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Letters of Recommendations

A Complete Guide to Medical School Letters of Recommendations

By Lauren Druml

Applying to medical school is a competitive process, and medical schools will expect that you have an in depth relationship with your chosen letter writers.  A generic letter won’t cut it.  Having a great recommendation (as opposed to a mediocre one) from a respectable source can make all the difference. But not to fear! Here’s the good news: contrary to what you may think, recommendation letters are completely in your control. And in this article, my aim is to supply you with the tools and wisdom necessary to ensure your recommendation letters for medical school are the best they can be.  


Keep in mind that your letter writer needs to really know you. You want to choose someone who can offer you a detailed, personalized letter of support with anecdotes and specific examples supporting what they say about you and how you may have represented yourself in an application [4].


Potential Letter Writers

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You have plenty of sources for a great recommendation letter, but as a general rule, schools expect to see some of your letters from one or more of the following:


  • A professor from your major field of study [1]

  • Your undergraduate committee or advisor [1]

  • Your research advisor, if you have conducted academic research [1]

  • Your supervisor if you are currently employed [1]


Any of the above must be a successful leader, researcher, or scholar with an excellent academic or professional reputation [2].  Many students wonder how important the title is of their recommender.  The most important thing here is to veer away from the extremes.  According to a research study, “Medical schools are looking for appraisal from people with extensive experience in the field; in academia this is tenured faculty”[2].  And by all means, veer away from asking for recommendations from individuals with high positions or titles that hardly know you at all. You don’t need a Nobel Prize winner!  


In addition to the expected sources above, other potential sources for a recommendation letter include:


  • Physicians you have volunteered for

  • Supervisors/managers of places where you volunteered or interned (clinical settings favorable)

  • Researchers you may have worked under, outside of school

  • Mentors who guided you along your medical journey


These individuals can likely speak to your leadership skills, humanitarian outreach, and responsible qualities.


Who NOT to Ask

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It is important to recognize that you should NOT ask for letters from certain types of people.  This list includes: friends, school alumni, family, clergymen, politicians, and (despite what most students think) teaching assistants or research assistants [1].  Often, the most surprising of this “Do Not” list is the inclusion of TA’s and RA’s since students often get the closest to these individuals.  Do not ask for a letter from a TA or RA with absolutely no title or credibility; these recommenders simply won’t be regarded with the same seriousness as distinguished faculty or very accomplished persons.  


Where to Find a Recommender

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In the classroom, the best place to get to know a professor is through office hour visits.  Once a professor gets to know you, it becomes much easier to encourage the type of recommendation letters that today’s competitive medical schools are looking for.


Outside of the classroom, just be active and get involved!  Attend events, volunteer, join clubs and assume leadership positions.  By doing so, you will consistently put yourself in positions where you may stumble upon an accomplished individual who will willingly write you an outstanding letter in the future.  


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In some cases, obtaining a recommendation letter is simply a matter of asking.  For instance, obtaining a letter from a supervisor you worked under does not require much strategy since he/she will likely already be familiar with you and your work habits.  In other cases though, it will be necessary for you to make an extra effort to reach out to an individual you may want a letter from.  For instance, obtaining a letter from a professor requires extra effort on your part. During my time as a student at a large public university, often feeling like just another number, recommendation letters from professors seemed out of reach.  After all, it is tremendously difficult to gain the attention and admiration of a professor in a large classroom setting like the 600 person lecture halls I was accustomed to.  If you are going to be looking for a letter from a professor, you will want one from someone whom you connect with and admire.  Here are some ideas for getting to know him or her on a more personal level:  


  • Attend frequent office hours (weekly if possible)

  • Invite professors to student-faculty lunches often hosted by various student organizations and clubs

  • Take more than one class from a professor who may be willing to write a recommendation letter on your behalf

  • Get involved in research with your professor of choice if possible


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Overall, you want to think of the image you want to put forward, and convey that image to your letter writer. The type of person who you want to write you a letter should have worked closely with you in an academic or professional environment and regard you as a talented candidate with incredible potential. When you do have a letter writer in mind, be sure to convey your image consistently so that the letter writer would have an easy time describing exactly who you are.


Timing is Everything

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Once you’ve established contacts and developed relationships with some of those who you want to write a letter, it is important to remember to keep them updated so they won’t forget you! Often when getting to know professors, it is crucial to leave a lasting impression, and in order to do so, you sometimes have to think outside the box.


Asking for the Letter

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Once you have a good idea of whom you would like to ask to write you a letter of recommendation, you will be on to the easy part:  actually asking for the recommendation letter!  The biggest point to emphasize here is that you do not just want to ask for a letter [3]. You need to ask for a positive letter, and the way you phrase your request is absolutely crucial.  The ideal “flow” of a meeting with a potential recommender should go as follows:


First, explain that you are applying to medical school and provide some background of how you got to this point in your life.  Talk about why are you a good fit for medical school.  Sell yourself.  Then say something like, “Would you feel confident providing a positive letter of recommendation for me?” [3]  The great thing about phrasing the question this way is that you will most likely get a very honest response, and if the recommender agrees, then he or she will be committed to writing you a positive letter!


When to Ask

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Recommendation letters are stressful.  This is not something you want to procrastinate on.  Get your letter writers to commit ASAP and be sure to follow up frequently so you know your letter writers are doing their job.  With the busy schedules they likely have, some may need reminding every once in a while.  If you ever feel concerned about the progress of your letter, you can send friendly emails or even meet with your letter writer in person asking if they need assistance or have any questions about their task.  You can even send an early thank you note or gift that may also function as a reminder! [4]       


What to Give Your Recommenders

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When someone commits to being your letter writer, you want the process to be as smooth for him or her as possible.  In order to aid the process, assemble a well-organized packet/binder/folder with all the necessary materials.  The following things should be included:

  1. Resume

  2. Transcript

  3. Personal Statement for medical school or past essay questions

  4. Bullet points of what you would like your recommender to include in your letter

  5. Instructions for submitting the recommendation letter and deadlines

  6. List of schools you will be applying to


Other things to include if applicable include: writing samples, personal website address, artwork, photos, or videos.  Essentially, add anything to your packet that you think will offer: clarification, relevant information, or a deeper perspective on who you are as a whole person.


What Admissions Committees Are Looking For:

In “What to Give Your Recommenders”, I stated you should give your recommender a bullet point list of what you would like him or her to say about you.  A lot of pre-meds feel lost at this point, so here is a start!  Make sure your letter writer addresses the following points:


  • Length of time they have known you

  • Relationship to applicant

  • Qualities they have seen in you as a person

  • Specific academic and professional experiences they have shared with you [1]

  • Your unique traits that aren’t covered anywhere else in the application [2]

  • Your demonstrated commitment to pursuing a medical career [1]

  • How you compare to other candidates with similar aspirations [1]

  • Your overall qualifications as a future doctor. [1]


Good vs. Bad Letters

In a recent research study, six real medical school recommendation letters were examined and ranked based on how helpful the letters were and how in line they were with what admissions officers were looking for.  The findings:


Bad Letters and least helpful information:

As discussed earlier in this article, it is crucial to get a letter from someone who knows you well and can attest to your positive personal qualities.  Thus, medical schools in this research study indicated that the “poor letters” were written by individuals who clearly did not know the candidate well.  Here were some of the other most common mistakes:


  • Discussion “revolved around laboratory techniques", "lab skills" and
    scientific knowledge in a narrow area". [2]  

  • The letter "shed no light on applicant’s personal or humane qualities". [2]


Admissions participants in the study stated that least helpful information provided in letters included:


  • Repetition of information provided by the applicant [2]

  • "unsubstantiated superlatives" [2]

  • "vague generalities" [2]

  • Comments regarding grade earned in the class [2]

Good Letters and most helpful information:

On the other hand, across all schools the committee members liked to read descriptive and factual personal information written by faculty who knew the applicants well.  Thus, "good letters":


  • Demonstrated a "clear relationship" between evaluator and the candidate. [2]

  • Included a complete evaluation of candidates’ non-cognitive abilities and cited specific life experiences to support claims. [2]

  • Evaluated “motivational factors” for applying to medical school as well as “intellectual abilities.”  [2]

  • Clearly told something about the applicant deeper than credentials and accomplishments [2]


Admissions participants in the study stated that most helpful information provided in letters included:


  • Examples of behaviors "illustrating particular personal characteristics that were difficult to assess from the file or the medical school interview." [2]

  • Important personal characteristics: “integrity, honesty, reliability, professionalism, determination, leadership, judgment, and motivation for medicine." [2] These qualities shone through the best letters.  


Note: Although the committee members expressed little interest in grades in a particular class, most indicated interest in "summary comments and comparisons, either narrative or numerical, that helped them assess the applicant’s competitiveness with others in a the pool from that undergraduate institution.” [2]


Be Gracious

Without a doubt, preparing a recommendation letter is both time consuming and an inconvenience.  Therefore, by all means, say “thank you” by sending a personalized note to the individuals who wrote recommendation letters for you.  And remember to keep you recommenders updated.  They would love to know your progress!



  1. “45 Medical School Recommendation Letters: That Made A Difference” by Dr. Nancy L. Nolan

  2. "Predicting Performance and Satisfaction: Beyond the Crystal Ball: Medical School Admission Committee Members' Evaluations of and Impressions from Recommendation Letters". Johnson, Mitzi; Elam, Carol; Edwards, Janine; Taylor, Douglas; Heldberg, Cynthia; Hinkley, Robert; Comeau, Roger

  3. “How To Ask For A Letter of Recommendation” by Daren C. Brabham Ph.D.

  4. SCOPE article: Medical Schools &Applications by Michael Davies