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One of the most important elements of a successful medical school application is the letter of recommendation. Recommendation letters provide extensive insight about you and help medical schools gauge your ability to excel in medical school as well as your preparedness for becoming a physician.   Below we address some of the key issues relevant to obtaining and sending your letters of recommendation:

Who to get letters of recommendation from: There are many individuals from whom you could request a letter of recommendation. In general, your letter writer should know you well and be able to comment in a substantial way about your ability and aptitude for medical school and the medical profession.

Most medical schools require 3-4 letters of recommendation and generally expect two of these to be from professors with whom you have taken science courses. We recommend getting letters from the following:

  1. Science professors: This should preferably be with science professors in challenging upper division courses that are related to the medical field. A letter of recommendation from a microbiology or medical genetics professors will help more than a letter from an entomology professor. Also get your letters from professors with whom you took courses at a four-year institution.
  2. Physicians: It is always a good idea to get a letter of recommendation from physicians who you have shadowed or volunteered with.
  3. Research faculty: If you have done substantial research with a faculty member, that faculty member can be a good source for letters of recommendations.
  4. Others: Other individuals who can comment on your intellect, compassion, curiosity, work ethic, maturity, or responsibility are valuable.  For example, if you have participated in a community service or leadership activity, a supervisor in those capacities who knows you well can be a good resource for a letter of recommendation. Athletic coaches and music/art instructors can be potentially good resources for letters of recommendation but only if you have been pursing the athletic or artistic activity on a serious basis and the individual can provide substantive commentary about your abilities and character.

Who NOT to get letters of recommendation from: Medical schools do not place much value on letters written by friends or family members or letters written by professionals with whom you have not worked in any professional capacity

Also, letters of recommendation from supervisors in fields not related to medicine are generally not considered valuable. For example, if you held a position in sales or worked in banking a letter from supervisors in those roles will not help your medical school application.

When to begin  thinking about letters of recommendation: Although you ask for letters of recommendation several months before you are ready to submit your medical school application (the winter or spring before your are applying to medical school), its always a good idea to invest in your letter writers way earlier. This means thinking about who could serve as a potential letter starting early in your premedical career.

Once you have identified a potential letter writer, you should make every effort to make yourself known to that person. The more your letter writer knows about you, the more personal the letter she can write. On the other hand, even if you were a top student in a very difficult science course, if the professor does not know you or has not interacted with you, chances are the letter she writes will be generic. A good way to get to know your professors is to attend their office hours, ask questions, and show sincere interest in the subject.

Ask for letters early: You should approach your letter writers in January of the year you are planning to submit your AMCAS application. After you approach them, make sure to follow up regularly with them to ensure they have not forgotten about you.

How to politely and professionally ask for a letter of recommendation: Approaching a professor or physician for a letter can be tricky. You have to make sure NOT to come across demanding or entitled. Do not ever approach anyone with the expectation that they will definitely write you a letter. In general it is always best to ask for a letter of recommendation in person. Email the professor, physician, supervisor or other individual from whom you are requesting a letter and ask for an appointment to see her or at least speak to her on the phone. When you see her:

  • Explain that you are applying to medical school
  • Tell her that you really enjoyed her course, or the research, or the shadowing experience, etc.
  • Explain that as a result you would be grateful if she would be wiling to support your application in the form of a letter
  • Ask her if she would feel comfortable writing a strong letter of recommendation for you – You  want your letter writer to write you a very strong letter.  By asking her directly if she feels comfortable writing a strong letter, you are essentially telling her that you are only interested in a letter if it is thoughtful, well-written, and provides valuable insight about you.  This way, you reduce the chance of having the letter writer submit a short letter that lacks true substance.
  • Gauging the letter writer’s response: When you ask a letter writer how comfortable she feels supporting your application, carefully gauge her response. Some letter writers may be uncomfortable saying no but if you sense hesitation in their tone, you should probably find someone else.  Ideally, if the letter writer remembers you and your work ethic, she will not be reluctant to support you.
  • Tell your letter writers that you would be happy to provide any additional information they may need – Your letter writers may ask you to submit a resume or personal statement.  For a guide on how to prepare a premedical resume, please visit our resume preparation guide. Although you may not have a final draft of your personal statement ready when you approach your letter writers, its a good idea to give them a working draft.

Waiving your right to view your letters:

Most schools or application services like AMCAS and AACOMAS will ask you if you are willing to waive your right to see your letter. We encourage applicants to waive their right to see their letter. When you waive your right, your letter writer will be notified. Letter writers will feel more comfortable writing a candid letter when applicants waive their right to see the letter. Medical schools know this and as a result they place greater value on letters when the applicant has waived her right to see the letter.

How to send your letters to medical schools:  

Allopathic Medical Schools: Most allopathic medical schools participate in the American Medical College Application Service (AMCAS) letter of evaluation program. This means they will only accept your letters of recommendation from AMCAS.  If you are applying to these medical schools, you must have your letters sent to AMCAS.

Osteopathic Medical Schools: Like for allopathic medical school, the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) serves as an intermediary through which you can submit letters of recommendation to osteopathic medical schools.

You can either have your letters directly sent to AMCAS or AACOMAS by your letter writers or use third party services such as Interfolio that will collect your letters and submit them on your behalf upon request.  Some schools also have a career/advising center that will collect your letters of recommendation and submit them to AMCAS or AACOMAS on your behalf.

Some medical schools (e.g. foreign medical schools and a few US medical schools including Texas medical schools) do not participate in AMCAS or AACOMAS.  For these schools, you can either request your letter writer to directly send the letter to the school or have your letter writers send your letters to the third party service and ask the third party service to send to the different schools.  The advantage of using a third party service is that it saves your letter writer the hassle of having to submit your letters multiple times if you are applying to

medical school that have different mechanisms for applicants to submit their letters (e.g. both allopathic and osteopathic medical schools).

When to submit your letters of recommendation:  

Most medical schools do not consider your secondary application complete without letters of recommendation.  To ensure that medical schools receive your letters in time, you should submit them at least a few days in advance if you are submitting online and a few weeks in advance if you are sending by regular mail. We generally recommend planning to have your letters of recommendation submitted with the rest of your primary application to ensure expeditious review of your application.

Sending different letters to different schools: AMCAS allows you to send different combinations of letters to different schools.  This allows you to tailor the combination of letters you send to each school based on the school’s requirements and preferences.

 Number of letters to send: In general, four letters of recommendation are a happy medium.  You can submit more letters of recommendation, however, we encourage applicants to strive for quality, not quantity.  Too many letters can be overwhelming for medical schools to review.

 Committee Letters: Some undergraduate institutions have a health professions committee which will write a committee letter for applicants to medical school.  This is a comprehensive evaluation of your candidacy that is written by multiple faculty members at the institution. Generally medical schools look favorably at committee letters if your undergraduate or premedical institution offers such letters.

Most institutions that offer committee letters have stringent criteria for giving such letters.  If your institution offers such letters, it is important to determine what the criteria are for obtaining a committee letter and do your best to meet these criteria.  They may include GPA and MCAT cutoffs and a minimum amount of extracurricular or clinical experience.

Remember obtaining committee letters, may be a lengthy process.  Make sure you know the timeline and you apply in time to meet the deadlines.  We suggest looking into committee letters one year before your application.