In addition to your AMCAS and secondary applications, one of the major components of MD and MD/PhD admissions are letters of recommendation. This can often be a confusing topic, as each college might have different formats for letters (individual, committee, packet, etc) and then each medical program might have different expectations as well. Thus, we decided to make a Q&A, so please feel free to skip around to whatever information you need as you apply!
- WHEN should I ask professors for letters of rec?
Refer to our timeline post here. AMCAS will open for submission towards the beginning of June. You want to do everything in your power to ensure that your entire application doesn’t get delayed due to missing letters. While most schools will still send you a secondary application even if your file is not complete yet, your application can never ultimately be considered for admission (and at almost all institutions, you cannot be interviewed) without the letters.
As always, I truly cannot over-emphasize my recommendation to just be as early as possible with these. I would like to share what I personally did with my letters, as I felt that this worked extremely well and helped me avoid delays.
I first spoke to my professors for letters of recommendation in mid-February of the year in which I applied. I asked them what documentation they would like from me to help them write, and I spent the next couple of weeks updating my resume or compiling any other information they requested. Each of my professors received what they needed to write my letter by early March.
Although I knew I could not submit AMCAS until June, I gave my recommenders a deadline of May 1. This proved critical when, as is VERY common, one of my recommenders did not have the letter in by the deadline. I was then able to gently contact him multiple times over the coming weeks so that the letter was submitted by mid-May, which was still plenty in advance of when it was needed.
- HOW should I ask professors for letters of rec?
One of the most important things is for you to ensure that you receive the most positive letters possible. If you are still in the early stages of your pre-medical career, this all begins by developing a strong relationship with your mentors!
In my case, I attended a liberal arts school where the professors all generally knew me well. However, even if you are at a larger state institution, programs will expect your letter writers to know you personally. This may involve some effort on your part; be sure to attend a professor’s office hours, to introduce yourself, and to find ways to stay in touch with certain professors. You of course want all of your interactions to be genuine and do not want to interact solely for the purpose of letter writing, but be aware that it is important to know your professors well and to invest time in those relationships.
When the time comes to apply: Rather than ask professors if they will simply write you a letter, I highly recommend using the phrase: “Would you feel comfortable writing me a positive letter of recommendation?” This allows people to assess their comfort level in doing so and tell you if there is a problem (perhaps they do not know you well enough or have only a lukewarm impression of you). This also makes it clear that you are hoping for something positive rather than just “Johnny attended my class.”
If you notice that the professor seems hesitant or uncomfortable, do not collect the letter! Thank him/her very much for their time and for being honest with you. It stings, but he/she is truly doing you a favor by allowing you to find other resources so that you have the best chances of putting a positive profile of yourself out there.
If the recommender says they do feel comfortable writing you a positive letter, great!! Ask if there is anything you can provide to facilitate this writing. Typically, your recommender might ask for a resume/CV so they can talk about your experiences (or just grab titles/dates of things they already know). They might also ask for your personal statement, or for a short essay describing the programs to which you are applying and why (especially common for non-science professors). If this is the case, you do not have to give them your “final” AMCAS-ready drafts of anything, but it can definitely help to just jot down some coherent thoughts about why this is important to you.
Finally, it is important to provide recommenders with a deadline. See question #1 for an overall timeline for the application and letters of rec, but know that it is very customary to provide recommenders with at least 4 weeks to write. Anywhere from 4-8 weeks would be appropriate. So again, if you’d like to be complete by May, you should ask by March or April at the latest.
- What “types” of letters are there?
INDIVIDUAL LETTERS: These are what you likely picture when you hear about a letter of recommendation, and they’re probably what you previously used to get into college. In this format, you will have separate letters from multiple people whom you’ve asked to write on your behalf. These letters will stand completely on their own – you will later be able to assign whichever letter or combination of letters that you want to each school. They are not connected to each other in any way as part of your application.
COMMITTEE LETTER: Some schools have a pre-medical committee, made up of multiple professors or faculty members who assess each applicant every year. This is VERY different from any of the other formats, as you are essentially being evaluated and ranked/assessed by your own school before applying. Typically, schools with a committee will have you sit down and interview with the committee. The committee will consider your interview, as well as the letters of recommendation they receive on your behalf (so this is another big difference – your letters go to the committee, not directly to AMCAS). They will then write a letter that evaluates/recommends you, and it will include just tiny quotes from some of the letters they received about you.
LETTER PACKET: A letter packet is an interesting hybrid of the individual and committee approaches. Like the committee letter, you will have only one document to send to each school. Your letters will all be included and cannot be separated from each other. However, in this format, each letter is included in its entirety. Your pre-medical advisor may attach a brief coversheet of some kind (mine did, to explain a little bit about my small liberal arts school and also to put my performance in context), but there is no actual committee evaluation of you. These are typically just full letters compiled by your pre-medical advisor or your school’s career center.
- How many letters do I need, and from whom?
If your school has a committee, make sure you understand their requirements. Again, they’ll use only a fragment of each letter in one overall evaluation that you will send to every school.
Letter packets are very similar. You will need to check with your premedical advisor or your school’s career center (whoever is in charge of these!). You can’t separate these letters at all, so each school will just receive your entire letter packet. You’ll notice that even when schools have “limits” to the letters you can send them, committee or letter packets are always an exception since they realize you are stuck with whatever is in your packet. (Thus, most websites will say something like “a maximum of 5 letters of recommendation OR a committee letter.” If you come across a school that asks for only 4 letters and your letter packet has 5, this is an exception and not a problem.)
For individual letters, however, it is an entirely different game. To give the simplest answer: you will need to check each school’s website individually to determine their letter of recommendation requirements. Most schools will provide a minimum and a maximum amount of letters, and they will even say who these letters should be from. If a school sets a maximum, DO NOT exceed this number. It is important to follow instructions during the application process; don’t give programs any grounds to toss out your application!
As a reference, I found that most of my schools asked for a minimum of three and a maximum of five letters of recommendation if they were going to be sent individually. Of these, it is often required that two are from science professors, and one is from a non-science professor. You may also then send letters of recommendation from the PI in the labs in which you’ve worked or perhaps a letter from a physician you shadowed, if the school allows.
For MD/PhD, it is CRUCIAL that these additional letters be from your research mentor(s). You really want to demonstrate that you have the potential to succeed in the lab, and it is crucial that you have a letter from your PI demonstrating this (note that regular-MD applicants often should include PI letters but do not necessarily “have” to – this is not the case for MD/PhD). See question #5 for more information!
- For MD/PhD, is a letter of recommendation required from ALL of my PIs if I’ve worked in multiple labs? What if this makes me exceed the maximum of 5 letters at certain schools?
Generally, for MD/PhD, yes – schools want to have a letter from each of your research experiences. Research is crucial for these programs, and schools will want to hear from each person who can evaluate you in this capacity.
If this exceeds the maximum number of letters that a school will allow you to send and you do not have a letter packet that will allow you to just send them all anyway, then you will likely need to contact that school to ask what they would prefer you to do. If you had a very short research experience (1 summer or less) in the context of much longer ones, it is likely OK for you to skip out on the letter from that experience. Do make sure that you put down a contact information for that person in your 15 activities section and that you are prepared to talk about it in your interview, at the very least.
- How do I upload letters to AMCAS?
Fortunately, AMCAS does most of the work here. You only need to enter in the email addresses of those who will be writing your letter of recommendation. AMCAS will then send them an invitation to upload your letter to Interfolio, the system that AMCAS uses to collect your letters. You will do very little work here, as you are not able to actually possess/see your letters… check out question #10 for more on this!
- How do I choose which schools will see which letters? How do I send the letters to schools?
Thankfully, AMCAS also handles most of this for you. As you are selecting schools, you will have to assign letters to every school. If you have individual letters, then just pick the names of the professors from the dropbox list you’ll see for that school (and remember to follow whatever rules each program sets for the minimum/maximum amount of letters… see question #4!). If you have a packet or committee letter, you will likely have entered your pre-medical advisor or equivalent person’s name on AMCAS. You will simply select his/her name from the dropbox to send the packet each time.
- What should go in to a letter of recommendation?
For the most part, you will not have huge control over this issue, so I will not spend too much time emphasizing it. However, some newer professors may ask what you would like them to speak about, and you may also be able to guide professors to discuss the important topics, so this seemed worthy of a spot in the FAQ. 🙂
Here are some of the subjects/topics that are often discussed in a letter. This list is not comprehensive but may allow you to guide a recommender in the right direction:
- How long the recommender has known you and in what capacity
- A little bit about your performance in a certain class can be helpful, but remember that schools will have your transcripts. Thus, your letters should focus instead on what will not be captured by a transcript.
- Did you regularly attend office hours?
- Did the professor see you help your peers better understand the material?
- Did you seek other resources? Did you show a desire to learn, not just to score well?
- See question #2 for more about building relationships with your mentors
- Primarily, the letter should demonstrate that you have the qualities necessary to be a good physician. It should speak a lot to your character and to traits that will suit you well for a medical career. These traits will be different for each person and perhaps even for each letter, but it is the most important thing that your recommender can include.
- Can I see my letters of recommendation?
The technical answer: yes. The actual answer: NO.
You will have the option on AMCAS to determine if you would like to waive the right to see your letters. This means that you will need to decide whether you will not see the letters and do not have a legal right to access them, or if you can later request from schools that you view your own letters of recommendation.
As my mentors told me last year, while this is technically your choice, you really need to waive your right to view the letters if you want them to be taken seriously. This is because schools will believe (understandably) that if a professor knows you might have not waived your right to see what he/she has written about you, the letter might not be as honest… i.e. a professor who knows you can see the letter might be more hesitant to write bad things about you in it if that is how they feel. You may be curious as to what your professors have said about you, but don’t let that curiosity jeopardize your application.
As a side note, refer back to question #2 on how to request letters in a manner that will facilitate positive letters rather than allow for negative/impartial ones to join the bunch!
- Should I thank my letter writers?
YES! Generally, a gift is not really necessary. However, a little card to thank a professor can really go a long way; they took a lot of time to help you, and thus a few minutes of your time to show your appreciation is often warranted. Even emailing the professor to thank them is wonderful, especially if you can update them. Let them know which medical school you will be attending, thanks to their help!
Keep hanging in there throughout the admissions season — you’re getting closer to the finish line with each step!
Emily Hayward, MS-2