1/
Arrrgghhh! A couple of years ago, I wrote a thread on #recommendationletters. Somehow it got all mixed up and out of order.

Booo!

I decided I'd reorganize & retweet it for any who are gearing up to get their letter game going--including me!

Y'all ready? Let's do this!
2/
How do you feel when someone asks you to write them a letter of recommendation for residency or fellowship?

Do you feel:

Honored?
Indifferent?
Conflicted?
Obligated?
Happy?

Now that I have a good approach, I actually love writing letters. Crazy, I know!
3/
Since many are in the throes of letters (or just finished) thought I’d share my approach. I welcome your insights, too!

Cool? Cool.

Let’s 1st assume that the person you’ve agreed to recommend, is 1 you CAN recommend. If you can’t? You owe it to them to be honest.

But how?
4/
Them: “Do you think you can write a strong letter of recommendation for me?”
You: “I’m concerned that our time together didn't afford me the chance to see you at your best. May I support you in a different way?”

Hopefully, you gave tons of feedback so this isn’t a shock.
5/
Pro-tip: Take out the guessing by letting learners know that you’d be willing to write a letter when you give end-of-rotation evaluation. It spares everyone cryptic meeting requests and saves time.

Now for the letter.

I start by sending them some questions to answer.

Yep.
6/
For starters:

* WHAT are my strongest attributes? What am I MOST proud of about myself?
* WHAT have I done that could set me apart from other applicants? What is my unique strength?
* HOW would my peers describe me? What makes me a good teammate?

But wait. There’s more. . .
7/
The next is the pièce de résistance:

* WHAT would I want to MAKE SURE programs knew that I have done?
* WHAT hardships (if you are willing to share) might cause you to be misunderstood? (optional)
* HOW can I best advocate for you in this letter?

Remember: We're advocates.
8/
I also ask to see their CV AND their #personalstatement. Why? Because sometimes the cool things that they couldn’t fit into the PS or that are buried in the CV can get slipped in by me in my letter.

*Completed an Ironman?
*Raised $20K for an urban garden?

Yooo! I got you.👊🏾
9/
I can also be WAY more effusive about you than YOU can in your personal statement. Sure can.

Also:

Who are YOU to be writing this letter? I like to say that in my 1st paragraph. Work with nearly every student in your role? Been at this for 30 years?

Why not share that?
10/
In what capacity do you know the learner? Be specific.

What did you see? Share what will attest to their potential in their next step. What did you see? Be specific and personal.

Does it take longer to do this? Yes.
Does it make a difference? Fo sho.

Yup.
11/
How does this learner compare to who you’ve seen?
Make a clear statement of recommendation.
Bring it home, man.

Read it again. If the letter could not be changed to support a different person? It’s personal enough. If you can change names and pronouns and reuse?

Hmmm.
12/
Here’s my cheat sheet:

P1: Who am I & how I know you
P2: Character traits observed with supporting specific example
P3: Peer descriptions and what you’re proud of
P4: How you compare to others, +/- clarity on speed bumps
P5: Statement of rec, bring it on home

Easy, right?
13/
I think of a letter of recommendation as an opportunity to be a piece of someone’s dream.

Of course, learners vary greatly and it isn’t always easy. But the older I get in #MedEd, the more I want to be a good steward of my influence. And that starts with intention.

Yup.
14/
My caveat is that I’m not a large program PD or a Chair writing 40 letters. But as one who writes about 8 – 10 annually & doesn’t want them to be cookie cutter, this has helped me a ton.

But best of all this happens—and reminds you that it was worth it.

#supportisaverb👊🏾

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More from @gradydoctor

6 Jun
1/
You: “Hello! Will this be your first dose today?”
Me: “No. Second.”

You nodded and then entered something into the tablet in your hands. Suddenly your head flung up as if you’d forgotten something.

You: “I’m sorry. How y’all doing this evening?”

I offered a thumbs up.
2/
Me: “Especially glad to get here before y’all closed.”
Son: “Not me!”

*laughter*

Me: “What about you, friend?”
You: “Ma’am?”
Me: “How're you doing?”
You: “Oh! Me? I’m good!”
Me: "Yeah?"

*laughter*

You: “You’re the first person to ask me that all day!”
Me: “Awww dang.”
3/
You handed me two forms to fill out and gestured for us to roll forward.

Son: “Do you think this one will hurt more?”
Me: “Mine didn’t.”

When I finished filling out the forms, you were back beside my window.

You: “Perfect. Y’all should be next.”
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*laughter*
Read 22 tweets
4 Jun
1/
Y’all! In less than 1 week, the first of hopefully many #HDPHumpDay drops will happen!

OMG!

@ash_mcmullenMD and I are nervous + excited + + grateful + ready (which pretty much sums up how we feel every day as academic physicians. 😂)

Here’s what you can expect. . .
2/
1. A glimpse of the interaction between 2 Black women physicians & friends being their entire selves and uplifting one another.

2. Stuff we learned or are learning.

3. A story of the week then us unpacking it.

4. A whole lot of unfiltered #BlackWomanMagic.

Yes indeed!
3/
Our first #HDPHumpDay will kick off with 3 (!) episodes for the price of 1 (which is #free btw!😂)

👊🏽Ep 1: #BlackWomanMagic Intro to us (and our hair)
👊🏽 Ep 2: “Oh, you work here?”
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Mmm hmmmm, chile. Intrigued, ain’t you?
Read 6 tweets
2 Jun
1/
You: “‘How do you even know how you feel? You’re still young.’”

I listened in silence as you reflected on the response your parents gave when you told them who you are. And because they were seemingly older and wiser, you said OK.

But you knew. Even then, you knew.

Yup.
2/
Me: “When did you know?”
You: “I feel like I knew for a while. But for a long time I kept telling me what they kept telling me.”

*silence*

You: “I’m young. And that maybe the right person hadn’t come along yet.”
Me: “Damn.”
You: “Yeah. Damn is right.”

Hmm.
3/
You stared straight ahead and sighed.

You: “A piece of me wishes my family was just fully opposed, you know? This quasi-openmindedness combined with this idea that I was ‘too young to know’ sucked.”
Me: *listening*
You: “Then again. . . I don’t know.”

You sighed again.
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26 May
1/
If I close my eyes, I can see it
My daddy in a faded tank top
Standing in front of a rusted, half barrel grill

Uncles and aunties slapping down dominoes
On rickety folding tables
Wet with condensation from cold drinks

And us with our feet in a circle
To pick who would be it
2/
If I listen hard enough, I can hear it
Gravelly laughs and nicknames
Hard finger snaps to the O’Jays
or Frankie Beverly & Maze

“Hot Peas and Butter! Come and get your supper!”
The explosion of bare feet running
Cornrows with beads on the end clatter

A screen door slams
3/
If I inhale deeply, I can smell it
BBQ from a charcoal grill
a wad of bubble gum

Hot combs on kitchen stoves
and sizzling Blue Magic hair grease
My Auntie’s perfume when I kiss her cheek
And tell her that the “Sock It To Me” cake is good

The funky aftermath
of kids outside
Read 7 tweets
13 May
1/
#HumpDayHumanism

I'd just gone hard on some #motivationalinterviewing about smoking cessation with a Grady elder one day. We talked about his grandbabies and his life. We even talked about his "nature."

He was looking deep into my eyes--like it was really resonating.

Yup.
2/
Me: "Well?"
Him: "Well what?"
Me: "What're your thoughts?"
Him: "My thoughts 'bout what?"

I groaned. He was tickled.

Me: "Sir! About quitting smoking?"

He raised one eyebrow at me and laughed again. This raspy, gravelly chuckle.

Him: "Miss Manning?"
3/
Me: *listening*
Him: "Tell me. Have you ever had somebody piss you off on a hourly job real, real bad--then step outside, flick your lighter, and then take a good, hard drag on a menthol cigarette?"

I shook my head no. Because I had not.
Read 19 tweets
29 Apr
1/
Grady Hospital, 2019

Her: "Um. . . the family invited us to the funeral. Dr. Manning, how do you handle something like that?"
Me: "Like what?"
Her: "Like being invited to a patient's funeral."
Me: "When I am, I'm honored. So if I can go, I go."
Her: "You do?"
Me: "I do."
2/
Her: "Should I go?"
Me: "Do you want to go?"
Her: "I do."
Me: "Then let's go.”
Her: *smiles*
Me: *smiles back*

And so. On a wintry Saturday, we met up at our patient's church. And from the countless cars surrounding every inch of the building, the love was evident.

Yup.
3/
"Loooord...help me to hold out...until my change has coooome. . ."

Those are the words that the mass choir lifted over the sanctuary as loved ones walked down the center aisle into our patient's homegoing service that next day.

And those loved ones included us.

Yup.
Read 22 tweets

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