Residency Letter of Interest: Asking for an Interview

Residency Letter of Interest: Asking a Program for an Interview

A pre-interview letter of interest is an email to a residency program that has not invited you, saying you want to interview there and why. NRMP allows it. Most of the 2026–27 specialty guidance we checked discourages it, some programs say they won't consider it, and at least one requires it. So the answer depends on your specialty and the program, in that order. This page sets out what each says, verbatim, and when a letter is still worth sending.

This is a different document from the post-interview letter of intent. If you have already interviewed, read the residency letter of intent guide for the 2027 Match and the three annotated letter of intent examples instead. If you just want to thank an interviewer, see residency interview thank-you notes.

All sources on this page were retrieved on October 27, 2026. Guidance changes each cycle, so check your specialty's and program's current pages before you send anything.

What NRMP allows

NRMP doesn't use the term "letter of interest." It regulates what you say. In the 2027 Match Participation Agreement, the communication rule sits under the heading "Before the Rank Order List Certification Deadline and/or the start of SOAP Offer Rounds". There is no separate pre-interview rule, so it covers letters sent before an interview as well as after. Its §6.4 says:

"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's Match Code of Conduct for Applicants adds: "Applicants may freely express their interest in a program, but they must not request a program director or any member of the recruitment team to disclose program ranking preferences or intentions."

So a letter that says you're interested, and why, is within NRMP's rules. Whether it is welcome is a separate question, answered by your specialty and your program. (2027 MPA; Code of Conduct.)

What each specialty says about letters before an interview (2026–27)

Most of these come from the Organization of Program Director Associations (OPDA) 2026–2027 specialty guides. Each guide has a field called "Pre-Interview Communication Guidance". The quotes below are that field, word for word, unless marked otherwise.

Two patterns stand out. First, where a specialty uses program signals, its guidance points you to the signal, not a letter. Second, the exceptions that specialties name are narrow and concrete: a couples match, a major life event that changes your preferences, a major update to your application.

Emergency medicine and OB-GYN applicants apply through ResidencyCAS, not ERAS. The ResidencyCAS vs ERAS breakdown covers that platform.

What programs say on their own pages

A program's own instruction overrides general advice for that program. These four pages show the range. All were read on October 27, 2026:

• UTHealth Houston internal medicine (page headed "Welcome to the 2026-2027 Interview Season!"): "Letters/emails of interest will not be considered–all preference signaling should happen through the ERAS supplemental application unless you are a couples match applicant." (program page)
• Northwestern psychiatry: "Our Selection Committee does not consider letters of interest in making interview offers. Due to the volume of letters of interest we receive, our program does not reply to letters of interest." (program page)
• University of Missouri internal medicine: "Due to the high volume of applications we receive, we are unable to extend interview offers to applicants who do not signal our program." And: "Interview requests via phone or email will not be considered." (program page)
• University of New Mexico orthopaedics goes the other way. Its page lists "Letter of Interest (Due: October 10)" and says: "This letter is required and we will only review applications that have submitted one." The page shows no year next to that date. (program page)

The last example is the reason to read every program's page rather than rely on a rule of thumb. At one program a letter of interest is ignored; at another it is a condition of review.

Should you send one? Four checks, in order

This is our procedure, built from the sources above. It is not an NRMP or specialty rule.

1. Does the program say anything? Read its website, its FAQ and any application instructions. If it says it won't consider letters, don't send one. If it requires one, send it by its deadline. Either way, the program has decided for you.
2. Does your specialty say anything? Use the table above. If your specialty asks applicants not to contact programs before interviews, a letter needs a real exception to justify it.
3. Do you have a real exception? The exceptions named in the guidance are a couples match, a major life event that changes your preferences, and a major update to your application. "I really want to go there" isn't an exception. Neither is a reminder that you applied.
4. Is the letter doing a signal's job? This check limits what the letter says; it doesn't decide whether you send it. If your specialty signals, a letter can't stand in for a signal you didn't send (anesthesiology's and radiology's guidance point applicants to the signal instead), and a signal you did send already tells the program you're interested. So write only about the exception from check 3, not about your interest.

If checks 1–3 support a letter and it passes check 4, a letter is reasonable. Keep it short, specific and new. If you don't, the most useful thing you can do is make sure the rest of your file is complete. Also make sure your remaining applications are as strong as they can be.

When not to write at all: after a program has turned you down, and in pediatrics before its earliest interview release date (October 5, 2026), the only specialty above that sets a no-contact date. Anesthesiology's guide says that after a rejection email, "further communication asking for an interview should be avoided". Some specialties also set a universal interview offer day: OB-GYN October 27, 2026; general surgery October 21–23, 2026; orthopaedic surgery November 16, 2026. After that day, invitations may already be out, and a program's silence is not by itself a reason to write.

Is it different for IMGs?

The rules are the same. None of the specialty guidance quoted above sets a separate rule for international medical graduates, and NRMP's agreement and code apply to every applicant.

What differs is what counts as a genuine update. NRMP's Code of Conduct says: "It is the applicant’s responsibility to inform programs at any time there are changes in the applicant’s personal, educational, or professional experiences that could affect their ability to begin training." For an IMG, that can include a change in certification or immigration status that affects when you can start. That is a reason to write. Telling a program you are an IMG who wants to interview there is not, because your application already says so.

Two cautions specific to IMGs:

• Read the program's eligibility rules before you write. If a program publishes a requirement you don't meet, a letter is unlikely to change it. If the requirement is unclear, ask a short, specific question instead.
• A regional tie belongs in the application. If you have family in the city or did clinical work there, that is real information. It belongs in your application, and the IMG residency personal statement guide covers how to place it. In a letter it works only as part of a genuine update.

What a letter of interest should and shouldn't say

If you do send one, make it an email to the program director, copied to the program coordinator. Three or four short paragraphs at most. The structure we suggest:

1. Who you are: your name, school, AAMC ID or application ID if the program uses one, and the specialty.
2. Why you are writing now: the exception or update, stated in the first two sentences.
3. Why this program: one specific reason tied to your own experience. It should stop being true if you swapped in another program's name.
4. A single, modest close: you would welcome the chance to interview, and you thank them.

Leave out:

• Ranking promises. "You are my first choice" before you have interviewed anywhere is hard to believe, and it sets up a promise you may not keep. Save commitment sentences for the post-interview letter of intent.
• Questions about your standing. The Code of Conduct bars asking a program to reveal its ranking intentions. Don't ask where you are in the queue or whether you'll be invited.
• A second personal statement. The program has your application. Retelling it adds length, not information.
• Repeat emails. One letter. If the program doesn't reply, that is not a signal either way. Several programs say they don't reply to these letters at all.

Three constructed examples

Read this first: these are constructed examples, written by us for teaching. They are not real applicants' letters. Every name, program, date and detail is invented, and program names are placeholders. Each one shows a situation that the guidance above treats as a legitimate reason to write. Check your own specialty and program before you use any of them.

Constructed example 1: US MD senior, couples match (psychiatry)

Context (invented): psychiatry's guidance discourages early contact "Unless there are extenuating circumstances (e.g., couples match or related process)". This applicant's partner is applying in internal medicine at the same institution.

Subject: [Your name], psychiatry applicant, couples match with internal medicine

Dear Dr. [Program director's surname],

I am a fourth-year student at [Medical school] applying to [Program name] Psychiatry, and I am couples matching with my partner, [Partner's name], who has applied to [Program name] Internal Medicine (AAMC ID [number]).

I wanted you to have that context while you review applications. Your consultation-liaison service, where residents follow patients across the medical floors, is the training I am looking for, and it is the part of your program my partner and I talked about most.

Thank you for considering my application. I would welcome the chance to interview.

Sincerely, [Your name] · AAMC ID [number] · [Email] cc: [Coordinator's name], Program Coordinator

Why it works: the reason for writing, the couples match, is in the first sentence, and it is the exception the specialty names. The partner's ID helps the program link the two files. The program reason is a single, specific feature. There is no ranking claim and no question about interview status.

Constructed example 2: DO senior, major update (family medicine)

Context (invented): family medicine's guidance says applicants "may wish to notify programs of major updates to their application materials that occur after the initial application is available for review". This applicant has a case report accepted for publication after she applied.

Subject: [Your name], application update (family medicine)

Dear Dr. [Program director's surname],

I applied to [Program name] Family Medicine in September, and I am writing with one update. On October 9, my case report on [topic] was accepted for publication in [Journal name], with [Faculty name] as senior author.

The case came from my rural family medicine rotation at [Clinic name], where I followed the patient over three visits. That rotation is why your rural track is the part of your program I most hope to learn more about.

Thank you for your time.

Sincerely, [Your name] · AAMC ID [number] · [Email] cc: [Coordinator's name], Program Coordinator

Why it works: the update is real, dated and new since the application. It connects to one program feature in one sentence. It doesn't ask for a reply, which fits a specialty that warns programs "may not respond."

Constructed example 3: IMG, change in eligibility (internal medicine)

Context (invented): this applicant applied before her ECFMG certification was complete. It has now been issued, which changes when she can start training. Internal medicine's 2026–27 guide states no position on pre-interview letters, so she checked the program's page first: it doesn't ask applicants to avoid contact.

Subject: [Your name], ECFMG certification issued (internal medicine applicant)

Dear Dr. [Program director's surname],

I applied to [Program name] Internal Medicine through ERAS, and I am writing to let you know that my ECFMG certification was issued on [date]. When I applied, my application showed it as pending.

I completed four months of inpatient medicine in [City] as a [role], and I would welcome the chance to interview with your program.

Thank you for your consideration.

Sincerely, [Your name] · AAMC ID [number] · [Email] cc: [Coordinator's name], Program Coordinator

Why it works: the update changes something a program needs to know, which the Code of Conduct asks applicants to report. It is two short paragraphs. It doesn't repeat her application or ask whether she'll be invited. If the program's page had said it doesn't consider these letters, as UTHealth Houston's internal medicine page does, she would not send it.

After you send it

This guide is for residency applicants. College applicants who were deferred or waitlisted should read the letter of continued interest guide instead; the rules differ.

Don't expect a reply. Northwestern psychiatry says it doesn't reply to these letters, and family medicine's guide warns that programs "may not respond." Silence tells you nothing about your application.

Keep your interview season moving instead. The 2027 ERAS timeline has the dates that matter from here: rank order list entry opens February 1, 2027, and lists must be certified by March 3. If you are invited and interview, the post-interview rules are different again. The residency letter of intent guide covers them, and does a letter of intent change your rank list? sets out what the evidence shows.

Get a free review of your ERAS personal statement

Get a free Quick Review of your ERAS personal statement, the document programs read first, against the public ERAS personal statement rubric. After an interview, use the residency letter of intent rubric for your post-interview letter.

---

Sources, all retrieved October 27, 2026: NRMP 2027 Match Participation Agreement for Applicants (§6.4) and Match Code of Conduct for Applicants; OPDA 2026–2027 specialty guides as linked in the table; APD dermatology statement (May 1, 2026); APPD pediatrics recommendations (June 2026); program pages as linked above. The AAMC's "Letters of Interest" chapter could not be retrieved by our tools on that date, so it isn't quoted here.