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APDIM-CDIM Guidelines for Department of Medicine Summary Letters

In a 2012 AAMC survey, 72% of internal medicine residency program directors indicated that they used letters of recommendation (LORs) when deciding whether to invite an applicant for an interview.1 Yet, when ranking applicants for the match, these letters were less significant than other factors, such as USMLE Step I scores and interactions during the interview day. Other studies confirm that internal medicine program directors rely heavily on USMLE Step I scores when evaluating applicants.Program directors struggle to interpret other information from medical schools, including LORs. In 2012-2013, CDIM and APDIM collaborated to develop guidelines for the DOM letter, defining it as a “Summary Letter” that features the unique perspective that academic leaders in internal medicine bring when communicating with one another. 

The guidelines allow for consistent information, eliminate superfluous information, and provide guidance on the timing of letters.

Guidelines for Writing Department of Medicine Summary Letters

Timeline
DOM letters should be sent by October 1 to maximize availability for the residency selection process.

Length
Recommended length is no more than 1-2 pages

Structure and Content

1. Statement regarding preparation of letter: who writes it, who approves/signs it, what data it is based on, and acknowledgement that it was written in accordance with these guidelines. Also clarify student request for the letter and whether student has waived right to review letter.

2. Description of key DOM rotations

  • Core medicine clerkship: duration, setting(s) of student participation, relationship to faculty members and residents, student role and responsibilities, grading policies and procedures including use (or not) of shelf exam
  • Grade distribution in medicine clerkship for student’s class
  • Sub-internship: duration, setting(s) of student participation, relationship to faculty members and residents, student role and responsibilities, grading policies and procedures
  • Grade distribution for sub-internship in preceding year(s)

3. Description of student’s performance on medicine clerkship and sub-internship (if completed).

  • Detailed narrative description of student performance; may include representative verbatim comments from faculty members and residents
  • Student grade(s) for the rotation(s)

4. Do not include content unrelated to the DOM that is accessible in other documents:

  • USMLE scores
  • Performance on non-Medicine rotations
  • Summary of curriculum vitae (e.g. prior education, extracurricular activities)

Final Paragraph
1. Overall assessment of applicant as a candidate for residency in internal medicine

2. Numerical statement of where student stands relative to other students in class, based on experiences in DOM. Examples: specific rank (e.g. 46/110), quartiles (1st, 2nd, 3rd, 4th), percentage groupings (e.g. top 10%)

Quick Downloads

Download guidelines as PDF

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Read AAIM Perspective in AJM

"Guidelines for Writing Department of Medicine Summary Letters " (AJM. 2013;126(5):458-463)

CDIM-APDIM Work Group

Valerie J. Lang, MD
University of Rochester School of Medicine & Dentistry

Brian M. Aboff, MD
Christiana Care Health System

Donald R. Bordley, MD
University of Rochester School of Medicine & Dentistry

Stephanie Call, MD
Virginia Commonwealth University

Kent J. DeZee, MD
Uniformed Services University of the Health Sciences

Sara B. Fazio, MD
Harvard Medical School

Matthew Fitz, MD
Loyola University Stritch School of Medicine

Paul A. Hemmer, MD
Uniformed Services University of the Health Sciences

Lia S. Logio, MD
Weill Cornell Medical College

Diane B. Wayne, MD
Northwestern University Feinberg School of Medicine