Rakmala thanks for the reply, I am debating whether I should send the letter to every one, or If I should carry it with me to interviews.
I realize that the letter from the unknown will be more descripitve but at the same time which will get me more invites.

ortho2003. its not about name dropping or being arrogant. right now its about getting interviews, and to get my foot in the door. I can't think of any ortho program I would avoid like the plague. I will enjoy myself wherever I go, and a program directors point of view on one specific topic DOES NOT determine ANY THING about a program.
ps. Sawbonz-- trying to change my name at this time.
:smokin:

I disagree sawbones. I think an opinion about one thing like this can say a lot about a man's character. If a program director would rather have a letter from Dr. Iamanass, who is a world known hand surgeon that you happened to run into at morning report one day over a letter from Dr. Whoami who you worked with every day for a month, I say he is an arrogant prick. I wouldn't want to work with him and I wouldn't want to be at a program where he is the director.

ortho2003 -- i agree with your comments for the most part. If a PD really thinks that way, then he may very well be what you described him to be. BUT, he may just have the applicants' best interest in mind. He realizes that academic orthopaedics is a relatively small world, and if Dr. X is well-known around the country, more PD's are likely to know him on a social level because all chairmen and PD's are in academics. This can be an advantage in getting interviews!

Yes, if the guy thinks academic hotshots are somehow superior, yeah he's prick. But he could just be giving a piece of advice to help an applicant out.

Last year, I had 4 letters from orthopods. 2 of them were well-known individuals who were editors of a few journals, including JBJS. Their names were mentioned at many of my interviews. In fact, at the place where I ended up matching, one interviewer told me that this individual gives talks at their program once a year and they were very good friends. He couldn't say enough great things about him. He knew this guy better than I did! As for my other 2 letters, well they were really good letters but no one knew who they were. A couple of interviewers, as they were flipping through my file, even said "who's Dr. Y?...I've never heard of him".

So it's just a game. It's human nature. We're all more likely to pay more attention to a letter that's written by someone we've had drinks with in the past.

This is a really tough question,

I had four ortho letters. Three were from well-known orthopods the other from a not so well known. I was lucky enough to get great letters from all my writers (I saw my letters at my first interview). But an attending on the trail told me that he'd rather see and incredibly enthusiastic letter from a no-name orthopod, than a luke-warm letter from one of the Who's who in ortho (i.e. bob worked hard and showed up every day). But this was just one attending's opinion. I agree that interviewers seemed more impressed by my "big-name" letters. But I'd be willing to bet that NO one gets an interview based on letters alone. Dr. Hoppenfeld could write you a letter that says you taught him a few things about physical exam, but if your USMLE score doesn't get you pass the cut-off, then your Hoppenfeld letter would goes into the trash with the rest of your app. Most of the time my letters didn't get read until I was sitting in front of the interviewer, and a lot of the time it seemed as if they just looked at the name before they read the letter. With that said, if I had to chose between a stellar letter from an unknown vs a luke warm letter from an Ortho God, I'd go with the stellar/unknown letter.

I see you point Micky. The arrogant prick I am referring to is the guy that doesn't care what the letter says or how well they writer knew the applicant, but only cares about WHO it is from. Obviously if the "well known" writer goes way back with the director, then I would expect him to hold that letter a little higher.

Yeah, this is a very interesting topic. I've got four letters from "Who's Who in Ortho," president of this and active in that national ortho thing, but I was wondering about them, cause I mostly knew them from the limited occasions that I spent in their clinics/ORs/meetings. I got along with all of them well, and I was told by my ERAS advisor who read them that their letters are excellent for apps, but don't say that much personal stuff about me other than I'm easy to get along with, good with patients, and have done well in ortho and med school. I did, however, spend a bunch of time with an community ortho guy that knows me well in the OR and outside. He would write a letter that lets all the programs know what I'm really like and encourage people to take a good look at my app, but I was discouraged from sending one cause no PDs would know who he is. Wadda ya think about getting his letter and just taking copies to interviews with me?

I have already shared my opinion on the high powered who's who letters, but don't you think that three "who's who" letters would be enough if you have one from a guy that really knows you and will write and outstanding letter? I would dump one of the "who's who" letters and put the good letter in from the no name that will actually give the pd some usefull information.

I agree with Ortho2003. send your 3 who's who letters and then send your community guy letter as a fourth. I think it's a great game plan that won't hurt you.