How to Choose Medical School Letters of Recommendation Writers

Your personal statement tells admissions committees who you are in your own words. Letters of recommendation tell them who you are when you’re not in the room. That distinction matters more than most premeds realize.

A strong letter from someone who knows you well and can speak specifically to your abilities carries real weight with admissions committees. A lukewarm one, even from a prestigious name, can sink an otherwise competitive application. The goal isn’t to collect letters. It’s to collect the right ones.

How you choose your letter writers, and how early you start building those relationships, will determine whether your letters help you or hurt you.

Understanding Letters of Recommendation/Evaluation

Medical school letters of recommendation have evolved significantly over the years. What was once a simple “stamp of approval” from a few teachers has transformed into a comprehensive letter of evaluation (LOE), a more expansive assessment that aligns with the holistic review approach now used by most medical schools.

This shift reflects how medical schools now think about admissions. Rather than simply confirming you were a good student, letters of evaluation are designed to demonstrate whether you possess the core competencies required to succeed in medical school, residency, and beyond. Admissions committees want to see evidence of qualities like critical thinking, communication skills, empathy, professionalism, and resilience—not just good grades.

The AAMC has developed specific guidelines to help letter writers craft effective evaluations. These guidelines encourage writers to provide concrete examples of how the student has demonstrated the competencies medical schools seek. While you won’t be writing the letters yourself, understanding this framework can help you choose letter writers who have observed you in situations where these qualities shine through.

Sharing the AAMC’s Guidelines for Writing a Letter of Evaluation for a Medical School Applicant with your letter writers ensures they understand what medical schools are looking for and can structure their letters accordingly.

With this context in mind, let’s explore the key criteria for choosing the right letter writers for your application.

How to Choose Medical School Recommendation Writers

There are a number of aspects to consider when choosing your letter writers, and some factors are more important than others. Use the following criteria to maximize your chances of success.

1 | Will They Provide a STRONG Letter?

Whether or not the letter writer will provide a strong letter of recommendation is the most important criterion to consider.

You NEED strong letters. Anything less is not worth including, as it will only hurt your chances.

While it can be enticing to choose someone who has excellent prestige, don’t do this at the expense of getting a strong letter. If the writer doesn’t know you, how can they authentically speak to your strengths? Proving that a big name in medicine knows who you are and can confirm your existence in their class doesn’t provide an admissions committee with any information—it merely suggests a bit of shallowness and short-sightedness on your part.

Choose writers who know you well and are extremely confident in your abilities. This is why it’s so important to start this process early: to secure strong letters, you need to develop strong relationships—and this takes time.

Be polite but professional with your professors and mentors. Seek their advice and engage them in conversation. Demonstrate your vast interest and commitment to medicine. Once you feel you have developed a strong bond, it’s a good idea to ask them if they will write you a strong letter. They have been through this process too, and they have likely written dozens of letters of recommendation for other students. They will know what you’re looking for.

2 | Do You Have Your Bases Covered?

The number of letters you need will vary depending on the medical schools you’re applying to. Generally, for AMCAS, it’s ideal to acquire 4-5 strong letters of recommendation, but it’s important to check each school to ensure you know what they expect.

Your letters of recommendation should include:

• 3 academic letters written by undergraduate professors. 2 of those letters should be written by science professors, and 1 should be written by a non-science professor.
• 1-2 letters from your extracurriculars. Generally, these letters come from professionals you worked with during your research and clinical experiences.

Shoot for quality over quantity. Having fewer strong letters is always better than a large number of mediocre letters. A few qualified professionals saying you’re great is a lot better than several professionals offering a collective shrug.

Committee Letters vs. Individual Letters

If your undergraduate institution has a premedical advising committee, you may have the option—or requirement—to submit a committee letter instead of individual letters.

A committee letter is a single, comprehensive evaluation authored by your premedical committee or prehealth advisor that represents your institution’s official evaluation of you as a medical school candidate. Committee letters may include a cover letter along with individual letters from professors and mentors compiled into one packet, or they may be a standalone evaluation based on an interview with the committee.

Should you get a committee letter?

• If your school offers a committee letter and the medical schools you’re applying to accept them, it’s generally recommended to pursue one.
• Some schools view the absence of a committee letter as a red flag if your institution offers one.
• A committee letter typically counts as one letter entry in AMCAS, even if it includes multiple individual letters.
• Committee letters demonstrate that you’ve engaged with your institution’s advising resources.

Start the committee letter process early, as many schools have specific deadlines and requirements, such as attending workshops, submitting materials, or completing a committee interview. These deadlines are often months before you plan to submit your application.

If your school doesn’t offer a committee letter, don’t worry. Most applicants submit individual letters, and medical schools are accustomed to reviewing applications with either format.

How to check requirements:

• Review each school’s admissions website.
• Consult the AAMC’s Medical School Admission Requirements (MSAR) database.
• Contact schools directly if requirements are unclear.

Don’t assume all schools have identical requirements. Taking the time to research ensures you submit exactly what each school expects and avoid any surprises that could delay your application or hurt your chances.

3 | How Well Do They Know You?

It’s crucial that your letter writers know you very well. If they don’t know intimately why you’re qualified to be a strong medical student and doctor, they cannot speak to your strengths and unique personal qualities authentically.

If you choose a letter writer you have barely spoken to, they won’t have anything interesting to say. A perfunctory confirmation of your student status is useless to an admissions committee and boring to read. In other words, it’s a complete waste of their time.

Choose someone who knows you well and can speak to your unique characteristics and strengths. This will help ensure you receive a strong letter.

Now, getting to know your professors and mentors well is easier said than done. Since most students take classes alongside 300+ hopeful premeds, it’s necessary to attend office hours to secure strong letters from your professors. Come prepared with intelligent questions and topics to discuss. Demonstrate your interest and engage the professor with intriguing topics to help yourself stand out.

When it comes to extracurricular letters, developing relationships with research, clinical, or other mentors is a bit easier, as you will have more individual interactions with these mentors. But don’t take this for granted. Make the most of each interaction; be engaging and polite, but professional.

The best letters of recommendation are written by professionals who can speak specifically to their relationship with you and their interactions with you. A strong, personal, and specific letter is best, so work on developing your relationships as soon as possible.

It’s also essential to aim for diverse perspectives.

Beyond meeting the basic science and non-science requirements, aim to showcase different dimensions of your qualifications through your letter writers. The strongest applications include letters that collectively demonstrate:

• Academic rigor and intellectual curiosity (from professors)
• Research skills and scientific thinking (from research mentors or PIs)
• Clinical aptitude and patient interaction (from physicians you shadowed or clinical supervisors)
• Leadership and teamwork (from volunteer coordinators or extracurricular advisors)
• Professional maturity and work ethic (from employers, for non-traditional students)

Rather than having three professors all comment on your excellent exam scores, strategically choose letter writers who can each speak to different strengths. For example, one professor might highlight your analytical thinking in class discussions, a research mentor might emphasize your perseverance and problem-solving skills, and a physician might discuss your empathy and professionalism with patients.

This diversity paints a more complete picture of who you are as a candidate and demonstrates that multiple people across different contexts have witnessed your potential to become an excellent physician.

4 | Do They Have a Positive Impression of You?

This may seem like a no-brainer, but it’s crucial that your letter writer likes and respects you.

What is their opinion of you? Do they have positive memories of you? Can they speak highly of you? Think long and hard. Did you do anything that might have left a sour memory or bad impression?

For example, consider the grades you received in their class. If you got below an A- in the professor’s class, they are not the right person to ask. The professor has almost certainly already received numerous requests for a letter of recommendation, and you will be at a significant disadvantage if your academic performance falls below that of other interested students.

Seek out letter writers who gave you excellent marks and who seem to enjoy the conversations they have with you. The more confidence they have in you and your abilities, the stronger your letter of recommendation will be.

It’s also possible that your letter writer may ask you to write your own letter of recommendation, and then they will sign it.

If this happens, remember that it’s still a win. The person is saying yes to supporting your application; you just need to do the legwork. This situation actually offers some advantages: you can ensure the letter is strong, control the narrative to fill gaps in your application, and highlight specific qualities.

When writing your own letter, avoid being too humble while also avoiding exaggerations. Provide specific examples that demonstrate your skills and qualities rather than just listing them. Most importantly, write in the recommender’s voice—consider their background, your relationship, and how they would authentically speak to your strengths. The letter should be approximately one page long and sound natural, not generic.

After drafting the letter, proofread carefully for any errors, then submit it to your recommender for their review and signature. They will read it over before submitting, so make sure it accurately represents their perspective.

5 | Are They an Authority in Their Field of Study?

This is an important consideration, but not quite as important as you may think. It’s ideal if your letter writer is widely considered to be an authority in their field of study, but always opt for someone who knows you well first.

A letter from a doctor with a prestigious reputation will carry more weight and make a larger impression on admissions committee members, but it’s much more important that your letter writer knows you intimately and can provide you with a strong recommendation.

Having a ‘big name’ write one of your letters definitely gives you a leg up over your competition, but not if the letter itself is mediocre. If a ‘big name’ has a lukewarm impression of you and writes you a lackluster letter of recommendation, your attempt will backfire, and it could seriously hinder your chances of acceptance.

6 | Do They Understand the Medical School Application Process?

Choose letter writers who understand the medical school application process to ensure they know exactly what’s expected. These writers will already be familiar with the submission portal, and they’ll know what medical schools are looking for in a letter of recommendation.

Choosing someone without this intimate understanding or who doesn’t know what a ‘strong’ letter of recommendation is could mean your letter lacks important characteristics. It could also mean your letter is late. Ensure your letter writers understand the application process and what should be included in the letter of recommendation before you choose them.

7 | Are They Available and Reliable?

Can you count on them to get you your letter in time and to submit it through the proper portal? The proper portals for allopathic medical schools are the AMCAS Letter Service and Interfolio. A great letter that isn’t ready in time won’t do you any good, so choose letter writers you know you can count on.

It’s a good idea to make the process as easy as possible for them. Provide all the necessary materials so that writing and submitting the letter is easy and straightforward.

Letter of recommendation materials to include:

1. Submission instructions (including your AAMC ID and their personal Letter ID)
2. Updated CV (a comprehensive CV—not a resume)
3. Academic transcript
4. Personal statement (if you have it available)
5. MCAT score
6. Submission deadline
7. The AAMC’s guidelines for writing a letter of evaluation

Provide your letter writers with a clear deadline that’s long before your own application deadline. We recommend two to three months. Set a reminder 2 weeks before the due date. Be flexible and accommodate your letter writer’s schedule.

It’s also a good idea to have backup options available in case anything falls through. Your letter writers lead busy lives and are most likely writing several other letters of recommendation, so don’t leave anything up to chance. If your letter writer hesitates or implies they don’t have enough time, move on. They are signaling to you that they are not the best option, either because they know they don’t have the time or because they don’t have anything strong to say about you.

Get Started Early

Building strong relationships and choosing the best letter writers for your application is a tough skill to master. To make an impact, begin developing strong relationships early on. These relationships will be the foundation for your letter-writer requests. Carefully consider your options to determine who can provide the strongest letters possible.

And keep in mind that a strong letter won’t do you any good if it’s late. Don’t leave your acceptance up to chance. Our Medical School Application Timeline and Monthly Schedule outlines the timeline you should follow, including key dates and an ideal preparation schedule. We break things down by the due dates for each aspect of your application, as well as what you should be working on each month as you prepare for and navigate the application process.