2022 Medical School Letters of Recommendation Guide


Medical school letters of recommendation are often under-appreciated. Not giving your letters the respect and attention they deserve is extremely detrimental to your application and could be the difference between being accepted or rejected.

Letters of recommendation are vital to an effective and successful medical school application. They provide a respected professional’s opinion of you, as opposed to your own claims or the opinion of a biased friend or relative. A quality letter from a professor at an academic institution or someone who works with students through extracurriculars holds a lot of weight.

Letters of recommendation offer an impartial summary of your unique skills from a qualified professional—so they have a big impact on admissions committees.

Learn why letters of recommendation are so important, how to ask, and common mistakes to avoid. In this post, we’ll cover the Why, Who, What, Where, When, and How of letters of recommendation.


Why Letters of Recommendation Are So Important

Letters of recommendation are a crucial piece of the medical school application. Some argue they’re even more important than the personal statement since the personal statement is naturally biased. After all, a personal statement is all about trying to paint yourself in the absolute best light.

Read our free Step-by-Step Guide: How to Write a Medical School Personal Statement for tips on getting started, what to include, and common mistakes to avoid.

On the other hand, letters of recommendation are written by respected professionals, such as mentors, professors, and physicians. An admissions committee is very likely going to take their word over yours. If the person you ask to write your letter of recommendation has worked closely with you and speaks very highly of you, it’s a big deal.

A negative letter of recommendation is a huge problem. A poor or lukewarm letter of recommendation could do irreparable harm to your application. You must approach this process in advance with plenty of organization, taking care to choose your letters wisely.


Who to Ask For Letters of Recommendation

You’ll need to include a total of four to five letters with your medical school application.

Three of these must be academic letters written by undergraduate professors—two science letters and one non-science letter. The two remaining letters are from your extracurriculars, typically research and clinical experience.

While it may be tempting to secure a respected, recognizable name to write your letters, it’s much more important that you choose someone who knows you well and thinks very highly of you. If you’ve only had a few conversations with the person you’re asking to write your letter, it won’t be effective. They simply won’t have that much to say about you and can’t offer much insight into who you really are.

Choose someone who can speak about your strengths on a deep level. The letter will have a much greater impact on the admissions committee.


What to Provide to Letter of Recommendation Writers

The people you’re asking to write a letter are busy with their own careers and lives. It’s up to you to make the process as smooth and simple as possible. In order to do so, there are a number of key pieces you need to provide.

  1. Submission instructions—Provide the writers of your letters of recommendation with all of the information they need to submit your letter to the submission service. Typically, this is the AMCAS Letter Service (for allopathic medical schools.) Your letter writer won’t be submitting the letter to you; they will need to submit it directly to the service. Provide your letter writer with a Letter Request Form, available in the Main Menu of the Letters of Evaluation section. This form is a PDF generated in the AMCAS application for each of your designated letter authors, and it includes your mailing address, AAMC ID, the Letter ID, and information about how to submit letters to AMCAS. The Letter ID is a unique seven-digit code assigned to each letter entry on your AMCAS application. It must be provided to each letter writer in order to correctly match their letter with the letter entry you created in your application.
  2. Updated CV—A comprehensive, organized, and professional summary of your academic, work, and extracurricular achievements to date. If you need any assistance crafting your CV, consider our advising services.
  3. Academic transcript.
  4. Personal Statement—If available. Ideally, you should have at least a first draft of your personal statement prepared by the time you request a letter, but you may ask for academic letters early in your undergrad. If you don’t have a draft yet, write a brief summary of the reasons you are pursuing medicine, including what makes you a unique and qualified candidate.
  5. MCAT score—This should be included in your CV, but it’s possible the letter writer will ask for a more verifiable source, such as a score printout. If you haven’t taken the MCAT, don’t delay asking for a letter just because you don’t have your MCAT score yet.
  6. Submission deadline—Include the date in writing, either through email or printed with the materials you provide to the letter writer. Make sure the date is at least a week in advance of when you actually need to submit the letter. We recommend giving letter writers six to eight weeks to complete a letter after receiving the materials listed above. This means it’s important to start the process two to three months before you plan to submit your application.
  7. A printed copy of materials—Even though the LOR submission process is completely digital, you may have letter writers who prefer to read and review physical materials. Ask them if they would like you to deliver or mail a printed packet of all of the above. It’s up to you to make this process as simple as possible for them and a crisp manila envelope with all of your materials and submission information is a nice touch for those less digitally inclined.


Where — Asking for Letters of Recommendation Virtually

Due to the COVID-19 pandemic, asking for a letter of recommendation in-person may not be possible, which means you will need to request a letter via email or possibly over Zoom, Skype, Microsoft Teams, and so on. While this may not feel as personal as you intended, all of us need to adapt to our new virtual world.

Virtual meetings are our new normal, so it’s important to cultivate relationships with potential letter writers and mentors online. A mentor could be someone you worked with, someone you met through a mutual contact, or you might find one through professional networks like LinkedIn.

For more advice on how to build relationships with mentors and letter writers online, read our article: Connecting with Mentors Over Zoom.


When to Ask For Letters of Recommendation

Start thinking about your letters of recommendation as soon as possible. It will take time to figure out who to ask and even longer to build strong relationships. If you have someone in mind, they may not have the time or feel they know you well enough, so make sure you have a backup plan and budget extra time in case a letter falls through.

Ask toward the end of your time working together or shortly after the conclusion of a class. Don’t wait months or years. You want the letter writer to have you on their mind so they can write a genuine letter full of fresh enthusiasm.


How to Ask For Letters of Recommendation

If you are requesting a letter of recommendation virtually, you can use our sample request template. Be sure to personalize the request with a sentence or two about your relationship. This could include involvement in their class/organization, the time you spent working together, what you enjoyed or learned, or how they inspired you.

1 | Think About Your Letters Well in Advance

Letters of recommendation can make or break your medical school application. Who you ask can make all the difference. Approach relationships with professors and mentors with the idea that they could potentially be one of your letters of recommendation.

2 | Work to Develop Strong Relationships

Relationships take time. Cultivate your relationships with professors and prospective mentors as soon as possible, and mark how often you check-in with them using a calendar. Share your goals and successes with them so they can clearly see your progress and watch you grow. Express gratitude, and be sure to help them in whatever way you can. Relationships are two-way streets, after all.

Since in-person office hours are more difficult due to COVID-19, be diligent about scheduling virtual meetings. You still need to build strong relationships even if you are unable to meet in person.

3 | Only Ask People Who Will Give You a Strong Letter

This is crucial. If you don’t know a professor all that well or scored anywhere under an A- in their class, do not ask that professor for a letter. Ask someone who you have worked with closely, knows you well, and thinks highly of you.

If the person you ask expresses any hesitation, don’t pursue the letter further. Their hesitation is a sign that they either don’t know you well enough, don’t have positive things to say, or simply don’t have the time. It’s better to catch that hesitation early on as opposed to ending up with a late or lukewarm letter.

More tips: How to Get Strong Medical School Letters of Recommendation.

4 | Make the Process as Simple as Possible

Provide all of the necessary materials to make writing and submitting the letter as smooth as possible. See what to provide in the above section, and ask them if they need anything else ahead of time.

5 | Provide a Deadline to Ensure You Receive Letters on Time

The best letter in the world won’t matter if it’s late. Provide a clear deadline to ensure you receive your letters on time.

Give your letter writers as much time as possible, as they are extremely busy and have likely received plenty of other requests. We recommend two-three months. Set a reminder two weeks out from the due date.

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


Common Mistakes to Avoid

Avoid the following common letter of recommendation mistakes.

  • Asking someone who doesn’t know you well.
  • Asking for a letter when you haven’t thoroughly prepared.
  • Forgetting to provide the writer with the necessary materials.
  • Asking people who don’t know you well enough to provide real insight into who you are.
  • Not obtaining a variety of letters across science, non-science, and extracurriculars.
  • Asking the professor of a class you scored below A- in.
  • Coming across as overly-friendly or unprofessional when asking for a letter.
  • Waiting too long after working with someone to ask for a letter.
  • Getting a letter from someone who was reluctant when you asked.
  • Not thinking about letters of recommendation early in your application preparation.


Letters of Recommendation FAQs

How many letters of recommendation do I need?

The medical school letter of recommendation requirements vary from school to school. Most schools require at least three letters, but some may ask for four or five. Make sure you check the specific requirements of each school you hope to apply to.

Since the number varies based on the school, we recommend all applicants plan to have four to five letters of recommendation spread across science professors, non-science professors, and extracurriculars.

How Many Letters of Recommendation for Medical School Are Required?

How do I submit letters of recommendation?

Your letter writers must submit their letter electronically through the AMCAS Letter Writer Application or Interfolio. You do not review or submit your own letters of recommendation.

You will need to provide each of your letter authors with submission information, including your AAMC ID, and a unique seven-digit Letter ID. Each letter writer will be assigned an individual Letter ID when you add them to your AMCAS application, which is needed in order to upload your letter(s).

If you are applying through multiple services, AMCAS, TMDSAS, AACOMAS, etc., Interfolio acts as a go-between so that writers only need to upload once. They will still need their unique seven-digit Letter ID for your letter to be matched to your application. There is a small yearly fee to use Interfolio’s Dossier Deliver service.

Letters submitted through either process will be marked as received—immediately with AMCAS, or within three days with Interfolio. Contact your letter writer and ask them to submit the letter again, if a letter is not marked as received by the deadline you provided.

When are letters of recommendation due?

Include your letters with your medical school application. You can also add letters of recommendation up until you submit your secondary application, though you shouldn’t procrastinate. They are a key piece of your application that shouldn’t be left to the last minute. It takes time to ask for letters, and you need to give the letter writer adequate time to complete it.

Secondary applications are due between July and January, but it’s best to submit yours, along with your letters, by the end of the summer.

Read our Medical School Application Timeline to ensure you plan ahead and don’t miss any important deadlines.

What if a letter writer doesn’t submit a recommendation?

If a letter is not marked as received through the electronic portal you are using, contact your letter writer and ask them to submit the letter again.

In rare circumstances, a letter writer may disappear or stop responding. They are people too, and emergencies happen. This is why it’s so important to have more letters planned than the bare minimum required for your application.

What if a potential letter writer says no?

If a potential letter writer says no, it means they do not feel they know you well enough, they’re already swamped with other requests, or they don’t have confidence in you. Whatever the reason, it’s important to move on and look for another option.

Even if they hesitate before saying yes, it may be better to find someone else. A poor or even lukewarm letter can jeopardize an otherwise excellent medical school application.

Who can write a letter besides professors?

You should have letters from two science professors and one non-science professor. In addition to professors, you may choose to ask a research PI or mentor, a physician you shadowed or worked closely with, or a volunteer activity supervisor.

You could also ask a TA or an employer for a letter of recommendation if they know you better than your other options. What’s most important is that you choose letter writers who know you very well and will speak highly of you.

Are extracurricular letters required?

While not required, we recommend securing letters of recommendation from extracurriculars that were particularly significant. This may include research mentors or principal investigators (PI), physicians that you shadowed, or leadership from other volunteer organizations. If appropriate, aim to secure a letter from each of your three most meaningful activities on your AMCAS.

Who shouldn’t give me a recommendation?

Don’t ask someone who is positively biased towards you, such as a friend or family member. Your letters should come from people who can provide an honest and impartial recommendation.

If the person you ask seems hesitant or unenthusiastic about submitting a letter of recommendation on your behalf, don’t push it; instead, find someone else. A poor or even neutral letter can jeopardize an otherwise excellent medical school application.

Can I add additional letters after I submit my application?

Yes, you can add additional letters after your application is submitted, but you cannot delete or change the letters your writers submit.

Although you can add letters of recommendation after submitting your application, we do not recommend it. Strong letters take time, so give your letter writers as much time as possible to compose thoughtful, detailed letters. You should choose four to five strong letter writers—having more won’t increase your chances, but it can dilute your positive recommendations with ones that aren’t as strong.

What types of letters does AMCAS accept?

AMCAS accepts Committee Letters, Letter Packets, and Individual Letters. Committee Letters are authored by a prehealth committee or prehealth advisor representing an evaluation of you by your institution. A Letter Packet is a set of letters assembled by your institution, often including a cover sheet from your prehealth committee or advisor. Individual Letters are written by, and represent, the opinions of one letter writer. All three letter types count as one letter entry.

Can I see my letter of recommendation?

Letters of recommendation are submitted confidentially, and you do not get to see them. Don’t ask letter writers what they have written, as they are under no obligation to show you. You should have absolute confidence that the person you ask knows you well and will speak highly of you.

How should I thank letter writers?

Don’t forget about your letter writers as soon as your application is submitted. Send a thank you email once they submit their letter and consider sending them a handwritten card by physical mail when you are accepted to medical school.


Get Help From Professionals

Med School Insiders offers Comprehensive Medical School Admissions Packages that will help you with every step of the application process. Our team of doctors has years of experience serving on admissions committees, so you’ll receive key insights from people who have been intimately involved with the selection process.

Read our Guide to Understanding the Medical School Application Process, which includes an application timeline, what you need to include in your application, mistakes to avoid, and what happens next.


Leave a Reply