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Best Time to Ask for a Letter of Recommendation (LoR) During a US Hands-On Clinical Experience for IMGs

Updated: Mar 20


best lor us hands-on rotation
best lor us hands-on rotation

A strong Letter of Recommendation (LoR) from a U.S. physician is one of the most valuable components of an International Medical Graduate (IMG) residency application. However, timing is crucial when requesting an LoR. Asking too soon may seem premature, while waiting too long could lead to a generic letter or a lost opportunity.

So, when is the best time to ask for an LoR during a U.S. hands-on clinical rotation? Let's break it down.

Why a strong LoR would be best for IMGs doing US hands-on clinical experience

A well-written U.S. clinical experience (USCE) LoR provides insight into your:

✔ Clinical skills and medical knowledge

✔ Communication and professionalism

✔ Ability to work in a U.S. healthcare system

✔ Potential fit for residency training

Many IMG-friendly residency programs require at least one U.S. LoR, preferably on hospital letterhead or from an academic-affiliated attending physician.

Best Time to Ask for an LoR During Your Hands-On Rotation

1. Towards the End of the Rotation (Final Week)

🔹 Ideally, you should ask for an LoR during the last few days of your 4-week or 8-week rotation.

🔹 By this time, your attending knows your clinical strengths, work ethic, and contributions to the team.

🔹 It allows the doctor to write a personalized letter rather than a generic one.

2. After a Strong Clinical Performance

🔹 If you have impressed your attending with strong clinical reasoning, enthusiasm, and professionalism, it’s the right time to ask.

🔹 Always ensure your preceptor has enough positive interactions and observations to write a compelling LoR.

3. If the Doctor Offers to Write One

🔹 Sometimes, an attending will proactively mention that they are willing to write an LoR for you.

🔹 If this happens, follow up immediately to ensure they complete it while they remember your performance.

4. Before You Leave the Rotation

🔹 Never assume the doctor will automatically write an LoR for you.

🔹 Set up a meeting or send an email before your rotation ends to formally request it.

How to Ask for an LoR Without Being Pushy

1. Schedule a Short Meeting with Your Attending

Politely request a few minutes at the end of the day to discuss your LoR request.

Example:"Dr. Smith, I’ve really enjoyed learning under your guidance during this rotation. I was wondering if you’d be willing to write me a strong Letter of Recommendation based on my performance?"

2. If Asking by Email, Keep It Professional

If you’re unable to ask in person, send a concise and professional email.

Example Email:

Subject: Request for Letter of Recommendation

Dear Dr. Smith,

I want to express my gratitude for the opportunity to learn from you during my hands-on clinical rotation at [Hospital/Clinic Name]. I greatly appreciate your mentorship and the knowledge I’ve gained.

As I prepare for my residency applications, I was wondering if you would be willing to write me a strong Letter of Recommendation based on my performance during this rotation. I believe your insights into my clinical abilities and teamwork would add significant value to my application.

If you are open to this, I would be happy to provide any necessary details or assist in the process. Please let me know at your convenience.

Best regards,[Your Name][Your Email]

Should You Ask for an LoR from Every Rotation?

🔹 Your goal should be to try and secure the best LoR from your US hands-on clinical experience.

🔹 It’s better to get quality over quantity – 2-3 strong LoRs are better than multiple generic ones.

🔹 Prioritize asking attendings from IMG-friendly hospitals or residency-affiliated clinics.

🔹 If you plan to apply to a specific specialty, get at least one LoR from a doctor in that field (e.g., Internal Medicine for an Internal Medicine residency application).

How IMG Rotations Helps You Get Strong LoRs

At IMG Rotations, we provide:

Hands-on USCE in top hospitals and clinics

Opportunities for strong LoRs from U.S. attending physicians

Rotations with program-affiliated doctors who can write impactful recommendations

🔗 Explore hands-on USCE options at: IMGRotations.com

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