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The letter of intent is crucial for students or international medical graduates (IMGs) who have had a favorable interview experience. It should not be a generic letter sent to all programs. Instead, it must be specific, brief, and direct, addressed to the program leader, usually the program director, unless instructed otherwise. For guidance, a free resource is available on my blog, drninalum.com, which includes a template and examples to help you craft your own effective letter of intent.