Letter of recommendation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Goal

WikiDoc is dedicated to a transparent and objective process of evaluating your performance as a WikiDoc Scholar. You can use this checklist for self–assessment as well. There is no guarantee that you will match into a program.

## Evaluation Throughout The Year

Throughout the year we will ask that you print out this document and circle those metrics that best characterize your contributions to WikiDoc. You and you alone will determine the trajectory ("D" below average, "C" average, "B" good, or "A" excellent) that you would like to set for yourself.

## Your Trajectory

The quality and quantity of your academic performance will define your career trajectory. In circling the quality metric at the top of each category, you are indicating the career track you would like to pursue (There is no guarantee that you will match into a program):

Quality Poor (Cannot Follow, Far Below Average): You will likely not match into a U.S. residency program.

Quality Needs Improvement (Has A Hard Time Following, Below Average): You will likely not match into a U.S. residency program.

Quality Meets Requirements (Follows, Average, a "C"): Matching in a US community hospital residency program will be a stretch goal. You may match if you are in a very very high percentile on your USMLE tests.

Quality Exceeds Requirements (Independent, Good, a "B")

Quality Outstanding (Leads, Excellent, an "A")

## Requirements to Obtain A Letter of Recommendation

WikiDoc Scholars must meet both of the following criteria:

1\. Actively participate in the WikiDoc Scholars program for a minimum of 3 months

2\. Complete a minimum of 4 microchapters and or a minimum of 6 single pages in 3 months

## Process to Obtain A Letter of Recommendation

1\. Contact Meghan Leitao at mleitao@bidmc.harvard.edu to request a letter of recommendation

2\. Provide an updated CV to mleitao@bidmc.harvard.edu

3\. Preparation of letters of recommendation takes an enormous amount of time. There are literally hundreds of people who request letters of recommendation. It is for this reason that you will need to provide objective metrics of you performance in college, medical school and from WikiDoc and put them into the letter of recommendation. These will be verified based upon your CV that you provide. Depending upon your career path at WikiDoc, the following objective metrics should be included in your letter of recommendation:

* Dr. ________________ participated in the WikiDoc Scholars program for _________ months.
* Dr. ________________ has made _________ edits to WikiDoc.org.
* Dr. ________________ completed _________ questions in the Board Review Project.
* Dr. ________________ completed _________ topics within the Crowdiagnosis project.
* Dr. ________________ completed _________ topics in the Dermatology Atlas Project.
* Dr. ________________ completed _________ topics in the Drug Project.
* Dr. ________________ completed _________ topics in the Genetic Disorder Project.
* Dr. ________________ completed _________ topics in the Guidelines Project.
* Dr. ________________ completed _________ topics in the Incidence and Prevalence Project.
* Dr. ________________ completed _________ topics in the Infectious Disease Project.
* Dr. ________________ completed _________ topics in the Resident Survival Guide Project.
* Provide a list of topics which best represent your work.

4\. Review the following areas of competency that are discussed on this webpage:

* Work Product – The quality and quantity of work produced by you
* Dependability – Being where he / she should be doing what he / she is supposed to do
* Cooperativeness – Working with people
* Adaptability – Adjusting to change
* Communication – Giving and receiving information Daily Decision Making
* Problem Solving – Thinking on the job
* Leadership Skills
* What Summary Statement Would You Like Dr. Gibson to Write About You

5\. Please also draw from the sentences below to prepare proposed sentences to be included in your letter of recommendation. No one is in a better position to advocate for you, than you, however, I will be editing these statements and adding to them. You should then forward the letter with these objective metrics, and I will then add in personalized statements regarding your performance and your suitability for residency slots or employment. I write the critical concluding statements and overall recommendation at the end of the letter. Failure to provide this letter in a timely fashion may in turn jeopardize the submission of your letter. There is no guarantee that you will match into a program.

## Work Product – The quality and quantity of work produced by you

Quality Poor (Cannot Follow, Far Below Average):

* He / she makes numerous typographical and formatting errors.
* He / she does not consistently capitalize words, proper nouns are not capitalized, a space is not present after a comma, and there are not two spaces between sentences.
* Unfortunately, when or he / she writes to me, they act as though they are communicating with one of their “besties” via text message. The first words of sentences are not capitalized and periods are missing.
* I have received numerous complaints about the quality of his / her work.
* The quality of his / her work is unacceptable.
* He / she was unable to follow the template for adding content to WikiDoc necessitating extensive revisions by myself and others within our organization. He / she was more of a liability than an asset.
* He / she and does not complete the required work, and moves on to another project before the first project is completed. He / she is not a “closer”.

Quality Needs Improvement (Has A Hard Time Following, Below Average):

* He / she is not as careful in checking work product for errors as he / she could be.
* He / she tends to miss small errors in work product.
* His / her work is completed late or is only partially completed.

Quality Meets Requirements (Follows, Average, a "C"):

* He / she does not require constant supervision.
* His / her error rate is acceptable, and all work is completed in a timely fashion.
* His / her work is completed on time with minimal errors.

Quality Exceeds Requirements (Independent, Good, a "B"):

* The director and co–workers have commented on the consistently high quality of his / her work product.
* He / she takes pride in work and strives to improve their work performance.
* All his / her changes to WikiDoc, slides, letters, reports, and correspondence are completed on time with few errors.

Quality Outstanding (Leads, Excellent, an "A"):

* He / she has less than a 1% error rate when adding content to WikiDoc or when preparing correspondence.
* The accuracy of his / her work is excellent.

Quantity Poor (Cannot Follow, Far Below Average):

* His / her work ethic is poor.
* He / she was often not present in the workplace.
* When at work, he / she has poor time management skills. This individual will not be able to manage multiple competing priorities as an intern or resident and compromise patient care.
* He / she is often on social media sites when I walk by their workstation.
* He / she is often watching videos when I walk by their workstation.
* He / she is often gaming in the workplace.
* He / she talks excessively to his peers and impedes not only his own progress, but that of others around him.

Quantity Needs Improvement (Has A Hard Time Following, Below Average):

* His / her work ethic needs improvement.
* He / she was sometimes not present in the workplace.
* When he / she does come to work, at least the first one hour is spent drinking coffee and conversing about social issues with co–workers.
* This individual may not be able to manage multiple competing priorities as an intern or resident and this may compromise patient care.

Quantity Meets Requirements (Follows, Average, a "C"):

* His / her work ethic is satisfactory and meets but does not exceed requirements for the job.
* He / she was consistently present in the workplace daily five days a week.
* He / she refrains from participating in social media, watching videos, and gaming in the workplace.
* Conversations with his / her peers are of appropriate nature and duration.
* This individual will be challenged to manage multiple competing priorities as an intern or resident.

Quantity Exceeds Requirements (Independent, Good, a "B"):

* His / her work ethic exceeds requirements, and this individual is an emerging professional who is striving to make a career in medicine. He / she consistently works more than a 40 hour work week by choice.

Quantity Outstanding (Leads, Excellent, an "A"):

* His / her work ethic is outstanding.
* He / she often works 7 days a week and many evenings by choice. When I am editing WikiDoc late at night, I’m always heartened to see him / her editing alongside me. When I am here at 7 PM or on a weekend, he / she is often / always here. I strongly believe that internship and residency is a test of one’s work ethic and character. In selecting a resident, what we all want to know is "would he / she get up at 3:00 AM to see a patient who the nurse thought didn’t look right?” He / she has the commitment, character and work ethic to do just that. I could tell from his / her interactions with patients that he / she will be a warm, caring, conscientious physician. Given his / her commitment and work ethic, I would be happy to have him / her be my physician.

## Dependability – Being where he / she should be doing what he / she is supposed to do

Poor (Cannot Follow, Far Below Average)

* He / she is often absent from work without prior approval, resulting in excessive unscheduled absences. Obviously this will be disastrous as an intern or resident and could result in adverse patient outcomes.
* He / she leaves the work area unattended to run personal errands. Obviously this will be disastrous as an intern or resident and could result in adverse patient outcomes.
* He / she is frequently late to work and often misses our 8:30 AM team meeting. I worry that this individual will not come to morning report as required by your training program.
* He / she frequently leaves work early. I’m concerned that his /her teammates will have to take up the slack in caring for patients and that this individual will engender enormous amounts of resentment from his / her teammates (as he / she has here). Obviously this may lead to adverse patient outcomes.

Needs Improvement: (Has A Hard Time Following, Below Average):

* He / she is occasionally absent from work without prior approval, resulting in unscheduled absences. Obviously this will be disastrous as an intern or resident and could result in adverse patient outcomes.
* He / she occasionally arrives late to work and occasionally misses our 8:30 AM team meeting. I hope this individual will come to morning report as required by your training program.
* He / she sometimes does not make sure all agreed upon work is completed before leaving for the day. Obviously this will be disastrous as an intern or resident and could result in adverse patient outcomes.
* He / she occasionally leaves work early.

Meets Requirements (Follows, Average, a "C"):

* He / she consistently arrives to work on time.
* He / she makes sure his / her responsibilities are covered at all times.
* He / she has had no unscheduled absences, except for documented personal or family emergencies.

Exceeds Requirements (Independent, Good, a "B"):

* He / she has an excellent attendance record.

Outstanding (Leads, Excellent, an "A"):

* He / she is always at work and on time, if not early.
* He / she never misses work without prior approval and appropriate notification.
* He / she has had no unscheduled absences during the rating period.
* He / she can always be counted on to step up to the plate and work hard.
* I would like to say “if you want something done give it to a busy person”. Despite being very busy I know I can always count on him / her to accomplish our mutual goals.

## Cooperativeness – Working with people

Poor (Cannot Follow, Far Below Average)

* He / she projects an attitude of superiority that turns off other employees.
* At the hospital, we have a fairly small workspace, and he / she is nosy and is always looking over others shoulders at their computer screen or is listening in to others’ conversations inappropriately.
* He / she is not cooperative and frequently criticizes others.
* He / she displays excessive negativity when working with others.
* He / she takes credit for others’ ideas.
* He / she lacks empathy and does not have insight into the emotions of their peers.
* He / she is not sensitive to cultural differences and nuances.
* He / she has made statements that demean others based on gender or race.
* He / she is not a team player.
* He / she cleverly unloads their own work on to others.
* He / she will do anything to get ahead: he / she engages in a two–pronged approach of promoting their own work while demeaning the work of others.
* While he / she was here as a visiting scholar, they were repeatedly disrespectful to the full–time staff.
* He / she is divisive.
* He / she never offers to assist others in the office.

Needs Improvement (Has A Hard Time Following, Below Average):

* He / she displays occasional negativity when working with others.
* He / she rarely offers to assist others in the office.
* He / she makes negative comments that affect working relationships with others.

Meets Requirements (Follows, Average, a "C"):

* He / she is friendly and works with peers in a courteous and respectful fashion.

Exceeds Requirements (Independent, Good, a "B"):

* He / she is a “team player” but has become a “team leader” as well.
* He / she is direct, straightforward, honest and polite.

Outstanding (Leads, Excellent, an "A"):

* He / she is the consummate “team player”.
* He / she is well–liked by both those below and above them on the organizational chart.
* He / she is well–liked by clinical sites and sponsors as well as other collaborators.
* He / she is a natural born leader.
* He / she is always cordial and willing to help both those above them and below them on the organizational chart as well as collaborators.
* His / her enthusiasm is contagious and lifts the whole group up.

## Adaptability – Adjusting to change

Poor (Cannot Follow, Far Below Average):

* He / she requires repetitive direct supervision, even for mundane and everyday tasks.
* He / she is not able to think independently or able to deal with unexpected occurrences.
* Unfortunately the lack of this person’s adaptability will be an impediment to their residency training and may adversely affect patient outcomes.

Needs Improvement (Has A Hard Time Following, Below Average):

* He / she gets flustered in unusual situations.
* He / she does not always make the best decisions to fit the situation.
* Unfortunately the lack of this person’s adaptability will be an impediment to their residency training and may adversely affect patient outcomes.

Meets Requirements (Follows, Average, a "C"):

* He / she usually adjusts as expected to changes in the work place.
* Even during stressful situations, he / she maintains his / her composure.

Exceeds Requirements (Independent, Good, a "B"):

* He / she independently proposes solutions to current problems and develops ways to improve processes to improve our odds of success in the future.
* He / she independently adjusts priorities as needed when unexpected situations arise.

Outstanding (Leads, Excellent, an "A"):

* He / she adapts to new systems and processes well and seeks out training to enhance knowledge, skills and abilities.
* He / she knows when they are in over their head and when to get help. This will be critical to their success as a resident.
* I can tell that they will know when to appropriately contact the supervising resident fellow or attending.
* He / she is proactive rather than reactive.

## Communication – Giving and receiving information

Poor (Cannot Follow, Far Below Average)

* Reports, forms, memos and correspondence are often completed late or not at all by him / her.
* He / she uses a condescending or disdainful tone when talking to others in the office.
* He / she does not take phone messages.
* He / she does not answer the phone.
* He / she does not answer the door.
* He / she does not deliver phone messages to the recipient in a timely fashion.
* His / her phone etiquette is poor.
* He / she does not record the call back number for phone messages.
* He / she does not record the date of phone messages.

Needs Improvement (Has A Hard Time Following, Below Average):

* His / her phone messages are often unclear or incomplete.

Meets Requirements (Follows, Average, a "C"):

* He / she takes messages, writes correspondence, deals with those outside the organization as well as peers in a polite and courteous fashion.
* His / her content are accurate, clear and well written using proper grammar and punctuation.

Exceeds Requirements (Independent, Good, a "B"):

* He / she has read and adopted the suggested writing style of the organization.
* The documents he / she prepares are excellent and require little if any editing by me.
* He / she is able to independently respond to the questions in a mature and intelligent fashion.

Outstanding (Leads, Excellent, an "A"):

* He / she exhibits an emotionally intelligent, non–confrontational, empathic way of communicating with both those above and below him / her on the organizational chart.
* He / she demonstrates excellent oral and written communication skills.
* He / she is at ease speaking in front of large groups of people.
* He / she is a natural orator and speaks in a way that is compelling.

## Daily Decision Making / Problem Solving – Thinking on the job

Poor (Cannot Follow, Far Below Average)

* He / she frequently comes to the wrong conclusions based on faulty information gathering and poor processing of that information.
* As a supervisor, he / she did not assure that all his / her subordinates were productive at all times, which is a daily requirement of this job.
* I found him / her always in a reactive mode: he / she is always putting out fires, and never planning ahead.
* He / she has poor executive functioning / planning skills.
* He / she cannot triage issues.
* He / she has problems with time management.

Needs Improvement (Has A Hard Time Following, Below Average):

* He / she needs to develop acumen necessary to weigh options and choose the best way to deal with situations.
* He / she spends too much time focusing on less important aspects of daily job.

Meets Requirements (Follows, Average, a "C"):

* He / she often offers workable solutions to problems.
* He / she uses good judgment in solving problems and working with others.
* He / she is objective and uses an objective performance review process to make decisions related to new hires, promotions and merit increases.

Exceeds Requirements (Independent, Good, a "B"):

* He / she can zero in on the cause of problems and offer creative solutions.
* He / she displays strong analytical skills.

Outstanding (Leads, Excellent, an "A"):

* He / she always offers creative ideas to solve problems based on unbiased, high quality information and sound judgment.
* He / she gathers good quality data upon which to make good decisions. He / she listens to both sides the story.
* He / she works to proactively prevent problems rather than functioning in a reactive mode.
* He / she has excellent “court sense” and instinctively knows all that is going on around him / her in the workplace.
* As Wayne Gretzky would say “He / she skates to where the puck is going to be”. He / she anticipates and prevents problems in the workplace before they occur.

## Use of Equipment and Materials

Poor (Cannot Follow, Far Below Average):

* He / she has damaged equipment through misuse.
* He / she wastes toner, paper and other valuable supplies.
* He / she has deleted software and/or data in error.
* He / she does not provide appropriate care for the equipment at their workstation.
* He / she has unfortunately lost equipment or data.
* He / she has opened others emails during off hours.
* He / she has left the door ajar to the entire office which posed an enormous security risk.
* He / she does not install antivirus software.
* He / she shares their password with others.

Needs Improvement (Has A Hard Time Following, Below Average):

* He / she sometimes forgets to turn equipment off at the end of the day.
* He / she does not always get equipment serviced as recommended by the manufacturer.
* He / she does not renew antivirus software and data has been lost as a result.
* He / she does not retain the warranties of equipment that is purchased.

Meets Requirements (Follows, Average, a "C"):

* He / she takes good care of equipment and uses supplies efficiently.
* He / she turns off and secures all equipment at the end of their shift.

Exceeds Requirements (Independent, Good, a "B"):

* He / she makes recommendations as to new hardware / software that should be acquired to improve our organization.
* He / she quickly masters new software programs.
* He / she can independently troubleshoot IT and equipment problems.

Outstanding (Leads, Excellent, an "A"):

* He / she independently develops code, software or databases to solve problems for our organization.
* He / she is able to independently troubleshoot and solve all work related hardware / software problems quickly and efficiently.

## Leadership Skills

Poor (Cannot Follow, Far Below Average):

* He / she dictates to others rather than involving them in the decision making process.
* He / she has reduced subordinates to tears.
* He / she yells and screams at subordinates.
* He / she does not have the capacity to lead a residency team.

Needs Improvement (Has A Hard Time Following, Below Average):

* He / she assumes others should know what to do and how to do it with little or no training.
* He / she frequently becomes impatient when things aren’t going their way.
* He / she may not have the capacity to lead a residency team.

Meets Requirements (Follows, Average, a "C"):

* He / she draws upon the knowledge and skills of others.
* He / she is available when needed to lead the team and has an open door policy for subordinates.
* He / she assigns work fairly and resolves disputes and grievances of subordinates fairly.
* He / she can lead a residency team.

Exceeds Requirements (Independent, Good, a "B"):

* He / she has the confidence and skills to independently lead a team of individuals to complete a simple projects with minimal oversight.

Outstanding (Leads, Excellent, an "A"):

* He / she leads by example.
* He / she seeks consensus, but takes final responsibility for decisions and failures.
* He / she does not ask others to engage in a task that they have not / would not undertake themselves.
* He / she has performed many of the tasks of the organization in the past and has insight into the struggles of employees.
* He / she has exceptional emotional intelligence and is empathic.
* He / she inspires others to improve their performance.
* He / she is charismatic.
* He / she is a visionary.
* He / she sets goals and drives a team to attain those goals.
* He / she is courageous and leads from the “front lines”.
* He / she is self–actualized.
* He / she is “in it to win it”. He / she plays to win and not to avoid losing.
* He / she offers appropriate rewards and praises in recognition of others accomplishments.
* He / she is motivated by the success of the team rather than their individual success.

## What Summary Statement Would You Like Dr. Gibson to Write About You:

A good recommendation letter is helpful but is not sufficient to assure that you will get into a residency program as many factors such as board scores come into play. There is no guarantee that you will match into a program.

* Dr. ________________ attended our WikiDoc scholars program. His / her performance was typical for his peer group. He / she is a nice person.
* Dr. ________________ has successfully met all of the requirements of the Wiki Doc scholars program, and I think he / she will do the same at your residency program.
* On a daily basis, Dr. ________________ has exceeded all of the requirements of the Wiki Doc scholars program, and I am confident that he / she will be an amazing addition to your residency program. In fact I’m so confident of his / her future record of achievement, I hope that he / she will return and undertake cardiovascular training or further research training here in our Harvard program.
* I would like to recruit him / her back to our Harvard program in the future.
* Dr. ________________ will be an excellent addition to any of the most competitive Residency Programs.
* Dr. ________________ has all of the qualities necessary to achieve great success in his / her career.
* Of the hundreds of people that I have supervised in my research laboratory (many of whom have been physicians) over the past 25 years, I would say that Dr. ________________ is at the top 60th 50th 40th 30th 25th 20th 10th 5th 1st _________ percentile.
* Of the hundreds of people that I have mentored over the past 25 years, I would say that Dr. ________________ is among the top 5.
* Of the hundreds of people that I have mentored over the past 25 years, I would say that Dr. ________________ is the top person.
* Dr. ________________ is more likely than any other Brigham resident in the past 10 years to become a Chief of Cardiology.