About Sending a Letter Of Intent

When the time for Rank Order List rolls around, there is one additional step residency candidates may take to further increase their standing with residency programs where they interviewed. Candidates can consider sending a Letter of Intent to programs they interviewed with to let them know they will be appearing on the candidate’s respective Rank Order List.

Letters of Intent are a somewhat grey area in the residency process. They are not mandatory, and there are differing opinions about whether or not they make a difference when it comes to programs’ ranking choices. The letter represents another action residency candidates can take to ensure they have done everything possible to improve their chances of Matching.

Below are some potential questions you may have about Letters of Intent with answers:

How should I send the Letter of Intent? Like with the Follow Up Letter or Thank You Letter, the strongest way to demonstrate your enthusiasm for any program is to send a handwritten or typed and hand signed letter in the mail. If you are running out of time, you may send an email, but you run the risk of getting lost in the pile or going to the spam folder.

When should I send the Letter of Intent? While this is not a perfect science, you should make sure your letter gets to the program between January 15th and February 21nd (the Rank Order List Deadline). Unfortunately, since there is such a wide variety of programs, there is no way of knowing exactly when programs finalize their Rank Order List. But, it is suggested that you don’t send your letter too early and risk being forgotten– but also don’t send your letter too late and risk missing out on a program’s final decision.  

Which programs should I send a Letter of Intent to? Only send a Letter of Intent to programs you interviewed with, preferably programs you felt you really connected with.

To whom should I address the letter? Address your letters to the Program Director.

What should I say in the Letter of Intent? In general, your Letter of Intent should include:

  • A reminder of when you had your interview
  • An announcement of your intention to rank
  • Specific details you like about the program that you have not mentioned in previous correspondence
    • ex. facilities, amenities, faculty, location
    • Draw your details from your actual experience with the program, people you met with, and the things you saw during the interview  
    • Don’t just tell the program you love them, show them why with how knowledgeable you are about them
  • Any other reasons you are interested in the program
  • Any additional strengths you have as an applicant that you feel would benefit the program 
  • Close with a summary of why you like the program and your intention to rank

**A Note about Language: One of the most ambiguous parts of the Letter of Intent is informing programs, “You are my #1 choice.” Of course, you can only have one program in the top spot, so what do you tell the other programs? Can you tell them all they are #1? Instead of directly saying they are #1, consider using different phrases such as “I will be ranking you highly” or “Your program is a top choice.” If you’re worried about communicating your interest in a program without saying #1, you aren’t using enough details to show your dedication to the program.

How long should the letter be? Many of the samples online have lengthy letters with multiple paragraphs and fill a whole page or more. Due to the busy nature of Program Directors and how many letters they receive each day, consider only writing 2 to 3 paragraphs. Keep it short, but sweet.   

Can Match A Resident provide samples or templates? Each Letter of Intent should be unique to your intentions and experiences with a program. Templates and samples are very tempting to follow and could lead to a formulaic or stiff letter. For that reason, Match A Resident does not provide samples or templates.

An important reminder: According to NRMP’s policies, residency programs are not allowed to ask a candidate about their Rank Order List. Do not write anything that could make a program uncomfortable or bait them into breaking the policy. Express your interest, but do not ask for or expect communication in return.

Letters of Intent can be tricky to write, but with careful language and the right intentions, they could be a benefit to your chances to Match.


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