How to Request a Strong Letter of Recommendation (LOR) During Your U.S. Clinical Experience (USCE)
- Ash Eighaei Sedeh MD
- Mar 1
- 4 min read
Securing a strong LOR during USCE is one of the most important steps for International Medical Graduates (IMGs) applying for residency in the U.S. A well-written, personalized LOR from a U.S. attending physician can boost your residency application and increase your chances of getting interview invitations.
If you're currently doing a USCE, you should plan ahead to ensure you get an LOR that truly highlights your strengths. Here’s how to request an LOR the right way during your USCE placement.
1️⃣ Build a Strong Relationship with the Attending for a Strong LOR During USCE
📌 Why It’s Important:Residency programs want LORs that give detailed insights into your clinical abilities, professionalism, and teamwork. A strong LOR comes from an attending physician who knows you well and has personally observed your work ethic and skills.
✅ How to Stand Out:
Arrive early and stay engaged during rounds or patient discussions.
Ask insightful questions that demonstrate critical thinking.
Show initiative – volunteer to present cases, research conditions, or help with paperwork.
Demonstrate professionalism – be punctual, respectful, and a team player.
Express enthusiasm for learning and working with patients.
2️⃣ Choose the Right Time to Ask
📌 When to Ask for an LOR?The best time to request an LOR is towards the end of your rotation (usually during the final week), after you've built rapport with the attending.
🚀 Pro Tip: If you're working with multiple attendings, identify the one who knows you best and has observed your skills closely.
✅ Ideal Timing:
1–2 weeks before the end of the rotation (so they have time to write it).
If you’ve worked closely with an attending for at least 2-4 weeks, they are more likely to provide a detailed and personalized letter.
3️⃣ Ask in a Professional & Polite Manner
📌 How to Phrase Your Request?When asking for an LOR, be confident but respectful. You can ask in person or via email if needed.
🔹 Example (In-Person Request):"Dr. [Last Name], I’ve really enjoyed working with you during this rotation, and I’ve learned a lot from your teaching. Since I’m applying for residency, I was wondering if you would feel comfortable writing me a strong Letter of Recommendation that highlights my clinical skills and work ethic. I’d be happy to provide my CV and personal statement for reference."
🔹 Example (Email Request):Subject: Request for a Letter of Recommendation
Dear Dr. [Last Name],
I hope you are doing well. I wanted to express my gratitude for the opportunity to rotate under your supervision during my clinical experience at [Hospital/Clinic Name]. I have truly learned a lot from you, and I appreciate your mentorship.
Since I am applying for residency, I wanted to ask if you would feel comfortable writing me a strong Letter of Recommendation. I would be honored to have your support, as I greatly value the skills and knowledge I have gained from this rotation.
To make the process easier, I can provide my CV, personal statement, and any additional details that may help you highlight my strengths. Please let me know if this is something you’d be willing to do. I truly appreciate your time and guidance.
Best regards,[Your Name][Your Contact Information]
🚀 Pro Tip:
Use the word "strong" when requesting the letter. You want a letter that stands out!
Offer to provide CV, personal statement, and residency goals to help them craft a personalized LOR.
4️⃣ Ensure the LOR is Submitted Correctly
📌 Types of LOR Submission:
✅ Waived LOR (Preferred) – Submitted directly by the attending via ERAS Letter of Recommendation Portal (LoRP). More credibility!
✅ Unwaived LOR – You receive the letter and upload it yourself.
💡 Important:
Most residency programs prefer waived LORs (meaning you don’t see the content).
If the attending is unfamiliar with ERAS submission, kindly guide them to the ERAS Letter Writer Portal.
5️⃣ Follow Up & Show Gratitude
📌 How to Follow Up?If your attending agrees to write the letter but hasn’t submitted it after a few weeks, send a gentle reminder.
🔹 Example Follow-Up Email:Subject: Follow-Up: Letter of Recommendation Submission
Dear Dr. [Last Name],
I hope you’re doing well. I wanted to follow up on the Letter of Recommendation for my residency application. I truly appreciate your time and support in helping me with this important step in my career.
If you’ve already submitted it, please disregard this message. However, if you need any additional details or help with the submission process, I would be happy to assist.
Thank you again for your kindness and mentorship!
Best regards,[Your Name]
📌 Show Gratitude!After your LOR is submitted, send a thank-you message or, if possible, a handwritten note to express appreciation.
Key Takeaways for Requesting a Strong LOR
✔ Build strong relationships with your attending before asking.
✔ Ask 1-2 weeks before the end of your rotation for better results.
✔ Phrase your request professionally & politely (use the word "strong").
✔ Provide your CV & personal statement to help the attending.
✔ Follow up if needed and always express gratitude after submission.
Need Help Securing a Strong LOR?
At IMG Rotations, we connect IMGs with U.S. clinical experience (USCE) in IMG-friendly hospitals & clinics, ensuring better access to strong LORs from U.S. attendings!
📩 DM us or visit www.imgrotations.com to secure your USCE today! 🚀