FAQ: Medical School Letters of Recommendation

[WayOutWestMom]

The first thing to know is the letters required for admission to medical school are Letters of Evaluation, not Letters of Recommendation.

What’s the difference?

A letter of recommendation is an endorsement. It’s advocating on someone’s behalf, telling a med school, for example, why an individual would be a great addition to their class.

A letter of evaluation is a critical assessment of a candidate’s fitness for medical school. It analyzes the strengths and weaknesses of the individual based on specific criteria. It’s more objective than a recommendation. And it asks the letter writer to compare a med school candidate against other students in the same class and historically against all students the letter writer has met/taught over their career.

General guidelines for LOEs

Every single med school has its own specific requirements for LOEs, both in the number of letters allowed and from whom they must come.

This information will be available on the admissions webpage of each medical school, and in MSAR (Medical School Admission Requirements) for MD schools, and in Choose DO Explorer for DO schools.

MSAR is a database maintained by AMCAS that is updated annually that holds a wealth of information about every MD program in the country. Access to all the data is by subscription only. Cost for a 1 year subscription is $33.

Choose DO Explorer is the DO equivalent to the MSAR (but with less data). It’s free to use, but requires registering with AACOM.

Applicants must explicitly follow a med school’s directions on the number of LOEs and who writes them. Send too few letters or send letters from the wrong type of letter writer, then the application is considered incomplete and will never get reviewed. Send too many letters—the applicant has then demonstrated an inability to follow directions and will be rejected without ever being reviewed.

Generally speaking a medical school requires between 3 and 5 letters of evaluation for an application. AMCAS allows applicants to upload up to 10 LOEs to their application account. ACOMAS allows applicants to upload 6. Once a student has selected which medical schools they are going to apply to, they may assign which individual letters they want to be sent to each medical school. Only the assigned LOEs will be sent.

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[WayOutWestMom]

Who to ask for a LOE?

Most medical schools require LOEs from professors who have taught you in class. The most common requirement is 2 LOEs from science professors and 1 LOE from a non-science professor. Science LOE writers must have taught you in a class in one of BCPM disciplines: Biology, Chemistry, Physics or Math.

In addition to professor evaluations, osteopathic medical schools frequently require a letter from a physician with whom the applicant has shadowed, worked or volunteered. A few DO schools require this physician letter to be from an osteopathic physician. Please check the specific requirements for each DO school.

Requesting an LOE from a professor is a big ask. LOEs are not just a couple of paragraphs. A comprehensive LOE often runs to 1 to 2 pages in length and can take considerable time to produce. However, don’t feel that you are imposing on the professor; writing these types of letters is part of their job. They expect to be asked to provide recommendations and evaluations for their students.

So, who to ask? If you have a comfortable relationship with a professor– perhaps one you’ve taken more than one class with, or one whose office hours you regularly attended, or one you’ve often chatted with outside of class– you should ask them. Ask if they can write you a strong letter for you.

If you don’t have any professors who know you as someone other just a name to go with a face in a huge lecture, then consider asking a professor whose class you excelled in. A perfunctory letter is better than no letter.

Occasionally, a student may want to ask a graduate student or TA to write an LOE for them. This is acceptable, but not ideal. Any grad student/TA letter needs to be co-signed by the grad student’s supervising professor — the professor who is actually teaching the course.

Most LOEs are not amazing, make-or-break documents so don’t worry too much about a perfunctory or “meh” letter. A negative LOE, however, can kill an application.

MORAL: always ask a potential letter writer if they can write a strong, or, at least, a positive letter for you. If they say they can’t, it’s better to ask someone else.

Once a letter writer has agreed to provide a LOE, ask what you can do to make their job easier. Provide them with your CV that includes all your activities and honors Occasionally, a letter writer will ask a student for their med school personal statement. If they ask for it, give it to them.

AMCAS publishes Guidelines for Writing a Letter of Evaluation for a Medical School Applicant to help an LOE writer get started.

LOEs must be on academic letterhead and include the writer’s name, position at the university and contact information. Professors routinely include this information in their signature line.

BTW, medical schools do occasionally contact a letter writer to verify the information contained in their letter. (It’s called doing due diligence.)

What if my letter writer tells me just to write my own letter and they’ll sign it?

Yikes!!!

Unfortunately this does happen sometimes. It’s highly unethical for a student to write their own LOE. The reasons are obvious.

In this case, it’s better to ask someone else to be your evaluator.

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[WayOutWestMom]

When to ask for a LOE?

Timing can be tricky, especially for students who will not be applying to medical school during or immediately after their senior year of undergrad.

Medical schools very strongly prefer “fresh” (recently written) letters and some medical schools will not accept or strongly devalue letters that are more than 12 months old.

The easiest way to work around this obstacle is to ask for a LOE before one graduates and leaves campus. The student’s academic performance is still fresh in the professor’s mind and it will be easier for them to write the LOE.

In order to preserve the letter, the future applicant should subscribe to a third party secure document storage service, such as Interfolio. (Interfolio charges $59.95/year) The letter writer will upload their LOE to Interfolio where it will remain secure and confidential. The student will not be able to access the contents of the letter, but will be able to see when it has arrived. When it comes time to apply for medical school, the applicant should contact the original letter writer, ask if they are willing to “freshen” the letter by updating it with the current date. Most are happy to do so if you will send them the original LOE.

Another option for getting a current LOE is to ask a different set of people for letters. Some applicants take one or two science classes during their glide years specifically just to get a fresh LOE. Some medical schools may accept a LOE from non-professors if a student has been out of school for several years. Contact the Admission Office at each school to get specifics. Employment supervisors, military superior officers, and healthcare job or volunteer supervisors may be acceptable substitutes for professors.

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[WayOutWestMom]

The Committee Letter

Many colleges and universities have a Health Profession Advising Office that will provide a committee letter to undergrads applying for medical school.

If your school has a HP Office be sure to read and follow the directions they provide. They will have their own requirements for what type of LOEs they want and when those LOEs are due.

Some HP letters are “packet letters,” that is, the HP Office collects a student’s LOEs, and assembles them into a packet, adding a brief cover letter about the college or university, often along with a statement about grading policies.

Some HP committee letters are more detailed. These letters tend to be evaluative. The HP office will interview the student, ask to read their personal statement, ask for a copy of their transcript and their ECs, then confer among the staff to decide how to rank the student (against others who are applying from the school or have applied from the school in the past).

These types of HP letters typically rank students into 4 categories: Highly Recommend; Recommend; Recommend with Reservations; and Do Not Recommend. Generally, if a student falls into one of the two latter categories, the HP advisory committee will tell them and suggest they postpone applying to med school until the student can remediate any weaknesses the committee sees in their application.

These evaluative letters will list the students strengths and weaknesses and use excerpts from and summaries of the provided LOEs to illustrate their points. These evaluative letters will also provide context for a student’s achievements. For example, the committee letter will assure the reader that a B+ is an excellent grade from Professor Smith who only rarely awards As in his 250 person large lecture each semester and only 15-20 students get B+s. Or that Professor Wilson has only allowed one freshman student [the applicant] to enroll in her molecular biology seminar since she first started teaching it at NoName University.

In general, medical schools prefer committee LOEs over individual letters if the applicant’s undergrad offer a committee letter. (In fact, some secondary applications will require an applicant to explain why they don’t have a committee letter if their undergrad does offer them.)

[CottonTales]

This should be pinned as it is so important.

[WayOutWestMom]

It will be later today.