for a surgery applicant, he is very well-known and holds an important leadership position in a national organization.

Otherwise, my application is hopefully strong with a Step 1 of 257, junior AOA, and mostly Honors in core rotations (including in Medicine and General Surgery), and lots of research (though I know I'd have to explain why I'm interested in community programs).

Any input is greatly appreciated!

Thank you,
Kalyx

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[thyroidectomy]

I think your application, regardless of LOR, will do most of the talking. With regards to LOR, the order of important for GS applications is basically: well-known general surgeon, general surgeon, non-GS surgeon (ENT, etc), non-surgery clinician/researcher. Ultimately since you need to rule-out/-in ENT, you made the right call. And as you alluded to, any inconsistencies in your app you'll be able to explain in interviews (have good answers for why a community program, why you have non-GS LOR, etc), but I'm pretty confident you'll get plenty of them.

 

[SouthernSurgeon]

The issue I see you having is that with a prestigious background, through the roof grades and board scores, a lot of research, and an application that smells like ENT, is that these community general surgery programs will assume you are using them as a backup. This may hurt your yield.

I would only include a letter from a non-surgeon (The IM doc) if they were your principal research mentor and/or you have no other choices.

 

[Winged Scapula]

So why *are* you mostly interested in community programs?

Like the others above (who've given excellent advice), I'd be concerned that you'll look like you're slumming it in GS as a back-up. Even one ENT letter and an ENT rotation is going to look "suspicious" to GS; 2 letters from ENT is going to weaken your GS application.

LORs from non-surgeons are only to be used if they are a significant research mentor, GI/MICU and as the "extra" letter.

 

[thedrjojo]

Plus, you don't read your letter, but it was a huge flag last year when I was reviewing apps and the letter talked about how good of an ent candidate they will be. If you decide gs and stick with only gs, you might want to explain to the letter writer the situation. They might even put it in the letter "he did our rotation, and while he excelled, he decided gs was for him. He will make an excellent gsurgeon."

 

[surg]

See what WS said. If I sense you are only considering GS or my program as a backup, I am not taking you. Too high of a chance of you being unhappy and making everyone else miserable or dropping out. Get your letters from GS people. 1 nonGS surgical specialist is fine, nonsurgeons are nearly worthless as letters barring something special about the letter (lab mentor). Can you get more letters from your initial rotation? If not, suck it up, do a surgical rotation during your step 2 studying and crush them both. It can be done, but you are not sleeping for a month.