Letters of Recommendation for MFM fellowship: A gap in best practices
Objective: Letters of
recommendation(LOR) for Maternal-Fetal Medicine(MFM) fellowship are a critical
part of applicant selection. Data regarding best practices for how to write MFM
LOR is absent in the literature. This pilot study aims to understand if
individuals who write MFM LOR routinely use ‘best practices’ described by other
specialties.
Methods: Subject matter experts developed e-survey to ascertain if ‘best
practices in LOR’ writing from other specialties were employed by MFMs writing
MFM LOR. Content and face validation performed. Survey sent to 8 MFM
divisions(Duke, Indiana,New Mexico,Dartmouth,ECU,Charlotte,OHSU&Vanderbilt)
in 3/2022. Respondents included if they reported writing MFM LOR annually.
Primary outcome was proportion of respondents routinely using each LOR-writing
best practice.
Results: Response rate was 78%(72/92). Thirty-eight(53% of respondents) wrote
MFM LOR annually. Letter writers were more likely to hold fellowship leadership
positions, read LOR annually, and have formal training in how to write LOR(all
p<0.01).
In letters, writers routinely describe their role with residents(92%); 79%
include highlights from applicants’ CV. Forty-five percent routinely use
bold/italics;only 11% use bias-checking
software.
Regarding preferences for the concluding sentence: 42% use percentage rank, 74%
use superlatives, and 68% describe desire to keep the applicant. Over half of
respondents use two of these. Many(42%) stated one page was sufficient; though
55% thought an LOR>1page was acceptable. None of these practices differed by
gender, time in practice, or LOR-writing training.
Conclusions: Routine LOR-writing practices among MFMs LOR-writers are varied.
Best practices in how to write LOR for MFM fellowship must be developed and
disseminated.
