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A letter of intent is crucial for students or IMGs who interviewed well and should not be generic. It must be specific, concise, and directly address the program leader, typically the program director. Instead of sending a broad letter to all programs, tailor it to each one. For additional guidance, a free resource, including a template and examples, is available on the blog at drninalum.com. It's recommended to read and study this resource while crafting your own letter of intent.