Are foreign LORs of any importance?

International medical graduates always have this question about letters of recommendations they get from their clinical instructors overseas. The question usually asked is like: Does the LOR s from India or Pakistan or any other country have weight is the residency application. The big myth is that most IMGs think that their home LORs are less important than their US letters. Actually program directors like to know about your real clinical background beside that you get from USCE rotations. A ratio of 2:2 is the perfect combination we noticed in those successfully matching. Bottom line is USCE is a big positive in your ERAS application but not without your home based letters of recommendations as well.