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Letters of Recommendation for OBGYN residency: Are there \'routine\' practices?

Purpose: This study aims to understand whether individuals who write obstetric and gynecologic (OBGYN) letters of recommendation (LOR) use routine practices described by other specialties


Background: LOR for OBGYN residency are a critical part of the application process. However, data regarding routine practices for how to write OBGYN LOR are lacking.


Methods: We used literature about routine practices in LOR writing from other specialties to develop an e-survey. After IRB approval, the survey was sent to 5 OBGYN departments (Duke, New Mexico, Dartmouth, ECU, Charlotte) from 3/22-5/22. Our primary outcome was the proportion of respondents that used each LOR-writing routine practice.


Results: Of 189 faculty sent the survey, 135 (71%) responded. Sixty-seven (50%) wrote OBGYN LOR annually. Letter writers were more likely to identify as subspecialists (61% vs 35%, p=0.003), but did not differ in gender, duration of practice, or formal education role. Most writers describe their role with residents (84%), include highlights from applicants’curricula vitae (67%) and write only one page (67%). Few (21%) use bold/italics and none use bias-checking software. Preferences for the last sentence varied: 73% use superlatives, 46% describe a desire to keep the applicant, and 28% use percentage rank. None of these practices differed by gender or LOR-writing training. Use of percentage rank was used less often by those with < 15 years in practice (69% vs 16%, p< 0.01).


Discussions: Though routine practices exist in other specialties, LOR-writing practices among OBGYNs vary widely. To ensure equity in LORs for OBGYN applicants, routine practices in LOR-writing must be identified and distributed.

Topics: CREOG & APGO Annual Meeting, 2023, Student, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, UME, Assessment, General Ob-Gyn,

General Information

Student,Resident,Faculty,Clerkship Director,Osteopathic Faculty,Residency Director,
Systems-Based Practice & Improvement,Interpersonal & Communication Skills,Practice-Based Learning & Improvement,
Clinical Focus
General Ob-Gyn,

Author Information

Elayna Kirsch, BA; Duke University Medical Center; Lori Avery, n/a; Lisa Hofler, MD, MPH, MBA; Lorene Temming, MD, MSCI; Jill Sutton, MD; Sarah Dotters-Katz, MD MMHPE

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