When the time comes for the Rank Order List to roll around for medical residency, an additional step can help you improve your standing with residency programs when you are interviewed. This extra step is sending a Letter of Intent to the programs they interviewed with. This step will inform them that they will appear on the applicant's respective Rank Order List.
In the residency matching process, Letters of Intent are considered a grey area. These letters aren't mandatory, and there is still a debate regarding whether these make any difference in programs' rankings at all. However, for candidates, the Letter represents another step to ensure they have done every possible thing to amplify their chances of Matching.
The Letter of intent isn't a legally binding document. The term intent indicates that the candidate plans to attend that particular school if your name could be taken off the waitlist. In case you don't 'intend' to join that school, you should then opt for a letter of interest. A candidate should send a letter of intent only if they are absolutely sure that they want to attend that school if they get accepted.
You need to write a letter of intent as you would write a Thank You or Follow Up Letter. You must strongly demonstrate your enthusiasm for the program. The Letter could be a handwritten or typed and hand-signed one and sent via mail or email. If there isn't much time left, we suggest that you send it via email. However, keep in mind that emails may get lost in the pile or land in the Spam folder.
There's no specific rule or timeline for sending out a letter of intent to your desired school. Ideally, your Letter should reach the program between 15 January and 21 February, as that's when the Rank Order List deadline ends. Given the wide range of programs nowadays, there is no way to know precisely when a particular program will finalize its Rank Order List. Still, we suggest that you neither send your Letter of intent too early as there will be the risk of being forgotten nor too late to avoid missing out on the program's final decision.
You can only send a letter of intent to the programs you have interviewed with. Prefer those programs that you feel a connection and passion for.
The Letter is almost always addressed to the Program Director. Here's is what your letter must include:
There are many sample letters of intent available online to give you a fair idea about the Letter's right length. One tip we would like to offer you is not to write a very length letter. The content should be divided into small paragraphs. However, since Program Directors have a busy schedule and have to read many letters in a day, you shouldn't write more than 2 or 3 paragraphs. Keep the Letter short and to-the-point.
The most confusing part of the entire Letter is how to inform the program you intend to join them. Usually, candidates use the phrase 'You are my first choice," which is a wrong approach. Of course, you want to join that program, and it is your first choice, but you don't need to inform them about it in such an informal manner. Since you can have one program only in the top spot, what will you tell the other programs? Would you tell them all that they are your first choice?
So, avoid using the term First or #1 choice. It sounds informal and impractical. You should use phrases that offer a similar meaning but more indirectly and formally. Such as you can write, "I will rank you highly," or "your program is my top choice," etc. The language you choose plays a fundamental part in relaying your dedication to the program to the director. Therefore, make informed choices.
It will help if you remember a policy rule of NRMP that residency programs cannot ask a candidate about their Rank Order List. Hence, it would be inappropriate to write anything that may make a program uncomfortable or break its policy rule. The only thing you should try to achieve through your Letter of intent is expressing your interest in joining a program and not asking for or expecting any further communication in exchange.
A letter of intent is although tricky to write, but with the right intentions and careful language, it can significantly improve your chances to Match.