Are You Ready for Commitment? When and How to Write a Letter of Intent

So you are nearing the end of your application season. You have spent years completing prerequisite courses, engaging in thoughtful and philanthropic extracurricular pursuits, preparing for the MCAT, and of course submitting primaries, secondaries and interviewing at your desired medical schools. Maybe you have multiple letters of acceptance in hand; maybe you have not yet received your fat envelope. But there is one school that has stolen your heart. And unfortunately, your love might be unrequited.

If you are still anxiously waiting for that dream acceptance, how can you thoughtfully and intelligently court this school? Here are a few points to consider before you submit additional updates to make the most compelling case for your admission.

1. Ensure that you fully understand the application jargon.

There are four main types of application correspondence. In chronological order of submission these are: thank you letters, letters of update, letters of interest, and letters of intent. Thank you letters should be sent immediately after your interview. Many applicants send these letters as emails to expedite receipt and response. Other applicants choose to send handwritten letters for a more personal touch. Consider nontraditional methods such as bringing envelopes and stationary to your interview so you can pen a thoughtful letter of gratitude on the spot and immediately deposit it into the interviewer’s mailbox. Such methods can preserve the idiosyncrasy of a handwritten response and still ensure a quick delivery to the interviewer. Letters of update can be submitted throughout the application cycle to inform a medical school’s admissions committee that an applicant has additional significant achievements that warrant consideration. Letters of interest or intent are often submitted later in the application season to convey an applicant’s passion for a particular school. These are more nuanced in temporality and significance.

2. Establish that you are under serious consideration for admission.

You should submit thank you letters to every interviewer you speak with. You can submit update letters to any school that has received your primary and secondary applications; these will likely be more impactful with schools that have interviewed you. You should only consider submitting letters of interest or intent to medical schools which have already interviewed you and have either not released a decision or have informed you that you are under “continued consideration”. Early in the application season this might be a notice that your application is deferred. Later in the season this might be an offer to stay on the school’s waitlist. Do not promise your heart to a school that has not sent you an interview invitation or even a secondary; she is just not that into you. Likewise, if you have already received a rejection letter, she will not undo her left swipe.

3. Determine each medical school’s interest in updates.

Is this a medical school which encourages letters to update the admissions committee on further achievements throughout the season? Does this medical school inquire about your level of interest in their program? Does this school invite letters of intent or provide additional instructions to deferred and waitlisted applicants? Some schools highly value letters of update and some will even consider the frequency of portal visits and uploads as a barometer of your continued interest in their program. But some schools do not want additional letters of update or intent; they may ignore these letters or even view your inability to follow directions unfavorably. Read the school’s previous communications, portals, and websites to gauge the school’s opinion of update and intent letters. If you are still uncertain, perhaps reach out to your student hosts or other medical students you met during your interview at the school.

4. Analyze your current position at this point in the application season.

a. If you have no acceptances.

If you have yet to receive a single offer of admission, then the medical school expects that you would love to matriculate. A letter of update, if substantial, may be impactful but a letter of intent is likely superfluous, and egregiously so. If you are in this position, you do not want to submit a desperate plea for admission. And you definitely do not want to submit a promise of intent to multiple medical schools. Try to be patient. Seek advice from knowledgeable mentors about your candidacy and options for the future. You may wish to start preparing for a subsequent application cycle.

b. If you have received other acceptance offers but would prefer this school.

If you currently hold at least one acceptance, then you likely want to submit a letter of interest to show your continued interest in the school that is still deliberating on your candidacy. Be sure to detail any important application updates. If you are certain that you would prefer this school over your existing offers then you may be a good candidate for a letter of intent, especially if your preferred school is not significantly more highly-ranked than your previous offers.

5. If you are considering a Letter of Intent.

Make certain that you would definitely attend if accepted; do not send a committed letter of intent if you are not absolutely certain you would happily attend if you are admitted. A letter of intent is not held as a legally binding document but it does hold an ethical imperative to matriculate. You are giving your word as an applicant that you will attend the school, if given the chance, and requesting additional consideration for this commitment. So if you fear you would feel some lingering regret in limiting your options to this degree, do not send a letter of intent. Consider sending a letter of interest instead.

Once you have established that you are a good candidate for a Letter of Intent or Letter of Interest, how should you organize this letter?

1. Start with a simple letter structure.

Use a letter structure and open with “Dear Admissions Committee of the University of X School of Medicine”. A basic four to five paragraph outline will then give you a good foundation. In your first paragraph you can restate that you greatly enjoyed your visit to campus to interview. You should state your main point here; if the reader does not finish the letter and merely skims, they will still see your commitment to attend. For a letter of intent, a simple statement of intent would work well: “With this letter I want to update the Admissions Committee on research developments and additional volunteer hours since my interview. Additionally, I want to demonstrate my utmost commitment to the University of X School of Medicine with this letter of intent.” You can be blunt. You may even wish to add directly after: “if I am accepted, I will definitely matriculate this fall”. For a letter of interest, simply state “interest” instead of “intent”.

2. Demonstrate any additional achievements as an applicant since the interview.

In your second paragraph, you may want to provide updates to your file. Definitely mention any new publications, conference presentations, and abstracts. Maybe state your additional community service hours and impacts. Consider which aspects of your application are the strongest—what questions were asked during your interview? Then highlight these strengths again, very succinctly. If you have had the time to strengthen any application weaknesses since your interview, briefly mention these as well.

3. Show, don’t tell, why you love this school.

In your third paragraph, you definitely want to articulate why you love their school and would love to enroll. You should mention a few aspects of the school that excited you during your interview. You can even politely reference advice or discussions with your interviewers but it’s not necessary. Make sure these are school-specific details such as student clinics, research blocks, opportunities for dual degree programs, or collaborations with big hospitals in the area. You may need another paragraph to elaborate but try to keep your entire letter to a single page.

4. Close with another statement of interest or intent.

In your closing paragraph, you should thank the school for the opportunity to be considered and again state your desire to attend if accepted. Close with a “Sincerely” or other formal closing. Then save as a PDF to prevent format changes and either email to the school’s admissions email or upload to the portal, whichever method the medical school has indicated is the preference. Double check for grammar and spelling mistakes. Make certain you have not forgotten a subject line or attachment. And save the file with the school’s name in the file name so you cannot possibly upload an update letter intended for another school.

In conclusion, commitment can be scary. But you have worked so hard for many years to achieve your medical school dreams. Do not get sloppy in the final stretch. Have faith in your application and your abilities. Then develop a compelling letter to get to yes!

Casey Paton, BS, MA, is a first year medical student at the University of Rochester School of Medicine. She graduated from Cornell University in 2015 ...
  • K
    Kayla Callender
  • September 24, 2018
Thank you for touching on this crucial part in the medical school application process. Great tips to know ahead of time.
  • J
  • November 21, 2018
Hello, thank you very much for these comments and tips. I was wondering, however, how should the update letter be formatted. I'm trying to submit an update about a poster presentation. I don't know if I should wait longer to submit it along with a letter of interest, but for now that is my main update and some schools just want me to add updates directly into their portals without any word or pdf format. Some other schools require a pdf. Should I just bluntly say I did a poster presentation in a single paragraph including what it was about? I was just worried it would not sound very personal.
Thank you very much !
    Thanks for reading Jose! You’ll have better luck getting answers to your questions if you post them in the pre-medical forums here: