Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Thirty years ago, education leaders in emergency medicine (EM) developed a standardized letter of recommendation to address limitations of narrative letters of recommendation in the residency selection process. Since then, multiple iterations and improvements with specialty-wide adoption have led to this letter being cited as one of the most essential pieces of a residency application. Based on the experience and success in EM, many other specialties have also now adopted standardized letters of their own. In this paper, we detail the 30-year history of the EM standardized letter including form changes and technological innovations, research and validity evidence, and discussion of research and administrative priorities for the future.