Strong letters of recommendation require both timing and intentional relationship-building.  Most students should plan to formally request letters toward the end of a rotation—after they have had sufficient time to demonstrate their clinical skills, work ethic, and professionalism. It is the student's responsibility to discuss this and approach faculty. Sometimes faculty will initiate this conversation or offer on their own. 

Your most important clinical letters will typically come from Sub-Internships (Sub-Is) and key specialty-specific rotations. These experiences allow faculty to observe you at a higher level of responsibility and often result in more detailed, personalized letters. For these rotations, it is appropriate to ask near the end of the experience or shortly after completion, while your performance is still fresh. 

If you identify a strong faculty connection earlier in the MS3 year or from a clerkship, you may “plant the seed” by expressing interest in a future letter at the end of the rotation. Then you may circle back later (e.g. early in the senior year) with a formal request. 

Whenever possible, ask in person (or via a thoughtful email if needed), and provide ample time—ideally at least 4–6 weeks—for letter writers to complete and submit their recommendation before a deadline. Provide your CV, any presentations you completed, and a brief reminder of specific patients or cases you worked on together to help anchor a detailed, personalized letter. Offer to reconnect with a brief meeting if some time has passed since you last worked together.

Being proactive, organized, and thoughtful in your timing will help ensure that your letters are both strong and submitted on time.

Do I need a letter of reference for a preliminary or transitional program?

• Under most circumstances, the answer is yes.
• We generally recommend at least 1 LOR from a medical or surgical faculty member, respectively, if applying for a preliminary position.

ERAS Letters of Recommendation

Beginning with the 2027 ERAS application season, all Letters of Recommendation (LoRs) will be submitted through the new AAMC Letter Writer Portal. The previous Letter of Recommendation Portal (LoRP) is no longer being used.

Applicants will continue to request letters through the MyERAS application. However, letter writers will now upload letters through the AAMC Letter Writer Portal using a secure email link or their existing AAMC account.

An unlimited number of LoR authors may be requested and finalized; however no more than four (4) letters may be assigned to any individual program.

Requesting Letters

1. Create a separate LoR entry in MyERAS for each letter writer.
2. Enter the following information:
• Letter writer name and email
• Specialty associated with the letter
• Whether the letter is a “Standardized” letter (e.g. SLOE) or “Narrative Letter”
• Whether the letter is fulfilling a Department Chair letter requirement
• Whether you waive your right to view the letter
3. Confirm the LoR entry in MyERAS to generate a Letter Request Form (LRF).
4. Send the Letter Request Form to your letter writer through MyERAS or by email. Letter writers will have the option of creating a AAMC account or upload letters using a secure guest link. 

• Applicants may continue assigning up to four letters to each residency program.

Specialty-Specific Standardized Letters

Some specialties, including Dermatology, Urology, and Integrated Plastic Surgery, may use specialty-specific standardized letters or evaluation forms. Applicants requesting these letters must select the correct specialty when creating the LoR request in MyERAS so the appropriate format is sent to the letter writer.

Assigning Letters

Once an LoR has been uploaded by the letter writer, it can be assigned to saved and applied to programs through MyERAS by selecting “assign” under the Actions column of the LoR. LoR assignments to programs that have already been applied to cannot be changed. Once the maximum number of 4 LoRs have been assigned to any given program, additional LoR assignments cannot be made.

 

 

	ResidencyCAS
Creating and Confirming LOR Entries	see below
To Finalize LoR Author(s)	ResidencyCAR refers to LoRs as “Evaluations.” Students can submit a request for an Evaluations in the Program Materials section of ResidencyCAS.  To submit a request students should Select the “plus” icon in the Evaluations section Enter the evaluators full name and email address as well as the date by which the request should be completed Enter a brief message or note to the evaluator Select whether you want to waive your right of access – OSA suggests that you do waive the right of access Submit the request The Check Status tab can be used to monitor the status of evaluations – which will be listed as “Completed” when the request is complete, or “Requested” or “Accepted” prior to completion.
Requesting LoRs	see above
Assigning LoRs	Students have the option to select which evaluations should be sent to specific programs. This can be done in the Evaluations sections under “Assign Evaluations.”

SF Match does not let applicants upload the letters themselves — instead, you request them and your writers upload directly. The typical steps are:

1. Log in to your SF Match account and go to the “Documents” (or “LOR”) section.

2. Select the option to request a letter of recommendation.

3. Enter each letter writer’s contact details — usually name, email, institution, and any other requested fields.

4. Once you submit the request, SF Match will automatically send your writer an email that includes a secure link they use to upload the letter in PDF format directly to the system.

 You don’t upload the letter files yourself — the author must do so.

The AUA uses the ERAS Application System.