what's up felton, i've heard that most programs like one letter from your dept's chair, and then all the others from only orthopaedists. To me, a letter from a different dept shows that you have the ability to adapt to different situations and are able to work with different types of people, a skill needed no matter what field you choose. I am going to have a letter from the chair, 2 other ortho LOR's, and one non-ortho, for a total of 4. Hope that helps.