If you've completed your residency interviews, it's a good idea to send a letter of intent for residency to help improve your standing with your preferred residency program. In this blog, you'll learn everything you need to know about the residency letter of intent including what to include, how to format the letter and common mistakes to avoid. Lastly, you'll have the chance to review a sample residency letter of intent.

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What is a letter of intent for residency and how can it help me match?

A residency letter of intent is a short, concise letter that is designed to tell your number-one program choice for residency that they are your top choice, as well as the reasons behind your decision. As with entry into medical school, admission into residency programs is highly competitive. Let's go back a few steps in the process to understand where the residency letter of intent comes into play.

Many of you will be familiar with The Match. It's the method by which the National Resident Matching Program (NRMP) facilitates and organizes the application process in the US. Thousands of residency applicants will use the ERAS or CaRMS to apply and compete for residency spots offered throughout the United States and Canada. Programs will then respond to applicants by inviting them for interviews during the fall and winter of their final year of medical school. Once interview season has come to an end, applicants will create and submit a Rank Order List (ROL), which is a list of programs, in order, that applicants would accept a contract with. Programs will also submit a ROL of applicants that they would like to accept as residents.

The Main Match algorithm plays “matchmaker” in setting up applicants and programs. Essentially, it pairs medical students and residents to postgraduate training programs based on these three factors:

The first factor is out of your control, but you have the power to influence the second and of course, you have full control over the third factor. On the Monday of Match Week in March, residency hopefuls are notified whether or not they have matched, but the specific program that they have matched to remains unknown. For applicants that are not successful in matching, residency positions that remain unfilled are made available for applicants to attempt to secure before the official Match Day results are released. Students are informed of which program they have matched to on Friday of Match Week.

If you've been lucky enough to sit down for a handful of residency interviews and know which program is your number-one choice, it's time to maximize your chances of getting ranked and matched to that program by sending a residency letter of intent. While sending this letter isn't required, it may increase your chances of appearing high in the program's Rank Order List, in turn, facilitating a match. Ultimately, this letter can help you match because programs want to rank and match with students that also want to rank and match with them, so letting a program know you're a guaranteed match can give you a competitive edge.

What to include in a letter of intent for residency

First and foremost, your residency letter of intent should be a maximum of one page in length. This is designed to be a short, sweet, concise, easy to read document, not a recitation of your residency CV. Keep in mind that this is a formal letter so using bullet points or casual language isn't appropriate. In terms of timing, the letter should be sent after your interviews, in late January to early February, but well before the final ranking deadline. This allows your letter to be genuine because you'll have had a chance to learn more about the program at your interview, and will also potentially have had other interviews at other programs. Essentially, you're showing, not just telling, your preferred program that you’ve really taken the time to consider all program options available to you, and they are still your number 1 choice. The letter can be handwritten or typed and should be sent either by mail or by email.

Just like with your residency personal statement, you need to start by brainstorming before you begin to craft your letter. You need to know what you like about the program, how the program aligns with your short and long-term goals, what about this branch of medicine interests you, and why you want to attend a particular program, as opposed to other programs in the same specialty. Hopefully, while you were at your interviews, you had a chance to learn more about each program, school, and residents by asking your interviewers questions. Be sure you review any notes you made during these interviews or while you were on campus to jog your memory regarding what you loved about a particular program. Obviously, you have the intention of ranking one program as your first choice, so really take the time to think about why they are your first choice, and be sure to include this in your letter. In general, your residency letter of intent should have an opening paragraph, body paragraphs, and a conclusion.

Check out our video for a quick recap:

Common mistakes to avoid

1. Sending the letter to space.

So, you've taken all this time to write a great letter of intent and then you email it to [email protected] This is a big mistake and can result in your letter getting lost in the email world. It's therefore essential that you address and send your letter to the residency program director, the actual person responsible for making applicant decisions. You'll have to do your research - check the school's website or make a few phone calls, just to ensure your letter makes it to the right person.

2. Listing unrelated items.

Listing anything in your residency letter of intent is not appropriate. Don't forget, this is a formal letter. Don't use bullet points and don't list your hobbies or random items off your CV. If it doesn't relate to your interests and suitability for the program, don't mention it.

3. Beating around the bush.

In your opening sentence, don't simply state that you like the program and will be ranking it highly. Tell the program director that they are your number 1 choice.

4. Sending multiple letters.

Sending residency letters of intent to more than one residency program is a massive no-no. The letter of intent is designed to genuinely inform your program of choice that you will be ranking them number 1. It's misleading and unethical to send this letter to more than one program. The point of the letter is to make an exclusive commitment to one program only.

5. Sending a letter of intent inappropriately.

Do not send a letter of intent for the sake of it; if you don't have a preferred program that you're in love with, it's best not to send anything, to any programs. Remember, if you send a letter of intent to a program and end up matching, you're ethically bound to that program.

Sample Letter of Intent for Residency

Dear Dr. Eric Johnson, Program Director, X University,

My name is Jonas Jones and it was an honor to share my goals and learn more about X University's Anesthesia Residency Program during my interview with Dr. Adam Cole and Dr. Melanie Smith on January 29, 2019. I am writing you this letter to express my strong interest in Anesthesia and to let you know that I am ranking your program as my number-one choice for residency and, should I be matched with your program, I will accept your offer. In addition, I'd like to provide a brief update to my application materials.

There are many great anesthesia programs, but the X University's program remains my top choice for three main reasons. First, my professional interests and research skills will be further promoted and supported by this program, as I will have the chance to work on the ongoing studies on sleep medicine at the X Hospital. Second, the program offers a great variety of training that will allow me to rotate through different areas of anesthesiology and related specialties, such as pain medicine, dental anesthesia, and intensive care rotations. Additionally, I will have the opportunity to learn from an array of preceptors with different expertise. Third, during my elective at X University, I found my colleagues and responsibilities to be educational and enjoyable. My peers and superiors were eager to share their knowledge and help me in any way. I felt a strong sense of community when I attended the Book Club, seminars, and resident meet-ups. Finally, I have great attachment to the West Coast and would love to remain in X state. After attending undergraduate college outside of [state], I came back to [state] to complete my medical school education and hope to remain here for residency.

During my residency, I look forward to challenges and professional growth that are inevitable in such an innovative and cutting-edge program. The University of X's commitment to community care, pedagogy, and the principles of our profession leave me certain that I will be the right fit for this program and that I can help your goals and mission. My research experience in sleep medicine can further develop your programs’ reputation in this field. I would be honored to become a an involved member of your medical community and complete the final stages of my training in your institution. For these reasons, I am ranking The X University’s Anesthesia Residency Program as my first choice.

Lastly, I would like to provide a brief update to my application materials. I was recently invited to present my latest publication and research to an audience of approximately five hundred people at the annual X Conference. Also, my research supervisor has recently promoted me to Research Assistant in his lab, where I am now managing workflow of 5 undergraduate research assistants.

I want to thank you for your consideration. If there is any other information I can provide, please don't hesitate to get in touch.


Jonas Jones

To your success,

Your friends at BeMo

BeMo Academic Consulting 

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DeeAnne Reynolds

what if you signed a letter of intent (due to an imposed deadline) and later had other interviews and after serious analysis want to back out of the letter of intent before the match deadline?


BeMo Academic Consulting

Hello DeeAnne! Thanks so much for your question. If you have already sent a letter of intent to a program, but changed your mind and want to attend a different program, consider being honest with the program director.