It’s a good idea to send a letter of intent for residency to help improve your standing with your preferred residency program, once you’ve completed the residency interview questions. 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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Residency Letter of Intent Sample What is a Residency Letter of Intent and How Does it Help Match? How to Write a Letter of Intent for Residency Mistakes To Avoid in Your Residency Letter of Intent Sample Residency Letters of Intent FAQs

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

Preparing for residency interviews? Check out some residency interview questions and answers:

What is a Residency Letter of Intent and How Does it Help 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. It is written to residency program directors to communicate your intent to join their program should you match. It’s another way to answer the “why should we choose you” residency interview question and affirm your desire to match with a specific program.

As with medical school acceptance rates, admission into residency programs is highly competitive. Sending a residency letter of intent can help you match to your top choice program. If you’re an international medical graduate (IMG), it can be the key to how to get into a residency program as an IMG. 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, for Canadian residency applicants, 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:

  1. Number of available positions for each program
  2. List of preferred applicants from each program
  3. List of preferred programs from each applicant

The first factor is out of your control, but you have the power to influence the second by knowing what do residency program directors look for, 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 programs 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 through the Supplemental Offer and Acceptance Program (SOAP). This means another round of SOAP residency interview questions, but you can still improve your application if you go unmatched and land a residency position.

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 a letter of intent isn't required, it may increase your chances of appearing high in your chosen 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.

Next, we’ll look at how to format your residency letter of intent, what to include in your letter and what mistakes to avoid.

How to Write a Letter of Intent for Residency

First and foremost, your residency letter of intent should be a maximum of one page in length, or around 200-300 words. 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 your letter of intent, you want to state clearly and explicitly that a residency program is your top choice. Similar to the “what do you hope to gain from our residency program” interview question and “what are you looking for most in a residency program” interview question answers, you’ll outline in your letter why you want to match, what you will contribute to the program and what you will gain in return. You will send a residency letter of intent to only ONE program for this reason. Your goal is to convince a program to choose you as their top choice, too.

What’s included in a residency letter of intent?

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 the 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.

Need help with your residency app? Here's what our students say about our services:

When should I send a residency letter of intent?

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 and Match Day. 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.

Your residency letter of intent should be addressed to the residency program director or primary interviewer. The letter should be emailed to your interviewer or program director by mid-January, ideally.

When should I NOT send a residency letter of intent? Do I need to send one?

You shouldn’t send a residency letter of intent to a program you’re not 100% committed to attending, or if you don’t have a strong preference for any program. Remember that whichever program you end up matching with, you are contractually and ethically bound to. You won’t be able to change your mind. So don’t send a residency letter of intent unless you are fully bound to a particular program.

A residency letter of intent is NOT a requirement to get matched, but it can give you an advantage when trying to match to the most competitive residencies or secure a spot in a coveted program. So while you don’t need to send one, it’s a great idea to write one to your top choice program to increase your chances of matching. Be aware, though, that not all programs allow applicants to send a letter of intent. Check the preferences of your residency program before sending a letter of intent!

Mistakes To Avoid in Your Residency Letter of Intent

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.

6. Forgetting to proofread

Your residency letter of intent is a formal letter, and it will reflect on your candidacy. Avoid a common mistake by proofreading your letter before you send it or ask someone to proofread it for you, like a trusted friend or residency application consultant. Just like residency CV editing, this is a critical last step which demonstrates your professionalism and attention to detail!

Need to improve your residency application after going unmatched? Here’s some more ways to boost your chances:

Residency Letter of Intent Samples

Sample Residency Letter of Intent #2

Dear Dr. Tania Smith,

My name is Rick Sampson, and I’m writing you this letter to tell you of my interest in your neurological surgical residency program at Z University. I was impressed with your program when I interviewed on [date] and even before my interview, I knew I would be ranking your program first.

In my first year of medical school, I planned to pursue a residency in neurological surgery. My rotations during my third year further solidified my decision to become a surgeon, and I began researching potential residency programs to apply to. Your program at [university] made it to the top of my list for the unique learning opportunities offered, as well as the world class surgeons teaching your residents.

In particular, I was intrigued by the simulation training and state-of-the-art facility you have at [university]. So much so that I decided to visit your facility in person last year to see it for myself. I was privileged to watch your residents working within the simulation under the instruction of [Dr. X] and [Dr. Y]. After, I attended a lecture from [Dr. Y] on the latest surgical techniques and how the surgical simulation was developed and idealized by herself and her peers. The observation visit was a great learning moment for me and [Dr. Y]’s lecture further instilled in me an appreciation for how much progress has been made in this specialty, and how much we have yet to learn. Were I to match to your program, I would be eager to work alongside your staff and benefit from their tutelage.

After visiting your program, I was struck by the diversity of cases presented and the adaptability of your team to take any illness, common or alien, and work together to find the right approach. Your team is truly dynamic, collaborative and forward-thinking, and they made a significant impact on me.

For these reasons, the surgical residency program at Z University is my top choice for residency training, and I would be honored to join your program.


Rick Sampson

Sample Residency Letter of Intent #3

Dear Dr. Melvin Black,

I am writing this letter to express my strong interest in joining your pediatrics residency program at [City Hospital]. After my interview on [date], I was convinced that the program was my number one choice.

[Dr. A]’s presentation on interview day highlighted the many benefits of your program, which matched perfectly with my desires in a residency program. I was especially enthusiastic about the dedicated time for independent research and encouragement for the residents to continue gaining research credits. With [university]’s dedication to emerging research in pediatric medicine, I am excited at the prospect of contributing to ground-breaking research projects and furthering my own knowledge.

I also had the opportunity to speak with some of the residents at [Hospital] during a visiting tour, and I was pleased by the camaraderie and the close-knit team you have. I enjoy working and collaborating with others, and it is great to see a program at such a large and busy hospital still has a strong team culture. A positive culture was one of my biggest asks in a residency program, and I have not seen another program with a team that rivals yours.

During my visit to your program, I also took some time to explore [City] and what it has to offer. I found it to be a vibrant and diverse place, with a special connection to art and music, which has long been a passion of mine. I even took the time to take in a show at [theatre], and hope to take in many more during my residency years here if I match to your program.

For these reasons, I will be ranking your program as my #1 choice for residency, and I sincerely hope to match with your program as well.

Please don’t hesitate to contact me for further information.

Kind regards,

Felicity Carmichael


1. What is a letter of intent for residency?

A letter of intent for residency is a short, formal letter candidates send to their top choice program, to state their intentions towards the program. It can be a useful tool to increase your chances of matching to your #1 program.

2. When should I send a residency letter of intent?

Send a letter of intent to your top choice residency program ONLY. You should send a residency letter of intent if you have a program you feel very strongly about matching with and it is your #1 choice.

3. How do I write a residency letter of intent?

Use your letter to explicitly state that a program is your top choice, why you’ve chosen this program, what you can contribute and what you will gain from the program’s training. Include a formal introduction, body paragraphs, and a conclusion to wrap up your letter.

4. What is the difference between a letter of intent and letter of interest for residency?

A letter of interest expresses your interest in matching to a particular residency program and may be sent to several different programs. A residency letter of intent is sent to only ONE residency program: your #1 choice.

5. What should you avoid in a residency letter of intent?

Avoid informal language, vague explanations of why a program is your top choice, and lengthy personal anecdotes. Keep your letter concise and to the point. Also avoid common mistakes like not proofreading your letter, sending more than one letter of intent and addressing it to the wrong person.

6. Does a letter of intent matter for residency?

While a letter of intent is not required, it can give you a competitive edge when applying to your top choice program. It’s a way of showing a residency program director that you are as committed to them as they are to you and convincing them to choose you over other applicants.

7. Who do you send a residency letter of intent to?

You should send your residency letter of intent to the program director or the primary interviewer. If you’re not sure who the director is or how to contact them, call the residency program for the right information.

8. How serious is a letter of intent for residency?

A residency letter of intent is a serious, formal letter. It should only be written to your top choice program if you are 100% committed to that program. Once you match with a program, you are bound to that residency program, so you won’t be able to change your mind.

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.