A Strategic Guide to Letters of Recommendation

Last Updated on July 3, 2024 by Laura Turner

Whether it is an internship or a graduate school application, letters of recommendation are generally expected or required for all applicants to affirm your fit with the program and potential as a professional.  Here are some strategic considerations for letters of recommendation as you prepare for your future application.

1. Does your institution offer a letter dossier/collection service? 

If so, find out how you can create an account, how much it costs, and how long you can keep this account to collect letters of recommendation.  Also see if the service only collects letters for your application to a health professional school or will also collect letters for a summer research program or clinical internship.

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In general, most schools that have a dossier service have contracted with Interfolio, the clear leader in this field for decades.  You may consider setting up an account for yourself, especially if you are at a community college or are likely to attend multiple academic institutions prior to going to professional school.

2. Does your institution offer a committee letter?

Committee letters (as detailed in a previous deep dive article) are a package of recommendations from an institutional pre-health committee. Different schools offer differing forms of this packaging of reference letters, so check with your institution to find out if they offer a committee letter and if so, what type.

3. Make connections with professors and advisors. 

As a future healthcare provider, there are several types of references you need: science professors, non-science professors (especially in humanities or social sciences), work supervisors, healthcare professionals, or academic/pre-health advisors.

If you are just starting out as a first-year student (community college or undergraduate), know that there are some summer clinical enrichment or research opportunities available, and those applications need at least one letter of recommendation from a professor or an academic advisor.

4. Find out upfront what is needed for a strong letter of recommendation 

It is awkward when, after several weeks of class or lab work, you ask for a letter of recommendation, and the reference waivers or says no.  Make it clear at the start that you are interested in a health professional career and ultimately need a letter of recommendation; what expectations do you have to write a supportive letter?  

5. Understand FERPA rights and why you waive your rights to inspect the letter from your professors or academic advisors. 

The Family Educational Rights and Privacy Act, or FERPA, governs the privacy of educational records from the institution (similarly to how HIPAA governs health information), so you should understand when and why you should waive your rights.  Every academic advisor should be able to give you basic information about this.

6. Know what letters you need before starting the application process, and make sure they are all there when you submit your application. 

As part of the process of selecting schools, make sure you know what each school requires and make sure you meet their requirements.  How many professor letters are required from each of your preferred schools, and is there a specific breakdown (science/math, social science, etc.)? Do your programs want a health professional letter (such as a DO letter for osteopathic programs)?

7. Don’t wait until the last moment to ask for letters of recommendation. 

Give your references a timeline on when they need to have their letters of recommendation ready.  Make sure they can write their letters on branded letterhead with a proper signature for the best professional look to reflect well upon your application.  If they are unable to write letters of recommendation on branded letterhead due to policy (such as for government agencies), they should disclose this information either in the header of their letter or as a footnote.

8. Ask the schools how letters of recommendation are involved in screening. 

Must all the required letters be received to be considered for an invitation to interview, or should they all be received before receiving a post-interview decision?  How will you be notified if you are missing a required letter of recommendation?  How do you handle applicants whose institution’s letter arrives in September?  Getting some answers to these process questions can help you understand the awkward silences that could occur between submission and a possible invitation letter.


Navigating the complex process of acquiring strong letters of recommendation requires early planning, clear communication, and an understanding of institutional policies. By following these guidelines, you’ll position yourself as a strong candidate backed by credible endorsements, highlighting your readiness for the next steps in your professional or academic aspirations.

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