The transition from medical school or residency to professional practice is a pivotal stage in a physician’s career, marked by intricate negotiations, strategic decision-making, and the exchange of critical documents. Among these, the physician letter of intent (LOI) has emerged as an indispensable tool for both early-career and established physicians seeking new positions or engaging in contract discussions.
Despite its prevalence, there remains widespread confusion within the medical community about what a physician LOI actually is, what purpose it serves, and how it differs from a formal employment contract. The stakes are high: a well-crafted LOI can clarify negotiation points, establish mutual expectations, and lay the groundwork for a successful working relationship.
Before diving into how to write one, it’s worth clarifying how a physician letter of intent differs from other job‑search documents—especially the cover letter.
LOI vs. cover letter: selling yourself vs. sealing the terms
A physician letter of intent (LOI) differs from a cover letter in both purpose and content. While a cover letter is a persuasive narrative designed to introduce yourself, highlight your qualifications, and explain why you’re a strong fit for a role, an LOI is a more transactional document that outlines the preliminary terms you and a potential employer have discussed.
The cover letter is part of the application process, often sent before any interviews, and focuses on selling your skills and enthusiasm. The LOI comes later, once mutual interest exists, and serves as a concise summary of key points such as position title, location, compensation range, and start date.
In short, the cover letter markets you as a candidate, while the LOI confirms the framework of an agreement before a binding contract is drafted.
What is a physician’s Letter of Intent (LOI) and is it binding?
Specifically, a physician letter of intent (LOI) is a written document that expresses a physician’s interest in a particular employment opportunity, outlines preliminary terms and expectations, and signals the intention to move forward with more formal negotiations or agreements. Sometimes referred to as a “memorandum of understanding” or “pre-contract agreement”, the LOI serves as an initial bridge between informal discussions and the creation of a legally binding contract. Its core function is to ensure that both the physician and the employer are on the same page with respect to major deal points before delving into the complexities of an employment contract.
Typically, the LOI identifies the job position, salary expectations, location, work schedule, benefits, contingencies, and other critical terms that matter to both sides. Importantly, a physician LOI is not legally binding in most cases; rather, it acts as a “good faith” declaration of intent, clarifying expectations, supporting negotiations, and reducing the risk of future misunderstandings.
The American Medical Association (AMA) notes that while an LOI cannot obligate either party to enter into a contract, it can prevent wasted time and resources by weeding out fundamental disagreements early in the process. Beyond job opportunities, medical letters of intent are used in various contexts across the healthcare field—including partnership agreements, mergers and acquisitions, and insurance credentialing. For job-seeking physicians, however, the LOI is primarily leveraged during employment discussions. It sets the stage for more detailed legal documentation and shows professionalism, seriousness, and organizational skills on the part of the physician.
Why the physician letter of intent matters
A physician letter of intent sets the tone for negotiations. By outlining key terms—salary, duties, benefits, location—it ensures transparency, surfaces deal‑breakers early, and prevents wasted effort on contracts that won’t work. Clear, upfront communication reduces misunderstandings and speeds the hiring process.
An LOI also signals professionalism. Employers see physicians who use them as organized and proactive, while physicians gain a written reference point to guard against last‑minute changes or “bait‑and‑switch” tactics.
Because it documents good‑faith understandings, an LOI builds confidence—especially when dealing with unfamiliar employers or large healthcare systems. In a competitive market, a strong LOI can even be a differentiator, giving physicians added leverage in salary or scheduling discussions.
Key components of an effective physician letter of intent
Many physicians admit the hiring process can feel exhausting. As two internal medicine doctors in the U.S. put it: “I wish this whole process weren’t so onerous!” and “I hate all of this paperwork!!!”
Sermo poll results show why guidance matters: 54% of physicians have written at least one LOI for a job, but 39% have never needed to, and 8% aren’t sure or don’t know how. Even among those with experience, confidence varies—34% feel comfortable after writing several, 44% have written only one or two and still find them challenging, 10% have considered it but haven’t tried, and 12% have never written one at all. When asked about offering advice, 43% had tips to share, while 57% said they’re still figuring it out.
These numbers highlight why a clear, practical framework matters. A well‑structured LOI not only reduces back‑and‑forth but also positions you as a strong, professional candidate from the start.
Physicians on Sermo across specialties share similar advice:
“Be concise and avoid redundant language.” – family medicine physician, USA
“Put yourself in the prospective employer’s shoes. What do they care about most? Lead with that.” – OB/GYN, USA
“Be honest, be concise, be confident.” – GP, USA
“Emphasize something noteworthy about yourself early on to snag the reader’s attention.” – radiologist, USA
“Like discharge summaries, we want them to be concise and to the point. Overwritten, flowery and generic letters are not helpful. They get you through the selection criteria, invite the selection to read your CV and invite you to interview.” – pediatric physician, Australia
With those real‑world insights in mind, here’s how to structure an LOI that works:
1. Introduction: express interest in the position
- State who you are and the role you’re pursuing.
- Mention how you learned about the opportunity or your connection to the organization.
- Convey enthusiasm and alignment with the organization’s mission or values.
2. Job details: outline key terms
Summarize the essentials you’ve discussed or expect to negotiate:
- Position title and responsibilities
- Location (facility, city, or region)
- Compensation range (salary, bonuses, incentives)
- Benefits (healthcare, retirement, CME allowances)
Pro Tip: again, while a physician letter of intent is not legally binding, it sets the tone for your working relationship. Keep it professional, concise, and free of binding legal terms. This document should guide the conversation—not replace the formal contract.
3. Commitment statement: show intent to move forward
- Clearly state your intent to proceed toward a formal agreement.
- Reinforce your interest in joining and contributing to the organization’s goals.
- Maintain a confident but collaborative tone.
4. Contingencies: define conditions before signing a contract
Outline any conditions that must be met before signing, such as:
- Credentialing or licensure approval
- Background checks
- Agreement on final contract terms
This ensures transparency and protects both parties.
5. Closing and next steps: invite further discussion
- Thank the reader for the opportunity.
- Suggest a next step, such as scheduling a meeting or reviewing a draft contract.
- Provide your preferred contact information.
The bottom line: the LOI is your roadmap—simple, clear, and flexible. The contract is the destination—binding and detailed. Use the LOI to align and negotiate; scrutinize the contract before you sign.
Letter of intent examples and templates
Below is a sample physician letter of intent, created for this article, that follows the five key components outlined above:
Sample physician letter of intent
[Your Name, MD/DO]
[Your Address]
[City, State, ZIP]
[Email Address] | [Phone Number]
[Date]
[Recipient Name]
[Title]
[Organization Name]
[Address]
[City, State, ZIP]
Re: Letter of Intent – [Position Title]
1. Introduction
Dear [Recipient Name],
I am writing to confirm my interest in the [Position Title] position at [Organization Name], as discussed during our recent conversations. I am excited about the opportunity to contribute to [specific program, department, or mission focus] and believe my background in [specialty/subspecialty] aligns well with your organization’s goals.
2. Job details
Based on our discussions, the preliminary terms we have considered include:
- Start date: [Proposed start date]
- Location: [Facility/city]
- Compensation: [Base salary or range, if discussed]
- Benefits: [Brief summary, e.g., health coverage, retirement plan, CME allowance]
- Responsibilities: [Concise description of role/scope]
3. Commitment statement
It is my intent to move forward toward a formal employment agreement that reflects these terms and our shared understanding of the role. I value the collaborative and patient‑centered approach your team embodies and look forward to contributing to that mission.
4. Contingencies
This letter of intent is contingent upon [successful credentialing, verification of licensure, background check, or other agreed‑upon conditions].
5. Closing and next steps
Thank you for the opportunity to join your team. I look forward to finalizing the details of our agreement and am available at [phone number] or to discuss next steps at your convenience.
Sincerely,
[Your Name, MD/DO]
This example is for educational purposes only and should be tailored to your specific situation. Always review final terms with a qualified attorney before signing.
More templates and examples can be found here:
- Physician Letter of Intent-article outlining LOI
- General Letters of Intent
- E-form Physician Letter of Intent-free .pdf
Join the conversation on Sermo
Physicians in the Sermo community have been candid about the hiring process: “I wish this whole process weren’t so onerous!” … “I hate all of this paperwork!!!” Others emphasize practical wisdom: “Be concise,” “Think like the employer,” and “Highlight something noteworthy early.”
Now it’s your turn.
- Have you written a medical letter of intent that opened doors for you?
- Do you have tips for making an LOI stand out without sounding generic?
- Or are you struggling to balance brevity with detail?
Share your experiences, swap templates, and get feedback from peers who’ve been there. On Sermo, you can connect with physicians across specialties, compare approaches, and learn how others have navigated the LOI and contract process.
Sign up to Sermo today and join the discussion on physician letters of intent. Your insight could be exactly what another doctor needs to land their ideal role.
