Here we discuss the Letter of Intent (LOI) as it relates to your USMLE residency interviews, when to send it to the residency program(s) you interviewed at, who to address it to and what should be the contents of this letter.
As with most aspects of the USMLE, the letter of intent started off as an AMG phenomenon, and now IMGs use it as well.
Typically, AMG applicants send communication (email or physical email) to the first-choice program of their rank order list showing strong interest in that program. In general, AMGs tend to send the letter of intent to the program that they intend to rank as their first-choice program and no other.

However, AMGs have a match rate greater than 95% whereas IMGs have a match rate of 53% or so. IMGs, therefore tend to send the LOI to multiple programs.
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How should you send this LOI?

You can send a physical letter, typed and without typos. If you are running short on time, you can also email this letter. To give a professional touch, attach it as a pdf and avoid writing the content in the body of the email.

Contents of the letter of intent for residency programs
  1. In most cases the letter of intent should be direct, telling the program why you like the program and that you will rank it highly rank order list. Many IMGs do tell their top ranked program that they are going to rank that program first. Be sure to consider the ethical issues if you intend to say this to multiple residency programs. It is a small world!
  2. The intent letter should describe why you liked the program and what factors made you come up with the decision also included in the letter should be a small anecdotal event that you remembered during your interview.
  3. The letter should be directed to the program director and the program coordinator should be sent a copy.
  4. The letter should be limited in content and should not be too wordy.
  5. Do not expect a reply to your LOI. A residency program will receive hundreds of letters of Intent and they many not have the time to reply to all.
  6. The letter of intent should also be limited in your expression don’t make it sound too excited. It is best to have it reviewed by a faculty or a member of the Sarthi team prior to emailing.

When to send the Letter of Intent?

the letter of intent should be sent in by early February before the final rank order list is completed by the program
The letter of intent is a very powerful way of communication your desire to be part of a program, it should be very well written with no grammatical errors, We  wish you all the best in the upcoming Match. If you have any queries, ofcourse get in touch with us. 

Useful Videos for IMGs

​How will programs rank you? Discussion with a former Program coordinator
Second visit to residency programs
How to prepare your rank order list