Letters of recommendation for anesthesiology residency reddit

Hey team,

My 'little sib' is a 3rd year with interests in anesthesia and is wondering what kinds of things are important for his app and were major cutoff criteria beyond just step scores (I applied rads so I can't help him there)?

Another concern he has atm is that he has the potential to change a Neurology elective rotation to a pain medicine rotation, however, the pain med rotation is exclusively shadowing with zero hands on, where Neuro he would do procedures and talk to patients. So he wouldn't really be able to get a good LOR from the pain med doc anyway. He has an anes SubI scheduled for July which he'll def get a letter from. The pain med doc is not academic at all apparently. He is wondering if he should bother changing from Neuro to pain med?

Also, he is wondering of the 3 LOR needed for Anes applications, how many should be from Anes docs? He didn't know if an IM LOR would be acceptable in there if he performed well due to the first year of anes being a lot of IM.

TIA

Please write in what capacity you know the applicant, your role, concrete/memorable instances of the candidate and for the love of god, do some of you really mean to write is in the “top 90% of medical students”. It either isn’t the compliment you think it is or you shouldn’t have agreed to write the letter! I love a good numerical ranking at the end (top 1, 5, 10, 20%), but if it’s anything worse than what I just listed, please don’t unless you are upfront with what you will write. Thank you for writing the letters. I know they take a lot of personal time, but they are often used to determine if we’re going to interview someone or not. Your efforts are very appreciated. And shout out to the people putting their insta/twitter handles under their signature.

My first anesthesia rotation was in September of 4th year. Got all my letters submitted by 9/15 with two of them being gas letters.

Agree with Ketodex. Reach out to the anesthesia department at your institution. If you don’t know anyone, try the PD. Set up a meeting with them to ask questions about submitting a solid application for anesthesia. Explain your situation with the letters. When I did that, the PD set it up so that we worked together the next day. She watched me intubate some people, asked questions to get to know me better, and had a letter for me within 48 hours.

What types of ICUs have you rotated through? You may have worked with an anesthesia critical care attending and not realized it. That would count as a gas letter too.

You definitely need at least one anesthesia letter.

LOR in anesthesia are hard. You spend 99% of your time with residents, when the attendings come in, it's to give you a break. My strategy was meet with program director a few times to establish a connection, that's 1, then pick someone who you're in a case with that goes south (or really well), they can comment on your stability under pressure, then just wing it on the third, try to find somebody who's young and who gets it. Most attending know letters are hard to come by in anesthesia and are helpful for that reason.

Alternative; get the third letter from a different specialty, no big deal. Or, you can meet with department chair as well, and try that

IMG here interested in Anesthesiology. I have had trouble getting an Anesthesiologist to shadow since most programs are requesting for a letter from an anesthesiologist.

However, I now have opportunity to shadow a pain specialist. He is a DO, did his residency in physical medicine and rehabilitation. He preforms a lot of pain management procedure.

I was wondering if this could be considered as Anesthesiologist recommendation letter? This is the best I can hope for right now as most hospitals have restrictions now due to COVID.

Thanks.

I'm applying rads where they recommend 0-1 specialty-specific letters, but I'm pretty sure for most specialties it's best to only have 1-2 out of your specialty (and have those be more general specialties, like medicine or surgery). So people applying anesthesia can correct me if I'm wrong, but I think your attending gave you sound advice.

Also, yes this is early, but if you already know that you want to do anesthesia, it could be really valuable to establish a relationship with a faculty mentor early on, maybe do some shadowing with them, then they'll be able to write you a super in-depth, personalized letter when you ultimately apply.