Learn when and how to send these two types of update letters to get off the waitlist and into your dream school
Part 1: Introduction
You can find countless articles online on how to write a great medical school personal statement, ace your interviews, and pretty much every other med school admissions topic.
However, very few of these topics address the hardest part of the med school application process: waiting.
As a med school applicant, you’re probably a go-getter. You put in tons of study hours to achieve a strong GPA and MCAT score, apply for the best physician shadowing and volunteering opportunities, take initiative and demonstrate leadership across your extracurricular activities, and work your tail off to write great application essays. In other words, waiting for good things to happen is not the way you operate.
Unfortunately, waiting—patient or impatiently—is an important part of your admissions process. You have to wait for interview invitations after submitting secondaries. You also have to wait to receive an admissions decision after your interviews and possibly after being placed on various waitlists. In fact, some schools place up to 50% of interviewees on their waitlist!
What makes this process even more difficult is that adcoms run on their own schedules, and they don’t tell you when you can expect to receive notifications. And although rare, an adcom may inform you of your acceptance or rejection pretty much right up to the start of the Fall semester.
Naturally, there will come a time in your admissions process when you will wonder, “What should I do while I wait for [an interview offer/admissions decision]?” Sometimes, our answer is that you unfortunately must wait. Other times, our answer is that it’s time to reach back out to various admission committees by submitting a letter.
You may have heard of two types of related yet distinct letters you can send to admission committees—a letter of intent or letter of interest—that can help boost your odds of escaping admissions purgatory and getting into med school. However, different situations call for different types of letters, and approaching these letters the wrong way can actually hurt your chances of being accepted.
This article will clear up any confusion you may have about when and how to send each type of letter so that you can scratch your itch to do something in a productive manner.
(Note: We do not view “update letters” as a distinct letter category because we encourage students to include updates whenever possible in their letter of intent or letter of interest. In other words, these letters should operate as update letters in addition to expressing intent or strong interest to attend.)
Part 2: Letter of Intent vs. Letter of Interest
Many applicants mistakenly use letter of intent and interest interchangeably, perhaps because they share the LOI acronym. Therefore, we figured it would be worthwhile to discuss what each one is, when you should send them, and so on.
Letter of Intent
What it is: A letter of intent should express your clear desire to attend a particular medical school due to your perceived fit with its curriculum, academic environment, student body, culture, and so on. You must also communicate what you might contribute to the school if admitted.
Goals: To inform the medical school that it is unequivocally your top choice and that you will surely accept their admission offer.
How many schools to send it to: One, since only a single school can be your top choice.
Why medical schools appreciate it: Schools want to maximize their “yield”, that is, the percentage of admitted students who choose to enroll, because it impacts their rank, exclusivity, and prestige. Therefore, when comparing two otherwise equal candidates, schools will be attracted to the one who has expressed their clear desire to attend there if admitted.
When you could send it: One month after your interview, whether you’re placed on the waitlist or haven’t yet heard back. You may send a second letter of intent if over two months have passed since your initial one and you have meaningful updates to share.
What it should include: 1) An expression of thanks for considering your application, 2) recap of what you especially appreciate about their school, 3) updates since you last communicated with them, 4) demonstration of fit between your updates and experiences with the school’s unique offerings, 5) what you will contribute to the school (e.g., student body, curriculum, initiatives), 6) clear statement that you will attend if admitted, and 7) a second expression of thanks for considering your application.
Letter of Interest
What it is: Like a letter of intent, a letter of interest should express your enthusiasm for a medical school’s academics, offerings, and culture. Moreover, you should highlight ways in which you will fit with and enrich the student body.
Goal: To inform medical schools that you are highly interested in attending there if admitted.
How many schools to send it to: As many as you have continued interest in.
Why medical schools appreciate it: Much like with relationships, where romantic interests want to be pursued, medical schools want to be pursued by prospective students. If you submit your secondary and significant time passes without the med school hearing from you, they may assume you’re less interested in their program than in others. Moreover, many of your competitors will be taking the extra step to reach out and express their excitement about various programs. Although schools won’t be as convinced as with a letter of intent that you will help maximize their yield, it doesn’t hurt to keep yourself in adcoms’ minds.
When you could send it: Assuming you have a meaningful update to share, there are two situations that warrant a letter of interest: 1) six weeks have passed since submitting your secondary without hearing from the school, and 2) one month after your interview, whether you’re placed on the waitlist or haven’t yet heard back. You may send a second post-interview letter of interest if at least two months have passed since a previous letter and you have significant updates to share. In other words, don’t continue to write simply for the sake of writing; otherwise, you may run the risk of annoying adcoms.
What it should include: 1) An expression of thanks for considering your application, 2) emphasis of what you most appreciate about their program, 3) updates since your last communication, 4) connection between your updates and their offerings, 5) how you will contribute to the school, 6) statement about your continued interest in their program, and 7) a second expression of thanks for considering your application.
Part 3: Letter of Intent Example
(Note: The letter of intent and letter of interest should largely be written in the same way, save for the level of commitment you express near the conclusion—and perhaps the introduction—of your letter. All identifying details have been changed in the example below.)
Dear Tufts University School of Medicine Admissions Committee:
Thank you for offering me a place on your waitlist. I am writing to inform you that Tufts University School of Medicine (TUSOM) is my clear first choice for medical school. After my interview day, I spoke at length with Tufts alumni near me—Drs. Julie Simmons and Ruth Goldberg—to learn more about the Tufts experience. Their enthusiasm for TUSOM increased mine as I came to more fully appreciate how graduates live and pass on to others the Tufts values of compassion, innovation, healing, service, and respect. And hearing about the complex brain conditions being treated at Tufts’s neurology clinics solidified my interest in branching out of my ongoing research and undertaking research specific to these diseases with Dr. Nikhar Mehta or Dr. John Lewandowski.
I would also like to update you on what has occurred since my interview in November 2017.
As indicated in my secondary application, I completed Booth Fundamentals in December 2017. Booth Fundamentals is a 6-month certificate program on the foundational business concepts from The University of Chicago Booth School of Business. I passed with High Honors—the highest possible grade, assigned to the top 5% of the cohort. Stepping into the role of a business leader and tackling case studies of diverse organizations has equipped me to engage in business discussions, and I would love to participate more fully in business as a Tufts student through Medical Entrepreneurship program by collaborating with Boston companies on new healthcare ventures. I am also interested in representing TUSOM at the Progress in Medicine summit, which would prepare me to drive changes to improve the value of patient care as I progress through my training.
In December, I also took a contingent of Chicagoland volunteers to lobby alongside the American Heart Association at the Capitol. We enlisted the support of our state legislators on two bills that increase access to affordable healthcare and another to provide more healthy food choices to individuals living in the inner city. The scope of my advocacy has extended beyond pushing for legislation as a catalyst to fight heart disease. Over the past year, I worked with our local U.S. Senator to reform how child abuse cases are handled, culminating in the passage of Article 2451 in February January 2018. This law puts enforceable protections in place for children by requiring Child Protective Services representatives in Illinois to respond to all cases of alleged abuse within 48 hours, not only those they believe are reportable. TUSOM’s curriculum provides a remarkable range of options to continue sharpening my policy skills, including the health care policy course headed by Dr. Samantha Chin.
Collectively, I see Tufts as the ideal medical school to become the physician leader I have long dreamed of becoming. If admitted, I will accept without hesitation. I am confident that I would simultaneously benefit from Tufts and contribute to making it an even better place.
Please contact me via email at [Email] if I can answer any questions or provide additional information. Regardless of what you decide, I appreciate your consideration of my application.
[Your First and Last Name]
AAMC ID: [Your ID Number]
Part 4: Frequently Asked Questions
Question: How long should my letter of intent/interest be?
Answer: You should aim to keep your letter within one page, using one-inch margins and no smaller than 11-point font.
Many students feel a strong urge to write longer letters, thinking that the more updates and demonstrations of fit they provide, the better. Nevertheless, this is usually most reflective of these students’ anxiety. Consider how many essays and letters adcoms read and focus on writing your main points succinctly.
Question: I know a student who sent over [3/4/5/etc.] letters to X Medical School and got in. Are you sure I shouldn’t keep sending letters to express my interest or intent to attend?
Answer: Remember that correlation does not equal causation. Given how many thousands of students apply to medical school each year, chances are you will eventually hear about a student who sent six letters and got in, as well as a student with a 3.3 GPA who got into a top-10 school, and so on.
Rather than try every possible tactic—many of which are not sound—you heard about to get in, we encourage you to only implement strategies that authentically demonstrate interest and fit with a medical school while being considerate of their difficult task of selecting among an incredibly impressive applicant pool.