Physicians seeking a practice opportunity might think of the cover letter as an old-fashioned, generally unimportant component of their application for or expression of interest in a position, but that is not the case. In this digital age of clipped, often rapid-fire communications, the cover letter has become more important than ever because it offers a way to differentiate the physician from other candidates. It provides a vehicle for sharing personal and professional information that might be important to prospective employers but doesn’t quite fit in the CV. The cover letter should be brief, well written, professional and positive in tone, and absolutely error-free. It should also give the recipient the sense that the physician has researched the opportunity or organization before writing the letter.

By Bonnie Darves

When a physician encounters the seemingly perfect practice opportunity — with a mid-sized group in their hometown that is affiliated with a health system that has an excellent reputation — it’s tempting to quickly compose the requested cover letter to accompany her CV and send it off.

Yes, it is smart to express interest in a desirable position as soon as possible, but it’s not prudent to view the cover letter as a mere formality. Today, when so much communication between physicians and recruiters or prospective employers is electronic — in either brief email responses or via online forms — the cover letter has become increasingly important. Here’s why: The carefully crafted letter offers an opportunity to differentiate the resident or fellow from other physicians who respond, and a chance to demonstrate highly personalized interest in the position.

“The cover letter’s value is certainly not decreasing in the digital age. Because it is usually the second contact physicians have with an organization, it is very important,” said James Tysinger, PhD, vice chair for professional development in the University of Texas Health Science Center department of family and community medicine in San Antonio. “It is your opportunity to include something about who you are, and to provide information that won’t be in your CV about why the position and the geographic location interest you.” For the resident seeking a fellowship, the letter is the ideal vehicle to convey to the program director that the physician has researched the program’s focus and reputation, he added.

Longtime recruiter Regina Levison, president of the national firm Levison Search Associates, agrees that the geographic preference statement is a vital piece of information that should appear early in the letter. “The geographic ‘connection’ to the opportunity’s location is the most important message you can include — whether it’s because you grew up there, have relatives in the region, or simply have always dreamed of living or working there,” Ms. Levison said. “Health care organizations today are not just recruiting to fill a specific opportunity; they are recruiting for retention.” As the health care delivery system changes to incorporate accountable care organizations and quality focused reimbursement, organizations are seeking physicians who will “stay around” to help meet long-term organizational objectives.

Craig Fowler, president of the National Association of Physician Recruiters (NAPR), and vice president of recruiting and training for Pinnacle Health Group in Atlanta, urges residents to include at least an introductory cover letter or note with their CV, even when it’s not requested. In his experience, 8 out of 10 physicians who express initial interest in a position don’t take the effort to write a letter unless asked.

“The cover letter really is a differentiator, and even though a recruiter will always look at your CV first, the letter is nice to have. I often feel that it gives me a sense of the physician — a good letter can make the physician come to life,” Mr. Fowler said. He enjoys, for example, learning about the physician’s personal interests and family, in addition to what he seeks in a practice opportunity.

Peter Cebulka, director of recruiting development for the national firm Merritt Hawkins, agrees that the cover letter can provide information that isn’t appropriate in a CV but could be important to a hiring organization. “The letter gives you a chance to talk about your professional goals, or why you’re committed to a particular area or practice setting,” Mr. Cebulka said. It can also highlight something compelling about the physician’s residency program that the recipient might not know.

If there are gaps in the CV that are not sensitive in nature, and therefore don’t require a phone conversation, that information should be included in the letter. “It’s important to briefly explain gaps because your application might be passed over if you don’t,” Mr. Fowler said.

Jim Stone, co-founder and president of The Medicus Firm, a national physician search company, offers helpful guidance on incorporating a career objective in the cover letter. “You may want to include a career objective or job search goals, but be careful not to be too specific or you may rule yourself out of consideration,” he advised. “Therefore, if there is one goal that really sums up your search, or some objective that is a must-have for you under any circumstances, it would be okay to include that.”

On another note, Mr. Stone urges physicians to include brief examples of any soft skills, such as communication, teamwork, technological aptitude, leadership, or problem solving.

Format and structure: short and targeted works
While there are no rules per se about a cover letter’s length or content, there are general guidelines for what works best and is likely to be well received. (See “Cover letters: What to do, what to avoid” section at the end of this article.) Dr. Tysinger, who counsels residents and practicing physicians on preparing CVs and cover letters, and frequently presents on the topic, recommends a single-page, three-paragraph format delivered in a professional, business letter layout, in simple language. Following is his basic guidance on the letter’s structure:

• First paragraph: Introduce yourself and state why you are writing — whether that is to be considered for a specific position, to express general interest in joining the organization, or the recommendation of a colleague.
• Second paragraph: Provide brief details about yourself and why you are interested in the opportunity and the location. Note any professional connections to the opportunity or organization, and any special skills or interests, such as management or teaching.
• Third paragraph: Thank the recipient for the opportunity to apply and for reviewing your CV, and end the letter with a statement indicating that you look forward to hearing from the recipient soon.

Other sources agreed that cover letters should not exceed one page, unless special circumstances dictate an extra paragraph or two. In that case, a two-page letter is acceptable. Ms. Levison advised briefly summarizing education and training in the second paragraph, and if it’s the physician’s first opportunity search, stating briefly why he became a physician.

It’s best to avoid going into extensive detail about personal interests or extracurricular pursuits. That could give the recipient the impression that the physician is more concerned about lifestyle than medical practice.

Professional tone, error-free content are musts
It should go without saying that the cover letter must be professionally written and free of spelling or grammatical errors, but unfortunately, that’s not always the case. All of the recruiters interviewed for this article have received cover letters that are poorly written or, in some cases, replete with misspellings; all agreed that an error-riddled letter could prevent its writer from being considered for an opportunity regardless of her or his qualifications.

Of course, word processing programs include spell-checkers and, usually, some grammar-checking functionality. That’s helpful, but it isn’t sufficient vetting to ensure the letter is in excellent shape. Because of the letter’s potential importance, physicians should have several trusted individuals — on the professional and personal side — review the document, including a professional editor, if warranted. “If writing isn’t your strong suit, or English isn’t your first language, do get professional advice before you finalize the letter,” Mr. Cebulka recommends.

Ms. Levinson offers pointed advice regarding double-checking for errors. “Are there any typos or mistakes that would make the new organization question your ability to keep accurate records?” she said. It’s worth noting that some recruiting firms offer assistance with cover letter writing, but it’s best not to count on that service.

Striking the right tone in the cover letter can be somewhat challenging when the resident doesn’t have a good sense of the organization offering the opportunity. Some hospitals or groups are very formal, and therefore expect to receive formal communication. Others might be somewhat casual, from the standpoint of their culture, and therefore less inclined to bring in a physician who comes across as stiff, even if she isn’t. For these reasons, it’s smart to research the hiring entity to the extent possible before finishing the letter. The group’s website or the health system’s physician portal are good starting places to gauge the culture, but a discussion with a physician who practices there, happily, also can be helpful.

Ideally, the letter’s tone should be professional but friendly, and should sound like its writer, and not like a cookie-cutter form letter. “The letter should be professional and warm, and the tone should also reflect how you would communicate with patients and staff,” Ms. Levison said.

“A little colloquialism is OK, if it shows your personality,” Mr. Fowler maintains, provided the overall tone remains professional.

The sources concurred that the cover letter is not the forum for including a laundry list of the physician’s position parameters, or for negotiating compensation or other potential contract terms. Physicians in a highly recruited specialty might mention required equipment or infrastructure, if the lack of those items would preclude further discussion. But for the most part, those specifics should be left for an on-site interview.

“If the parameter is a potential deal-breaker, you can mention it, but avoid sounding inflexible,” Mr. Cebulka advised. That means not setting limits on the amount of call, or number of night shifts or weekends, for example. Those details can be discussed and possibly negotiated later.

Very important parameters should, however, be provided to the recruiter outside the context of the cover letter if such detail is requested. That’s especially important if the recruiter will introduce the physician to multiple opportunities.

“If you’re in a highly recruited specialty, there will be plenty of opportunities. But it’s helpful for recruiters to know what you’re absolutely looking for, so that you don’t waste your time or theirs,” Mr. Cebulka said.

Cover letters: What to do, what to avoid
The sources who contributed to this article offered these additional tips on what physicians should do, or not do, when they craft their cover letters.

Do:

• Address the cover letter to an individual physician, practice administrator, recruiter, or other individual as the situation warrants, and not “to whom it may concern.”
• Be upbeat and positive. Ensure that the letter’s tone reflects your excitement about medicine, and that it reflects the way you would speak in an in-person interview.
• Include letters of reference with the cover letter if you’re looking for a fellowship or are formally applying for a specific position.
• Close the letter with a call to action if it’s an ideal opportunity (and likely a popular one). Let the recipient know that you will call in a few days to follow up, and indicate when you would be available to meet in person. It doesn’t hurt to state the best ways to reach you.

Avoid:

• Don’t sound desperate or beg for the job, even if it’s the perfect opportunity or you are worried about securing a position.
• Steer clear of “selling” yourself or making claims about why you would be the absolute best candidate. Instead, let your credentials and references make the case for you.
• Avoid sarcasm in any context, and generally steer clear of humor, unless you know the person to whom the letter is addressed very well.
• Don’t disparage individuals, programs, or institutions if you have had a negative experience somewhere — regardless of the reason.