Background. The goals of this project were to evaluate the current perspective on letters of recommendation and to assess the need for, and acceptance of, a more standardized letter of recommendation (LOR). Methods. An eight-question survey was distributed to plastic surgery program directors. A five-point Likert scale was selected as a means of quantifying the participants' responses to the survey. Results. Twenty-eight of 71 program directors (39.4%) completed the survey. The majority of participants felt that current LOR did not offer a realistic way to compare applicants (mean ± SD, 2.9 ± 0.8). While most agreed that increasing the objectivity of LOR would be valuable in comparing applicants (mean ± SD, 4.1 ± 0.9), the overall average response to whether a more standardized letter format would improve the resident selection process remained only slightly better than neutral (mean ± SD, 3.5 ± 1.2). Most of the chairmen supported the notion that familiarity with the author of the LOR strengthened the recommendation (mean ± SD, 4.5 ± 0.6). Conclusion. The majority of plastic surgery program directors would like more objectivity in comparing applicants but are ambivalent about a standardized letter of recommendation.
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