question: deciding whether or not to use a rec letter

[ukfan323]

Question about rec letters..Does anyone have advice on whether or not it can make a big difference to have multiple PM&R letters as opposed to just one really good one? Reason I'm asking, I have one really good PM&R letter for sure, and a second that I'm not sure how strong it will be. Reason being, I asked for it before I realized the importance of specifying "strong, positive, etc" for the letter. I got a good evaluation from the attending and some of the residents at the program thought it would end up being a good letter, but I'm not sure about using it since I didn't add a qualifier when I asked.

I have 2 non-pmr letters that I'm confident will be strong and helpful (one in psych and one in surgery), so the question is the risk/reward of having a second PM&R letter that might end up being more generic. The two PM&R letters are from different programs, if this might make a difference. Any advice/opinions are appreciated! Thanks

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[RangerBob]

I would only use letters that you know are going to be strong letters. When I asked for letters of recommendation I specifically asked my attendings/mentors if they could write me a "strong letter of recommendation." They all said yes. Ones was a physiatrist, one a surgeon, and the other in FM. I don't see much value in more than one PM&R letter if you already know you have a really good one from a physiatrist and two good ones from psych and surgery.

I did have one additional LOR written by a physiatrist from an away rotation I did, but I only used that letter for that particular program (I just didn't think a letter from an attending I worked two weeks worth could compare to my PM&R mentor I worked with for two years, my medical school mentor I worked with all four years, and a surgeon I worked two weeks with but clicked really, really well with (he was a really patient-centered guy and also wanted me to apply to his specialty). In all honesty though, asking for that letter was more about trying to gauge if that attending thought I'd be a good fit for their program since I knew it wouldn't matter if I had a LOR from him or not as if they like you they'll tell the PD during or after your rotation.

I'm sure a lot of people will tell you that a LOR from a surgeon isn't that important for applying to PM&R, but I can't tell you how many interviewers/chairs brought up the LOR that the surgeon wrote for me (they also joked it was probably the longest letter from a surgeon they'd ever seen--it was more than one paragraph, ha!).

If you already have the strongest letters you can get and one of them is from a physiatrist, I think you're in very good shoes. You want LORs from people who know you well.