Letter of Intent and Update Letters for the Residency Match with Wording Examples

Residency season is a critical time for medical students, with many decisions already made and limited opportunities left to impact your application. One key post-interview communication is the letter of intent (LOI), which can play a pivotal role in securing a spot at your top residency program. In this blog post, we’ll break down the steps and strategies for crafting an effective LOI. Whether you're in the midst of your residency search or preparing for future cycles, this guide will provide valuable insights into maximizing your chances of matching with your number one program. After reading this post, listen to the related episode on this topic for more tips.

Why the Letter of Intent Matters

As you enter the final stages of the residency application season, the letter of intent is one of the few elements you still have control over. Your COMLEX or USMLE scores and ERAS application are already set, and the interviews are behind you. However, post-interview communication, especially the LOI, gives you the chance to solidify your candidacy and communicate your strong interest in your top program.

Having worked as an editor for ERAS applications and personal statements and serving on my own program's admissions committee, I understand how critical it is to present yourself effectively in written form. The letter of intent is a message that can influence where you rank on a program’s list. This letter can show your top program that you are a strong fit for the program and truly committed to matching there.

Timing Your Letter of Intent

Timing is essential when sending your LOI. The ideal window for submitting it is January or very early February, ahead of the rank list submission deadline. Sending it too early can make you appear overly hasty, while waiting too long could miss an opportunity to influence the program’s ranking discussions.

Your LOI should only be sent to your number one program after you’ve completed all your interviews. It’s crucial that your LOI reflects your genuine final decision. Sending a letter of intent to a program and then not ranking them first is a major misstep.

Crafting an Effective Letter of Intent

When writing your LOI, think of it as a continuation of the relationship that started with your ERAS application and continued with your interview. It’s not a time to repeat your personal statement or summarize your application. Instead, your goal is to convey why you and the program are a perfect match, based on your interview experiences and the program’s offerings.

What to Include in Your Letter of Intent with Examples

1. Clear Intent

Start the letter of intent by clearly stating your intention to rank the program as number one. Here is an example:

"Thank you again for interviewing me for the [name of the program]. After careful consideration, I have decided to rank the program number one on my rank list. I would be delighted to match with [name of program] in March and join you in the summer."

2. Specific Examples from Your Interview

Next, demonstrate that you’ve carefully considered what makes this program a great fit for you. Include specific details from the interview that are not readily available on the program’s website. This could include a conversation with a faculty member, a unique aspect of the program that stood out, or a personal connection you made.

"I am especially drawn to [name of program] because… [specific aspect of the program you learned about during the interview]. During the interview, I was particularly impressed by..."

3. Why You’re a Good Fit

Talk about how your personal goals and values align with the program’s strengths. This reinforces your genuine interest and assures the program that you’ll be happy and successful as a resident there.

"I appreciate the program's commitment to [specific aspect like research, patient care, resident education, etc.]. I am confident that my skills and passion for ... will allow me to contribute positively to your team."

4. Final Thoughts on Your Interview

Wrap up your letter of intent by reiterating how your interview confirmed that this program is the best fit for you. Reflect on your interactions with residents and faculty members, and express your enthusiasm for the potential to join their team. Here is an example to use in your letter of intent:

"Now that I’ve completed all my interviews, I can confidently say that my interview with [name of program] was my favorite. The conversations I had with faculty and residents truly reaffirmed my belief that this is the best place for my growth as a [insert medical specialty, e.g., family medicine physician, psychiatrist, surgeon]."

5. Gratitude and Reaffirmation

Conclude by thanking them for their time and reiterating your excitement about the possibility of joining their program.

"Because of these factors, I am ranking your program as my number one on my NRMP rank list. Thank you for your time and consideration."

Formatting and Professionalism

Your LOI should be under one page and formatted professionally. While you can copy and paste the letter into the body of the email, I recommend sending it as a PDF to avoid any formatting issues. This gives you control over the presentation and ensures your letter looks polished when the program director opens it.

Application Update Letter

In addition to the letter of intent, an application update letter can be an effective tool for strengthening your candidacy if you have an additional experience that has occurred after your ERAS submission. This letter is typically sent if you’ve received a new award, publication, or any other significant achievement that strengthens your application.

How to Know if You Should Send an Update Letter

Only send an update letter if you have something substantial to share—like a prestigious award, publication, or major recognition. Avoid sending update letters just to mention minor changes in your activities. For example, I sent an update letter when I was awarded Student DO of the Year at my school. This was an important achievement that occurred after my ERAS submission and could strengthen my candidacy.

How to Structure Your Update Letter

State the Update Clearly

Start by describing the new achievement and why it’s important.

"I’m writing to inform you that I was recently awarded [name of award] for [reason for award]. This honor reflects my dedication to [relevant skills or qualities]."

Explain Why It’s Relevant

Tie the update to your overall application and why it might influence their ranking decision.

"I believe this award demonstrates the values that align with [name of program]."

Include a Mini Letter of Continued Interest:

Without directly stating your ranking intentions, briefly express why the program is a great fit and how much you appreciated the interview experience.

Final Thoughts

Both the letter of intent and application update letter are critical tools in the residency application process. While the LOI directly communicates your intent to rank the program first, the update letter offers a way to re-engage with programs and share new information that could strengthen your candidacy.

Make sure to approach these communications thoughtfully. Programs want residents who are qualified and excited to be a part of their community. By presenting yourself as genuinely interested and a great fit for their program, you’ll increase your chances of matching with your number one choice.

Good luck to everyone in the 2025 Match cycle and beyond!