Residency Letter of Intent Example: 3 Letters

Residency Letter of Intent Examples: Three Letters, Annotated Line by Line

Below are three residency letter of intent examples for three different situations:

• a first-choice letter to the one program you will rank first
• an honest letter of interest with no ranking claim
• an update letter with genuinely new information

Each is followed by notes on why its sentences are there.

Read this first: these are illustrative letters we wrote for teaching. They are not real applicants' letters. The programs, people, dates and details are invented, and program names are left as placeholders. Don't copy a sentence from them. What makes a letter work is detail only you have, from your own interview day.

Before you use any of these patterns, check two things:

1. Your specialty's and program's current instructions on post-interview communication. Dermatology and plastic surgery ask applicants not to send post-interview letters, and several other specialties discourage them.
2. The 2027 Match dates.

Both are covered in the residency letter of intent guide for the 2027 Match. NRMP's rule sets the boundary for every example below. Under the 2027 Match Participation Agreement, applicants "may voluntarily communicate their interest to a program(s); however, applicants may not solicit verbal or written statements from a program(s) implying a commitment to rank the applicant" (NRMP MPA §6.4, checked 2026-09-28).

Example 1: the first-choice letter (internal medicine)

Context (invented): a fourth-year student has interviewed at eight categorical internal medicine programs and has decided on her first choice. Internal medicine takes part in NRMP's voluntary rank order list lock pilot. Before sending, she checks R3 to see whether this program has locked its list. Participating programs lock by a target date of February 8, 2027, and a letter sent after that can't change a locked list.

Subject: [Your name], Internal Medicine interview on January 14

Dear Dr. [Program director's surname],

I interviewed with [Program name] Internal Medicine on January 14, and I am writing to tell you that I will rank your program first.

Two parts of the interview day decided it for me. When Dr. [Faculty surname] described how residents keep the same clinic panel for all three years, including the patients who move from the diabetes transition clinic into general medicine, I realized that continuity is the part of outpatient medicine I have been missing on block rotations. I would want to build my panel around that clinic. The second was the resident-run morning report I sat in on. A PGY-2 presented her own admission, and the attending asked far more questions than she answered. That is how I learn, and I did not see it done as well anywhere else.

Thank you to you, Dr. [Associate program director's surname], and the residents for a thoughtful day.

Sincerely, [Your name] [Medical school] · [Email] · [Phone] cc: [Coordinator's name], Program Coordinator

Why each line is there

• The subject line carries your name, the specialty and your interview date. A coordinator filing a hundred of these can match it to your file without opening it. The University of Maryland School of Medicine's residency manual says the letter "should be addressed to the Program Director and cc'd to the Program Administrator," so the cc line isn't decoration.
• "I will rank your program first." This is the commitment sentence. It appears once, in the first paragraph, with no hedge and no condition. Send it only if it is true and your list is decided. Maryland's manual: "You should only send a letter of intent if you are certain of your rank list." Send it to one program. Pediatrics' 2026–27 statement says letters of intent, "if sent, should only be sent to one program." EMRA's guide says: "don't tell every program they're your No. 1 program."
• "When Dr. [Faculty surname] described..." is the reason, and it comes from the interview, not the website. It names a person, a program feature (the continuous clinic panel) and what the applicant would do with it (build her panel around the transition clinic). Try the swap test: put another program's name at the top. The sentence stops being true, which is exactly what you want.
• "A PGY-2 presented her own admission..." gives a second reason drawn from something she watched, then ties it to how she learns. "I did not see it done as well anywhere else" is a comparison. It works only because she really did interview elsewhere and means it. If you can't say it honestly, cut it.
• The closing thanks people by name and asks for nothing. There is no "please let me know where I stand" and no "I hope you'll rank me highly too." NRMP's Code of Conduct says applicants "must not request a program director or any member of the recruitment team to disclose program ranking preferences or intentions."

Sentences we cut from an earlier draft of Example 1, and why

Example 2: the honest letter with no ranking claim (general surgery)

Context (invented): a student applying in general surgery is deciding between two programs and hasn't settled the order. The 2026–27 general surgery guidance says "Thank you letters or post-interview communication is acceptable but not required." He wants this program to know his interest is real without making a claim he can't stand behind.

Subject: [Your name], General Surgery interview on December 9

Dear Dr. [Program director's surname],

Thank you for the interview on December 9. I have thought about [Program name] often since then, and I wanted you to know why.

The first reason is the Tuesday morning handoff on your acute care surgery service. Your chief resident presented every overnight consult, and the attending pressed on each plan without taking it over. That was the clearest picture I saw this season of a service that residents actually run. The second came from my conversation with Dr. [Faculty surname]. When I asked about operative autonomy, she described PGY-3s leading their own lists at the community site, with attendings scrubbed in but not driving. It was the most specific answer to that question I heard from any program, and it is the kind of graduated responsibility I am looking for.

I am very interested in training at [Program name], and I would be glad to answer any questions.

Sincerely, [Your name] [Medical school] · [Email] · [Phone] cc: [Coordinator's name], Program Coordinator

Why each line is there

• No ranking sentence at all. This is a complete letter, not a weaker one. The MPA gives applicants the right to "Keep confidential all information pertaining to ranking preferences and SOAP preferences." An EM associate program director, interviewed by the AMA, pointed out that "you're number one on my list" is "probably the exact same thing that a whole bunch of other applicants are also going to tell that program." He recommended saying why you're interested instead.
• "I have thought about [Program name] often since then" is true, and it doesn't imply a ranking. Don't substitute "you are at the top of my list" unless it is true. Don't write "you are one of my top choices" to two programs so it can be read either way.
• The handoff paragraph does what Example 1's reason paragraph does, with different material. He saw a specific practice and read it as evidence of resident ownership. The autonomy sentence records a specific question, the answer he got and why that answer matters to him. These details are what make a letter of interest worth sending.
• "I am very interested in training at [Program name]" is the interest sentence, at its honest strength. Say it once. Stacking three versions ("thrilled," "honored," "would be a dream") adds length and reduces credibility.
• "I would be glad to answer any questions" offers information. It doesn't request any.

Example 3: the update letter (family medicine)

Context (invented): a family medicine applicant has two concrete developments since her application was submitted. The 2026–27 family medicine guidance says post-interview communication "is discouraged unless it is a specific follow-up question from the interview or an update to an application," and "Applicants are discouraged from sending letters of interest or intent to rank." So her letter carries the update and nothing else. It makes no ranking claim.

Subject: [Your name], application update (Family Medicine interview on November 18)

Dear Dr. [Program director's surname],

I interviewed with [Program name] Family Medicine on November 18. I am writing with two updates to my application.

My COMLEX Level 2-CE score was released on January 6, and it is now available through my application. In addition, on January 20 I completed my four-week sub-internship at [Health center name], a federally qualified health center, where I managed my own panel of adult patients under supervision, including the prenatal patients I followed through two clinic visits each. Dr. [Preceptor's surname], my preceptor there, has agreed to answer any questions you have about my work on the rotation.

Thank you again for the time your faculty and residents spent with me in November.

Sincerely, [Your name] [Medical school] · [Email] · [Phone] cc: [Coordinator's name], Program Coordinator

Why each line is there

• "two updates to my application" tells the reader in the first paragraph why this email exists. Maryland's manual allows exactly this: "If allowed, you may follow up with programs to provide updates after your interview – e.g., a new publication or award."
• Each update is concrete and dated after the application. The first is a released score, with the date and where to find it. The second is a completed rotation, with what she actually did. Compare the updates that fail: "I have continued to grow as a clinician," or "my interest in your program has only increased." Neither is new information.
• The preceptor sentence points to someone who can confirm her work. It doesn't attach a new letter she wasn't asked for. Check whether your program accepts additional materials before you send anything beyond the email.
• No ranking claim, and no "letter of intent" framing. Her specialty discourages letters of intent and interest, so the update stands alone. This follows the specialty's guidance, which itself names updates as an exception.
• The close is thanks, nothing more. No questions about her standing, and no request for a reply. The family medicine guidance warns that programs "may not respond" even to thank-you notes. Don't read silence as a signal.

What all three examples leave out

• A second personal statement. Programs already have your ERAS or ResidencyCAS application. None of the letters retells the applicant's path to the specialty.
• Anything about the program's ranking. None asks where the applicant stands, whether she is "ranked to match," or what the program thinks of her.
• Anything conditional. No "if you rank me, I'll rank you." If your commitment really does depend on something, such as a couples match or a partner's placement, say so in the commitment sentence itself.
• Length. Each letter fits on one screen. No official word limit exists; Maryland's manual says "brief and direct."
• A promise of effect. None of the letters, and nothing on this page, claims a letter will move a rank list. What the evidence does and doesn't show is on does a letter of intent change your rank list?

Turning an example into your letter

Start with your notes from the interview day, not with a template. For each program you might write to, try to finish this sentence: "When [person] told me about [specific thing], I realized [what it means for how I would train]." If you can't finish it for a program, you probably don't have a letter for that program yet.

Then choose your commitment sentence before you write anything else: first, among your top choices, highly, or none. Choose the strongest one that is true today, and write it once.

When you have a draft, you can check it against the residency letter of intent rubric. You'll get qualitative feedback on whether your program reasons are specific and come from your interview, whether your interest is stated clearly and consistently, whether an update is actually new, and whether any sentence reads as asking about ranking. If your program or specialty has published a communication instruction, paste it above the draft. The review gives feedback on your letter. It doesn't write the letter for you, choose your commitment, or predict how a program will rank you.

For the thank-you note you might send right after the interview, a shorter and different message, see residency interview thank-you emails. If you are a pharmacy applicant, your letter of intent is a different, pre-application document. See the pharmacy residency letter of intent guide.

Sources quoted, all checked 2026-09-28: NRMP 2027 MPA; NRMP Code of Conduct for Applicants; University of Maryland SOM residency manual; EMRA, Making the Most of Interview Day; AMA, Meet Your Match; APPD pediatrics recommendations; OPDA guides for general surgery and family medicine; NRMP ROL lock pilot.