One of the main components of the residency application package is the Letter of Recommendation. In orthopedics, programs require at least three, with one being from the Department Chair of your home program. Some require four. Other letters, besides the Chair’s letter, are accrued from other faculty and from the rotations at other programs. But getting a letter of recommendation is much easier said than done. When I did it, I had post-traumatic flashbacks to being an awkward high school (and college) student asking a girl on a date. Let me explain.
The first one is by far the most difficult. First, you have to pick your target. Most likely it will be the person you spend the most time with, or the person who is most valued by other people.
This is something important enough that it should be planned. You find yourself focusing on the little details. “When is the best time? I should wait until she’s in the best mood. Maybe after a good case. What if she says no? Will it be awkward the next morning? Should I save it until the last day I’m going to see her for awhile? But then what if she’s in a bad mood?”
You finally decide the day you’re going to ask, and as the time approaches, you watch for opportunities. You know you should try to catch her alone, preferably in a private place, and with no other potential suitors around (though be careful not to come across as creepy!). This will lighten the pressure to say yes, because it’s important to give her an out.
Aha, the perfect opportunity! A conversation with a coworker has just ended, and she is collecting her things to leave. You approach, forcing a confidence to your step. Just as you are about to open your mouth, another person speaks up from across the room. Thwarted!
Now you have no other reason to be standing there. You grab a nearby chart and act as if you are brushing up on a history. But your heart is pounding so loudly in your ears you can barely hear when she’s done talking. “Are they winding down? Should I interrupt?” you ask yourself.
You’ve planned your words, planned to phrase the request in a way that lets her know you’re serious and interested, but that it’s ok for her to say no. You know what you look like saying it because you’ve practiced it in the bathroom mirror. Don’t put your hands in your pockets. Stand up straight. Stop blinking so much.
Finally, she’s alone. You look both ways and cross the office. Your voice cracks. Should have taken a sip of water right before. But is a crack better than a slurping sound? Will this hurt my chances? Too late now.
You call out her name with an expectant upswing at the end. She turns, and you see the look on her face. She knew it was coming. Expected it even. Is that good or bad?
There’s the falter, the stutter, and finally the request. “Of course” is the answer, as if it was silly of you to even ask. “You’re great” is all you hear, and you stammer out an awkward “so are you.” The details are worked out, and she extends her hand. You pull it out of your pocket, the only place that could hide the nervous shake. You turn and walk quickly away before she changes her mind.
Fortunately, it gets better after the first time. It’s still nerve-wracking, but at least you’ve seen what works (or what doesn’t…).
By the second letter you’ve refined your words, but the setup is still awkward.
By the third, you’ve gotten your timing and your ice-breaker down pat, with a clincher statement and a winning smile. The success of the previous two yes answers has gotten you to the point where your voice no longer cracks.
On the fourth try you change your inflection so it’s not so rehearsed and wooden.
The fifth time is just about tweaking your body posture.
By the sixth, you will have enough confidence to walk up to any attending and say “Can I get your letter?”
The best, though, is when you are offered one.