US Clinical Experience (USCE) Letter of Recommendation

In total, I submitted four letters of recommendation (LoRs) for my Match application. I received one from my research mentor in Boston, one from my clinical attending in Michigan, one from the NIH, and one from the Chair of the Department from my school.

Typically, clinical rotations in the US last for four weeks, with attending physicians changing every seven days (working one week on and one week off). Therefore, it can be quite challenging to make a lasting impression and impress your attending physician within just seven days, let alone for them to know you well enough and agree to write a strong letter on your behalf.

To address this challenge, it is important to communicate your intention early on. Inform your attending physician that you hope to obtain a LoR, so they can pay extra attention to your performance and evaluate you accordingly. If possible, try to work with the same attending physician again after their one-week break. This way, you can receive two weeks of supervision from the same attending physician. On a positive note, this may increase your chances of obtaining two different LoRs from the four weeks you spend in that rotation. You can then assess which letter is likely to be stronger and upload that one to your ERAS application.

The attending physician may ask you the following questions to assist them in writing the letter:

• Tell me about yourself and your future plans.
• Please send me your CV.
• To what extent were you responsible for patient care? (You should have been involved in admissions, writing H&P, progress notes, discharge summaries, and, of course, daily patient care.)
• Can you provide examples of cases that demonstrate your clinical skills?

During your USCEs (United States Clinical Experiences), make sure to keep track of your patient encounters and select notable ones to reference in your LoRs. Additionally, try to participate in as many case presentations as possible, as interpersonal and presentation skills hold great importance.

Lastly, it is recommended to waive your right to read the letter. Although my attending physician shared my LoR with me, even though I had waived this right, as a gesture of support and assistance for potential future use. Here is an example of an LoR:

A letter of recommendation (LoR) from the US is deemed to be very important. This is likely because it gauges how well you can adapt to their healthcare system, which may be completely different from your home country's. Since you do not have control over this rule, might as well just play by the rule. Hope you get to allocate time for United States Clinical Experiences (USCE) during medical school and check this box off. Good luck!!!