Evaluating the Impact of the Standardized Letter of Recommendation on a Successful Match in Urology Residency

Abstract

Objective: To evaluate the contribution of the standardized letter of recommendation (SLOR) to the likelihood of matching in urology residency by applying a novel scoring system and characterize utilization in the 2022 application cycle.

Methods: We conducted an investigation of all applicants to our urology residency program during the 2022 cycle. We developed a scoring system to assess SLOR strength across all templates. Match outcomes were verified with the Society of Academic Urologists listing. Statistical analysis was performed to assess for factors predictive of a successful match.

Results: Out of 386 total applicants, 239 (61.9%) had at least 1 SLOR in their application. SLOR utilization was more prevalent in MD applicants, in those with higher Step 2 scores, and in those who matched (P <.01). The majority of SLOR scores (66.5%) were above a 3.5/5 in our cohort. Step 1 score, number of research entries, and presence of an SLOR were predictive of successful match. However, a SLOR score of <3 was strongly associated with not matching (OR 0.021, P <.01).

Conclusion: The presence of a SLOR in our cohort overall was associated with a successful match. A poor SLOR score was highly deleterious to an applicant's chance of matching in urology. Our SLOR scoring system can be used across all letter templates and demonstrates that strength of SLOR can significantly impact an applicant's chance of matching.