Pediatrics Residency Letter of Intent: APPD Rules

Pediatrics Residency Letter of Intent: APPD Rules

Pediatrics has its own rule. The 2026–27 APPD recommendations say: "Letters of intent are not expected and, if sent, should only be sent to one program. Programs are not expected to reply to such communications." And in the 2026 Match, 153 of 281 pediatrics program tracks (54%) locked their rank lists by March 4, 2026 (our arithmetic from NRMP's pilot report).

Our view: in pediatrics the letter of intent is a narrow tool. It isn't expected, it can go to only one program, the program needn't answer, and that program may have locked its list before you write. If you send one, send it once, to your true first choice, after checking R3 for a lock. Otherwise send an update or a question, which APPD names as acceptable.

Every APPD, OPDA and NRMP document quoted below was checked on November 7, 2026. These are the 2026–27 recommendations for the 2027 Match. NRMP's rules for all specialties are in the residency letter of intent rules for 2027. This page covers APPD's one-program rule and the pediatrics rank list lock.

What APPD says about post-interview communication

The APPD, COMSEP, AMSPDC, FuturePedsRes and NextGenPediatricians letter (June 2026) has two lists, one for each side. For applicants:

"We discourage post-interview communication unless it is:

1. A thank you note (and this is considered optional).
2. Specific follow-up questions from the interview day.
3. Updates to provide to an application (e.g., new publication, award).

Letters of intent are not expected and, if sent, should only be sent to one program. Programs are not expected to reply to such communications."

For programs:

"We discourage post-interview communication unless it is:

1. A maximum of one follow-up with contact information of leadership/interviewers that states a response back is not expected.
2. A maximum of one program update at the end of recruitment that goes to all applicants together that states a response back is not expected.
3. Only individual communication if applicants/programs have questions for each other."

The OPDA pediatrics guide repeats the applicant list word for word. Its pre-interview line adds: "Applicants should indicate interest in a program using ERAS preference signals."

Read the two lists together. A pediatrics program following APPD sends you at most one follow-up and one end-of-recruitment update, and both say no reply is expected. A friendly follow-up that says no reply is expected is the message APPD describes. It doesn't call for a letter back. How to read program emails is covered in what a "ranked to match" email means.

Locked lists: check the program before you write

Pediatrics is one of three specialties in NRMP's voluntary rank order list lock pilot, with internal medicine and vascular surgery. Under the 2027 process and timeline, participating programs "must certify and lock their ROLs at least 24 hours before the first post-interview visit and by 11:59 pm EST on Monday, February 8" (2027). After that, NRMP says, a locked list can't be uncertified or edited.

APPD adds a pediatrics-only rule for visits: "No in-person visits should be held prior to February 2, 2027 and not before the program rank order list is locked."

Pediatrics used the pilot more than the other two specialties in its first year, the 2026 Match. NRMP's year-one report shows 159 of 281 pediatrics program tracks opted in (56.58%, against 21.66% in internal medicine and 36.14% in vascular surgery), and 135 pediatrics tracks locked by February 9, 2026, which is 48.0% of all pediatrics tracks (our arithmetic).

February 9, 2026 was that cycle's recommended lock date. Counting every lock through March 4, 2026, 153 pediatrics tracks locked, 54.4% of all 281 (our arithmetic). The 2027 numbers aren't published yet. Program sign-up closed October 16, 2026, per the lock timeline.

How to check: NRMP's pilot FAQ says locked tracks show a lock symbol in the R3 Program Directory, in ranking search and on your own rank order list. If the program you want to write to shows the lock, a letter can't change its list. How the lock interacts with visits is on the residency second look guide.

Other 2026–27 pediatrics rules that touch letters

How a signal relates to a later letter is covered in program signals and letters of intent.

Signal rules for home and away programs are on letters of intent to your home or away program.

Should you send a pediatrics letter of intent? A four-step check

1. Is this program truly your first choice after every interview? If not, no letter of intent. One program only, per APPD.
2. Is its list still unlocked? Check R3 for the lock symbol. Locked lists can't change, and APPD says visits come after the lock.
3. Is it before 9 p.m. ET on Wednesday, March 3, 2027? That is the 2027 Match calendar deadline for unlocked programs.
4. Do you have a reason from the program itself? It should be a session, a conversation or a feature you learned about. If not, send an update or a question instead (below).

Pass all four, and send one short letter. Expect no reply. APPD says programs "are not expected to reply."

Constructed pediatrics letter of intent

Two constructed examples, written by us, not real applicant letters. Context (invented): Hannah Mwangi interviewed virtually at a categorical pediatrics program in November. In February she has decided it is her first choice. R3 shows no lock for that program.

Weak version (68 words):

Dear Dr. Zhou,

I am writing to let you know that your program is my number one choice and I will rank you first. I also want to say I would be thrilled to hear back about whether I am ranked to match. I loved everything about my interview, the residents were so kind, and I know I would fit in perfectly. Thank you so much!

Hannah Mwangi

Revised version (63 words):

Dear Dr. Zhou,

Thank you for my virtual interview on November 18. I will rank your program first. In the resident panel, a PGY-2 described the continuity clinic paired with a school-based health center, and I want to train where I follow the same children through school and clinic. Since my interview, I have finished my sub-internship in pediatric hospital medicine.

Hannah Mwangi

What changed:

• No request for a reply or a ranking. "I would be thrilled to hear back about whether I am ranked to match" asks the program to disclose its ranking intentions. The NRMP Code of Conduct for Applicants says applicants "must not request a program director or any member of the recruitment team to disclose program ranking preferences or intentions." APPD also says programs aren't expected to reply.
• A reason from the virtual day. "Loved everything" becomes one feature (a continuity clinic paired with a school-based health center), where she heard it (the resident panel), and what she wants from it.
• An update APPD's list allows. A finished sub-internship is new since November.
• Sent once. Hannah sends no letter of intent to any other program.

What to send instead: a question or an update

APPD's applicant list allows three kinds of message besides a letter of intent:

• A thank-you note, which APPD calls optional. Templates are in the residency interview thank-you email guide.
• A specific question from the interview day. For example, how call works on a rotation, or whether a track you heard about is open to categorical residents. Ask one question per email.
• An update. A publication, award, finished rotation or released score. How to write one is in the residency update letter guide.

If you have one, the update is the better email. APPD names it, programs can use it, and it carries no ranking claim.

Questions about pediatrics letters of intent

Do pediatrics programs reply to letters of intent?

APPD says "Programs are not expected to reply to such communications." Silence is the expected response.

Can I send a letter of intent to two pediatrics programs?

No. APPD says letters of intent, "if sent, should only be sent to one program." If you changed your first choice after sending one, see changed your mind after a residency letter of intent.

Does a letter of intent help after a program locks its list?

No. A locked list is final, so the letter arrives after the ranking is done.

Should I go to a pediatrics second look to show interest?

APPD says "Applicants should NOT feel obligated to attend," and visits come only after the program locks its list. Go only if the visit would change your own list. The residency second look guide covers how to decide. Applying in diagnostic radiology instead? The radiology residency letter of intent guide covers that specialty's signal-first rule and the prelim-year letter.

Get a free review of your residency letter

Get a free Quick Review of your residency letter against GradPilot's residency letter of intent rubric. It reads whether your reason comes from the virtual day, whether your first-choice line appears once, and whether anything asks about ranking. Paste APPD's one-program rule above your draft, and the review checks the letter against it. It also checks that any update is a dated fact the program doesn't already hold.

For the statement you submitted with your application, see pediatrics residency personal statement examples.

Sources

Retrieved November 7, 2026, except where noted.

• APPD, COMSEP, AMSPDC, FuturePedsRes and NextGenPediatricians, Letter to Our Pediatrics Community About the Residency Recruitment Process (June 2026, 2026–27 season): post-interview lists, signals, virtual interviews, cancellation notice, December 1 status, visit rules, match probability.
• OPDA, Program Director Associations Guide for Residency Applicants: Pediatrics (2026–27): signals, applicant communications.
• NRMP, 2027 Voluntary ROL Lock process and timeline (posted April 2026): lock timing, October 16, 2026 sign-up.
• NRMP, Voluntary ROL Lock Pilot FAQs, 2027: lock symbol in R3.
• NRMP, Voluntary ROL Lock Pilot Report: Year One (July 2026; 2026 Match): pediatrics participation and lock timing; opt-in shares for internal medicine and vascular surgery.
• NRMP, 2027 Main Residency Match Calendar: March 3, 2027, 9 p.m. ET deadline.
• NRMP, Match Code of Conduct for Applicants: no requests about ranking intentions.