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Letters of Recommendation for Medical School: Everything You Need to Know

Updated June 3, 2021. The article was updated to correct minor grammatical errors, with technical details added by Aenia Amin, OMS-1.

The letters of recommendation (LOR) portion of the medical school application typically raises the most questions and takes the most time. It is the only part of the application that depends on the efforts of multiple busy professors and doctors, not to mention the emailing and letter sending that must take place to get the letter package finalized. This article aims to make the process a little less complicated by answering some of the most commonly asked questions about LORs.

What is the value of a letter of recommendation?

Let’s face it – anybody can write a personal statement. Because what more do people love than to talk about themselves? Just give them the prompt and a word count, and they can fill pages. Anybody can spin tales about why they need medicine in their life, and why medicine needs them. This is what makes letters of recommendation so valuable – somebody else fully believes in your capabilities as a future healthcare provider. To such an extent that they are willing to write an essay about your qualities and talents, in an attempt to convince an entire admission committee.

When applying, you have to keep in mind that other applicants have high GPAs, MCATs, and an extensive resume of extracurricular activities, including research and community service. Having the support of professors, physicians, research mentors, and community leaders vouching for you may be the factor that distinguishes you from all the other applicants.

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When should I start thinking about letters of recommendation?

As early as possible! I advise doing your research about the letter requirements of each medical school that you may end up applying to and to make an excel document or to write down which letters each school requires. This will help you determine who to consider as a potential letter writer. Especially if you are thinking about applying to medical school during your senior year, this means you only have three years to get your letter package together. Waiting until a couple of months before you apply to get your letters in order is a recipe for disaster.

During your first two years, focus on doing well and standing out in your classes so that you have a handful of options to ask, by your third year. However, it’s never too early to secure a letter of recommendation in your first couple of years! If you do particularly well in a class or develop a strong relationship with any professor in your lower-division courses and believe that the faculty mentor can speak to your academic ability, don’t hesitate to pop the question! Never be afraid to ask a professor if they are willing to write you a letter; the worst that can happen is that they say no. Future applicant version of you will be very grateful.

Letter service storages, like Interfolio and ones provided via the school’s career center, for example, are useful for storing letters obtained before the application portals open in a confidential and secure manner. When the application portals open, you can then request that the service sends your letter(s) over to the portals of your choice.

For those of you who want to set a timeline, it is best to have an idea of your letter writers by Spring vacation (mid-March) and have asked them all by the beginning of April, of the application cycle that you are applying in. This will give them at least two months to compose and submit your letters before your application submission.

How should I ask for letters of recommendation?

Obtaining letters of recommendation is a part of the application process that is not entirely within your control. As such, it is a source of significant anxiety among students. Your admission to your desired program will be based, at least in part, on the words of others. In this keystone article, Dr. Lisabetta Divita provides 7 tips on how to get stellar letters of recommendation.

How many academic letters should I have?

Most medical schools will require at least three letters from professors of undergraduate classes: two science & one non-science. A “science” letter refers to the BCPM category (Biology, Chemistry, Physics, Math). A “non-science” letter refers to a class that falls outside of the BCPM category, typically humanities, social science, or arts. Ideally, the professor of the class writes and signs the letter. However, in a large science class with limited one-on-one interaction with the professor, it is not uncommon for the professor to request a teaching assistant’s help, so get on first-name terms with the TA’s of the course as well.

The academic letters should come from professors of classes in which you excelled. This means you received an A or an A- at worst, if possible. The non-science letter is often overlooked, but it can serve a distinct purpose. Oftentimes the qualities that a humanities professor praises an applicant of will complement those of the science letters. Imaginative writing, analytical thinking, and public speaking are talents that have little opportunity to showcase in a typical chemistry or biology course.

What about letters from extracurricular activities?

With the three academic letters, the minimum requirement for most schools should be satisfied. However, any extensive extracurricular activity you are involved in should have a letter of recommendation from a faculty member. This includes research mentors, physicians shadowed, and volunteer organization leaders. A good goal to aim for is to get letters from each of the three most meaningful/significant activities listed on your application. This breaks down to anywhere from four to six letters – an example is below:

  1. Lower-division Molecular Biology professor (with input from a TA)
  2. Upper-division Physiology professor (with input from a TA)
  3. Upper-division Applied Linguistics professor
  4. Basic science research mentor
  5. ER physician shadowed for 2 years
  6. Student-run homeless clinic advisor

Tip#1: Don’t forget to double-check which letters each medical school you are applying to requires and accepts, as requirements may differ and vary from school to school, and some medical schools have limits on how many letters they will accept.

Tip#2: Go for quality over quantity. There is no magic number for letters of recommendation, but it is always better to have a few strong letters than a bundle of mediocre letters. When asking someone for a letter, be sure to emphasize if they are willing to write a strong letter of recommendation for you. You can help them by meeting with them frequently and providing information about yourself or a personal statement. A mediocre letter may hurt your chances more than help them.

What is a committee letter or committee letter packet?

Some medical schools do accept a committee letter or a committee letter packet from the school’s pre-health service, instead of individual letters. The benefit of such is that the committee’s recommendation strengthens your application and further demonstrates that you would be a good addition to the medical school. Additionally, many school pre-health services store the committee letter/committee letter packets for a set amount of time, which is convenient for reapplicants and for those applying via multiple application portals. When reapplying, you can request that the pre-health service send the letter/packet to the portals of your choice, should you decide to reuse letters of recommendation.

In order to obtain a committee letter, the process may consist of an interview with your school’s pre-health committee, submitted letters of recommendation from different professors, certain requirements such as an MCAT score, and etc. Some schools may offer to put together a committee letter packet for you, which consists of the committee letter and all of your individual letters. Then when you are ready to apply, you request that the pre-health service send your packet to the application portals of your choice as a letter package. In order to obtain more information about this and to see how the process works at your school, you should contact your pre-health services as soon as possible, to be aware of any necessary deadlines and requirements for qualification. Many students are not able to take advantage of these services due to missing deadlines and/or requirements, and if your school offers them, then it is a good idea to explore these options.

How do I ask for a letter of recommendation?

There are two ways to approach asking for a letter: in person or via email. I recommend that you pick the option that works better for the writer, taking into account any potential delays in response and which ensures a faster response. Ask near the end of a course or shortly after the course ends, especially if you are confident you will receive a high grade. Something along the lines of “Hi Professor X, I thoroughly enjoyed your class this semester and learned a great deal. I am applying to medical school, and a strong letter of reference from you would truly strengthen my application. Would you be willing to write me a strong letter of recommendation?”. If they agree, arrange for a meeting with them to go over logistics. At this meeting, provide each writer with the following items as needed:

  • A copy of all necessary forms, deadlines, application ID numbers, and other information required to submit the letter(s) onto the application portal(s), if submitting directly online. If you are applying using different application portals, like AMCAS, AACOMAS, and TMDSAS, then don’t forget to explain this to the writer and provide all the necessary information for each portal to make the process easier.
  • A pre-addressed manila envelope with a Post-It containing the agreed-upon submission deadline, if not submitting directly online.
  • A signed waiver for the letter service being used (Interfolio, your career center, etc.).
  • A curriculum vitae (CV) (or resume).
  • A copy of your transcript.
  • A personal statement and/or a few bullet points on what you want them to mention in their letter.
  • A list of schools that you are applying to where the writer’s LOR will be sent, as you do not want school X to receive a letter mentioning school Y.

How long should I give them to write letters?

This will be different with each letter writer. A research mentor who only works with a few undergrads may only need two weeks to write a letter for you; whereas, a professor of a class of 250 pre-health students may end up writing up to 20 letters that quarter and may require three months to put them all together. It is courtesy to allow the writer at least a month to write and submit the letter, but be sure to agree upon the submission date in advance. Once the submission deadline nears, feel free to pop into their office or send them a reminder email about your letter to be sure everything is in order.

Finally, a personal note: When I was applying, I waited until April to ask for my second science letter, only to be shocked that the professor was writing 11 other letters and projected a submission date of August. I submitted my application in June, but without a complete letter package, some schools waited until September to read my complete application. Please don’t make the same mistake I did; submit your letters early!

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