2023 AACOMAS Letters of Recommendation Guide


AACOMAS letters of recommendation are essential to successfully matriculating into osteopathic medical school. Neglecting the importance of these letters will do you absolutely no favors, as a poor or even lukewarm letter of recommendation could mean the difference between acceptance and rejection.

This post will cover AACOMAS letters of recommendation, including what makes AACOMAS letters different, strategies for acquiring the best letters, and how to submit through Letters by Liaison.

Not sure what application type you need to submit? Read our guide to AMCAS vs. AACOMAS vs. TMDSAS Med School Application Differences to find out how the three application services compare.


What is a Medical School Letter of Recommendation?

For both allopathic (MD) and osteopathic (DO) medical schools, letters of recommendation (or letters of evaluation) provide a respected professional’s unbiased opinion of your skills, work ethic, and ability to succeed in the grueling reality that is medical school. A quality letter from a reputable professor from an academic institution or a medical professional you worked with carries a lot of weight with admissions committees.

A letter of recommendation is a medical professional’s impartial summary of your unique abilities, so they have a significant impact on admissions committees.

While personal statements are also a vital piece of your application, it could be argued that letters of recommendation are even more important, as personal statements are inherently biased.

Personal statements are your chance to sell yourself to an admissions committee and paint yourself in the best light, whereas letters of recommendation are impartial evaluations written by respected professionals. This means that as great as you make yourself sound in your personal statement, an admissions committee will very likely take their colleague’s word over yours.

Want to know what admissions committees are looking for from a AACOMAS personal statement? Read our AACOMAS Personal Statement Guide.


The Anatomy of a AACOMAS Application

At the start of May every year, the AACOMAS application opens. Around the middle of June, you will be able to submit your application. Do not procrastinate. Submit your application as soon as possible, as rolling admissions mean your chances of acceptance decrease the later you submit. Stay on top of your deadlines—it could be the difference between being accepted to medical school or being rejected.

Regardless of what the technical submission deadlines are, complete your primary and secondary applications long before the actual deadline rolls around.

Our timeline below includes both possible and ideal schedules.

AACOMAS Medical School Application Timeline

Your letters of recommendation are only one piece of your primary application. In order to submit a successful application, you must work on multiple application components at once.

  • GPA and MCAT Score
  • Personal Statement
  • Letters of Evaluation (also called Letters of Recommendation)
  • Experiences and Achievements Section
  • Mini Essays
  • Depending on the schools you apply to, you may also be required to take a Casper test.

Read our complete AACOMAS Application Guide For DO Schools for more information about the other application components.


What Makes AACOMAS Letters Different?

AACOMAS letters of recommendation are essentially the same as AMCAS letters, the only real differences being that you can only submit a maximum of six evaluations (as opposed to ten for AMCAS), and at least one of your evaluations must be written by a DO.

It’s important to find out how many letters are required by the specific programs you’re applying to. Many DO programs have strict guidelines around submitting letters, and requirements vary from school to school. Take care to check with each of the osteopathic medical schools you’re applying to before you submit your letters.

For the most part, you’ll be set with four or five strong letters of recommendation across science, non-science, and extracurriculars, but you need a minimum of two for AACOMAS applications.

AACOMAS Letters of Recommendation:

  • 2-6 total letters of recommendation (we recommend 4-5)
  • 1-2 letters from science professors
  • 1 letter from a non-science professor
  • 1-2 letters from your extracurricular pursuits, most commonly DO research and clinical experience.
  • 1 letter from an employer
  • 1 of these letters MUST be written by a DO

If you wish to submit more than six letters, you will need to send those additional recommendations directly to the programs if the program allows it.

If you want to submit a letter packet or committee letter, you must enter the committee chair (or their alternate) as the evaluator. The committee chair will then be required to complete the ratings section and upload one letter, which will include assessments from a variety of committee members, via Letters by Liaison (the AACOMAS Recommender Portal.)

A committee letter only counts as one evaluation, and you cannot ask anyone who contributed to the letter for a separate evaluation.


AACOMAS Letters of Recommendation Strategies

Envelopes and Letters of Recommendation Guide

1 | Begin Developing Relationships Early

Who you ask for a letter of evaluation can make all the difference, so approach relationships with mentors and professors with the idea that they could one day be one of your evaluators.

Relationships take time to build. Begin to cultivate these relationships with potential mentors or professors as soon as possible. To ensure you are communicating with them on a regular but not pushy basis, create a calendar to mark down when you last checked in with them and when you should again.

Share your goals and accomplishments with your potential evaluators so that they can see the progress you’re making. Express gratitude and always be ready to help them in whatever way you can, as relationships are a two-way street.

One of the best ways to meet with professors is to attend office hours. Don’t just sit there and hope for the best; prepare some intelligent questions about the class to engage the professor. Keep things professional and polite. Take great care to schedule virtual meetings if you cannot meet in person.

2 | Ensure You Have at Least One DO Letter

You need to have some osteopathic extracurricular experience in order to be a competitive applicant. MD exposure, as well as research and clinical experience, is still beneficial, but you must have some direct experience with osteopathic medicine.

You cannot successfully apply to AACOMAS without a letter of recommendation from an osteopathic doctor (DO).

If you plan on becoming an osteopath from the get-go, securing an evaluation from an osteopathic professional should be easy, as you will be in regular contact with them. But if you’re still choosing between allopathic and osteopathic medicine, it’s important to involve yourself in the osteopathic community and seek out osteopathic research or clinical experiences.

Get involved in osteopathic pursuits and make sure to engage with the professor or supervisor on a regular basis. Volunteer, ask intelligent questions, and show an active interest in osteopathy. Once you have developed a friendly rapport and feel confident that they hold you in high esteem, ask them for a letter of evaluation.

3 | Prioritize Strong Letters

This point cannot be emphasized enough: you need strong letters. Anything else is a waste of time for both you and your evaluator.

If you scored under an A- in a professor’s class or don’t know them very well, do not ask that person for a letter. It is vital that you ask someone who has worked closely with you, knows you well, likes you, and thinks highly of your skills.

If the person you ask shows any signs of hesitation, find someone else. Their hesitation could indicate they don’t have positive things to say about you, they don’t know you very well, or they don’t have the time to write you an effective letter.

Whatever the cause of their hesitation, do not pursue it any further. A lukewarm or late letter could severely hinder your chances of acceptance.

Learn more about How to Get Strong Medical School Letters of Recommendation.

4 | Make the Process as Smooth as Possible

Let your evaluators know that they will be completing the evaluation electronically via Letters by Liaison, the AACOMAS Recommender Portal. They will receive the invitation to complete the evaluation by email, so ask them for their preferred email address and ask them to keep a close eye on their inbox (and spam and junk folders) for your evaluation request. It will be sent from [email protected], unless you choose a different portal, such as Interfolio.

Your evaluators are busy, and they’re likely writing a few letters for your classmates as well. Do everything you can to make the process as smooth as possible by including all the details and instructions they need upfront and by providing them with a deadline—a deadline that’s long before your actual submission deadline. The greatest evaluation in the world won’t matter if it’s late.

Give your evaluators as much time as possible. We recommend two-three months. Set a reminder for yourself to check in with them two weeks before the due date.

For more tips, read our advice on How to Ask For Medical School Letters of Recommendation.


How to Submit Letters of Recommendation to AACOMAS

AACOMAS recommends you submit the letters of recommendation through the Letters by Liaison portal, but it’s also possible to submit them through Interfolio, VirtualEvals, and the US Mail.

Letters must be submitted by the evaluators themselves. After asking for an evaluation either in person or over email and going over the details of the submission process, you will need to electronically request an evaluation.

Your selected letter writers will receive a request that they can either accept, complete, or deny.

The Letters by Liaison instructions are as follows:

  1. In the Evaluations section, click Create Evaluation Request.
  2. Select whether you requested a committee evaluation.
  3. Enter the evaluator’s full name and email address.
  4. Select the date you would like this evaluation completed by. This date should be at least two months before your program(s) deadline.
  5. Enter a brief message or note for the evaluator.
  6. Select whether you want to waive your right of access to the evaluation. (More on the below.)
  7. Click the checkboxes to indicate your permission to contact your evaluators.
  8. Click Save This Evaluation Request to submit it. Once you do, an email is immediately sent to the evaluator.
  9. Confirm that your evaluators received the email notification.
  10. Use the Check Status tab to monitor the status of your evaluations.

If you see an evaluation is still marked as “Requested” or “Accepted, be sure to contact your letter writer to ensure that evaluations are completed on time. This is your responsibility, as AACOMAS will not notify you about missing evaluations.

The Family Education Rights and Privacy Act of 1974 (FERPA) gives you the right to access your letters of evaluation, but you may also choose to waive those rights. You are asked whether or not you want to waive your rights before requesting any evaluations. Your choice will be passed on by AACOMAS to your evaluators as well as the programs you’re applying to. Whatever you choose, the waiver is considered a legal signature and is binding.

If you choose Yes, it means you waive your rights, and you will not be able to see your letters. According to AACOMAS, programs may consider your evaluations to be more accurate if you haven’t seen them.

If you choose No, you may ask your evaluator for a copy of the letter, but you still cannot access it via your application. Programs may consider your evaluations to be less accurate if you do not waive your right and choose to view your letters.

Take every advantage you can when it comes to your application. It’s in your best interest to waive your rights to show admissions committees you feel confident in your letter writers.


AACOMAS Letters of Recommendation Interfolio

While AACOMAS recommends using the Letters by Liaison portal, Interfolio is another option for submitting your letters of evaluation. Interfolio allows you to request letters of recommendation that will go to multiple applications services.

If you are applying through multiple different services, for example, if you’re applying through both AACOMAS and AMCAS, AACOMAS and TMDSAS, or all three, then Interfolio is a good option.

Learn how to use Interfolio.

It’s also possible to request your letters of recommendation through VirtualEvals and the US Mail.


Ensure Your AACOMAS Application Stands Out

Med School Insiders will help you curate an ideal selection of strong letters. We offer a range of Comprehensive Medical School Admissions Packages that will pair you with physicians who will guide you every step of the way.

We are committed to creating a generation of happier, healthier, and more effective future doctors. We can help with every aspect of your application, from MCAT tutoring to mock interviews to secondary editing to student advising. Our team is made of doctors who have years of experience serving on both MD and DO admissions committees, so you’ll receive key insights into the selection process.


This Post Has 3 Comments

  1. Zz


    Where are you getting the information that 1 LOR must be from a D.O.?

    The websites for most D.O. schools say that they do not require a D.O. to submit an LOR. It can be an M.D. Some of them do prefer a D.O. but say an M.D. is fine.

  2. DD

    how does a committee letter with 5 writers count as one…does that mean then that you still have to get 2 more? seems crazy

  3. Lynnzie

    Hi! What do you do after all your letters of rec are in AACOMAS? I am trying to chose which letters to send to each school but I don’t know how to send these to the specific schools? Any help is much appreciated!

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