Do letters of recommendation last forever? Obviously not! But, if someone provided you with a kind word once, shouldn’t it last? It all depends on the type of recommendation and what purpose it serves. So, let me provide you with a basic outline of the staying power of different sorts of recommendations for radiology residents and radiologists (kind of like the shelf life for foods!)
To organize this into something useful that you can use as a resource that you can come back to many times, I will divide the recommendation categories into both timing and purpose. And, I will begin in the order of training and subdivide the recommendations into subtypes. Let’s start at the beginning, medical school, and end with recommendations for attending radiologists.
Medical Students Applying To Radiology Residency
General Recommendations
Of course, before you even start talking about expiration dates, we need to mention the sorts of recommendations that medical students should obtain. It is not fixed (and dilated!). Instead, it can be fluid. From my experience, I like to see one radiology related reference and a couple of non-radiology recommendations for our program. But, I’ve seen some impressive applications with credentials coming from all radiologists and also all non-radiologists. So, in general, it is essential that the referrer knows you, the applicant well.
Unexceptional Recommendations
Now that we got this general caveat out of the way, how old can the average recommendation be before it begins to get stale? For the average, unexceptional reference, I would say no more than two to three years. Usually, it is best to get these recommendations from physicians with whom you work in your medical school. These recommendations are a general evaluation of your work ethics during this time. So, it shouldn’t be much older than that.
Exceptional Recommendations
Instead, let’s talk about extraordinary recommendations. What do I mean by that? Let’s say you are a former olympian, and your coach gave you an incredible reference and testament to your grit and personality. Or, maybe the President of the United States knew you and wanted to put in a word (for some that may not be so great!). But, I think you get the idea. These sorts of residency recommendations can be used as an adjunct and have a longer shelf life, perhaps indefinite. You can probably afford to put one of these in your application to differentiate your application from the others. And, this recommendation has some staying power. More importantly, it can help the program director to remember your credentials at the time of interview selection and ranking.
Known Entities
And, then, finally, what about the recommendation from a known entity/physician within the radiology residency or someone that the program director knows directly? These recommendations also come with a longer shelf life. These sorts of recommendations last until the referrer is no longer known to the program/program director. If you are talking about someone that a resident knows within the program, that shelf life only lasts until the resident leaves and no longer has much influence anymore.
Residents Applying To Fellowship
General/Unexceptional Recommendations
For your “Average Joe” recommendation for fellowship, generally, you should ask an attending from your institution to write you a reference. At the bare minimum, it shows that you can interact with your team and garner the appropriate support to apply for fellowships. These recommendations should be no older than the time you have already been within your residency. I would not request references from your former ERAS application for residency. That would show a bit of laziness as well.
Exceptional Recommendations
For Fellowships, the unique/unusual recommendation now has much less meaning. Most importantly, at this stage in your career, you want to show that you are capable of performing the work. Although it would be interesting to get a recommendation from the President, that will not help your program director to figure out if you can perform liver biopsies. Recommendations at this stage should be much more laser-focused on your future specialty. The role of this sort of reference wears off as you advance in your career.
Known Entities
These recommendations become more important than ever. Why? Well, that would be because the fellowship director wants to feel comfortable that he will be working with someone capable. And, for residency, there is no better way to accomplish that than to receive a recommendation from someone that you know. Therefore, the shelf life of one of these recommendations will last much longer. It may last as long as the person recommending you is actively involved with radiology!
Fellows Applying For Radiology Attending Jobs
General/Unexceptional Recommendations
These recommendations are a bare minimum requirement before beginning to look for your first job. Typically, most of these references are no longer actual letters. Instead, they come through direct phone conversations with the referrer. Practices will often place random phone calls to the referrers that you list on your application. So, these recommendations will only last as long as the person that recommends you is at your current institution. If that person leaves, the reference is no longer “kosher.”
Exceptional Recommendations
These sorts of recommendations no longer should play any role in your application for a job. Your future employer is only interested in two things, mostly. Can you function as an attending in your new job? And, can you get along with others. A recommendation from a President or other interesting source cannot tell you the answer to either of those questions.
Known Entities
At this point, these recommendations are the most critical. If the applicant receives a reference from someone that the practice knows, it is like proverbial “gold.” It is most likely a checkmark for you to get the job. Most partnerships take these recommendations the most seriously. Why? Because most other measures do not provide valuable information about the candidate. These recommendations will last as long as the referrer is in practice.
Bottom Line About Recommendations: Different Strokes For Different Folks
Depending on the stage of your training, recommendations do have different shelf lives and impact. Known entities usually have the most significant influence on chances of admission or getting a job, and they tend to have the most extended shelf life. On the other hand, “exceptional” recommendations play a smaller role as you go further in your career training. Additionally, in general, make sure that an average reference should not be older than your medical school or residency training time. Or, if you are trying to get your next job, these recommendations will last as long as your faculty are present and continue to remember you.
Laziness can prevent you from getting into the residency, fellowship, or faculty position of your choice, especially when it comes to references. Don’t rely on ancient endorsements. Instead, remember these guidelines the next time you ask for your recommendation. Don’t just leave the process on autopilot!
