How to Write a Standout Medical School Letter of Intent (Example Included)
Learn how and when to send an update letter to get off the waitlist and into your dream school.
A great medical school letter of intent or interest can boost your admissions chances.
What You'll Learn
A One-Time, Binding Commitment
Why a letter of intent tells a school you'll enroll if accepted, and why you should only ever send one.
When to Send It
Why the ideal window is about a month after your interview, and when a second LOI is appropriate.
What to Include and How to Format It
How to keep your LOI to one page with genuine updates, a clear statement of intent, and proper formatting.
Common Pitfalls to Avoid
Why you shouldn't rehash known info, use AI to draft it, address a specific officer by name, or ignore a school's submission guidelines.
Letter of Intent vs. Letter of Interest
Key differences in bindingness, timing, and quantity between these two commonly confused letter types.
The Real Impact on Admissions
Why an LOI can influence tie-breaking or waitlist decisions, but doesn't outweigh your MCAT score, GPA, or personal statement.
What Warrants a Second Letter
Which updates, like a major GPA jump or new MCAT score, are significant enough to justify a follow-up letter.
Medical school letter of intent
Example letter of intent
Letter of intent vs. letter of interest
What kind of updates warrant a second letter after a letter of intent is sent?
Frequently asked questions
For medical school applicants, waiting is not the way you’re used to operating. Unfortunately, waiting is a vital part of the admissions process. Even worse—most adcoms don’t provide you a timeline of when to expect to hear from them.
But you may be able to make a difference in your admissions odds during this waiting period. Enter the letter of intent (LOI).
Generally speaking, a letter of intent is an update letter that can boost your odds of escaping admissions purgatory and getting into med school. It is an optional, ethically binding contract that, if you receive an offer from a specific school, you will accept it.
Different situations call for different solutions. Approaching a letter of intent the wrong way may actually hurt your chances of being accepted. This guide will clear up any confusion you may have about when and how to send a letter of intent—as well as how it’s different from a letter of interest.
Note: We encourage you to use this resource alongside the Medical School Update Letter Example Library we developed with our partners at Health Admissions IQ, which includes 35 real-world examples of letters of interest and letters of intent to help you navigate situations where you’re awaiting a school’s response following secondaries, interviews, or being placed on a waitlist.
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What is a medical school letter of intent (LOI)?
A letter of intent is a physical or digital letter that informs a particular medical school that it is unequivocally your top choice and that you will absolutely accept an offer of admission. An LOI should detail what you’ll contribute to the school and why you’re a good fit.
Only send one LOI because you’re basically saying, “I will go here if you send me an admissions offer.” If you send multiple LOIs and get multiple admissions offers from schools you sent LOIs to, you will need to turn one of them down—which is highly unethical and will not go unnoticed.
Aim for an LOI length of one page at 11-point font. You can send an LOI after your med school interview or if there are major updates to your personal or professional life that are not reflected on your AMCAS or AACOMAS but should be known and considered.
Struggling to write your med school essays?
Get our free 102-page guide to help you with every step: Get Into Medical School: 6 Practical Lessons to Stand Out and Earn Your White Coat
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What to include
Below are points you should include in your letter of intent to your top-choice school:
Personal yet professional opening
Expression of thanks for considering your application
Recap of what you appreciate about their school
Major updates since you last communicated with them, such as any coursework completion, GPA increase, leadership experience, research involvement, and new MCAT score
What you will contribute to the school (e.g., student body, curriculum, initiatives)
Demonstration of why you’re a good fit for the school, why the school is a good fit for you
Clear statement that you will attend if admitted
Second expression of thanks for considering your application to close out your letter
Formatting and expert tips
Check out these expert tips for how to format your letter of intent for the best possible outcome:
Make sure the school actually accepts letters of intent. Some schools specifically ask that you not send an LOI. It could hurt your chances of acceptance if you shirk their admission guidelines.
Proofread your LOI to ensure it’s free of grammatical and spelling errors. Consider using Grammarly’s free app.
Send your LOI through the proper channels. Some schools specify that you must send your letter of intent through an online application portal, while others only accept LOIs sent to a specific email address. If there are no published guidelines, we recommend emailing the office of the dean of admissions for guidance.
Submit the right file type. Institutions may request that you submit a specific file type, such as PDF or DOCX. For PDFs, we recommend adding an image of your actual signature to the bottom of the PDF file.
Format your LOI correctly. The length should be one page with one-inch margins and no smaller than 11-point font. Use a standard font like Times New Roman or Arial.
Keep it concise. Students may feel the urge to write longer letters, thinking the more updates they provide, the better; however, a longer LOI risks making you seem anxious, impatient, or like you’re a poor communicator. Usually, succinctly crafting your main points into a one-page LOI reflects better on you as an applicant.
What to avoid
Here are a few things we recommend that you avoid in your letter of intent:
Avoid writing a web of lies. Embellished information will be discovered and will reflect very poorly on your candidacy.
Avoid rehashing things the adcoms already know, such as your GPA, MCAT scores, or extracurricular activities you’ve included in your primary application or referenced in your secondary essays.
Avoid addressing specific individuals, like the director of admissions. Don’t start with “Dear Dr. Jones,” but instead address the admissions committee as a whole.
Avoid using AI to write your LOI. There’s a case to be made about using a chatbot to suggest edits to a letter you’ve already written, but do not rely on artificial intelligence to do the work for you. It’s lazy and unethical and may come off as obvious, not your voice.
Avoid fluff. Don’t go on and on about minor updates that elongate your LOI while adding nothing of substance. Get to the point, and don’t waste the adcom’s time.
Avoid simple errors in spelling and grammar.
Avoid breaking a school’s submission guidelines.
Avoid sending a letter of intent to more than one school. Consider letters of interest if you want to send update letters to more than one school. Read more below.
When should I write a letter of intent?
The ideal time to send a letter of intent to medical schools depends on several factors, including when you last communicated with a program and the meaningfulness of your updates.
Generally speaking, plan to send an LOI about one month after your interview, especially if you’re placed on the waitlist. Meaningful updates are great to include, but you don’t need any updates for a first LOI; it’s okay just to say, “I intend to attend your school if I am offered acceptance.”
You may send a second letter of intent if 1) more than two months have passed since your initial LOI and 2) you have meaningful updates to share.
Do not send a letter of intent before you go to an interview. It looks hasty, presumptuous, disingenuous, and unprofessional.
Do letters of intent significantly impact admissions decisions?
Letters of intent can make a small to medium impact on admissions committee decisions—if the school actually accepts LOIs. An update letter may help break a tie between two similar candidates or influence which medical students are the first to come off the waitlist.
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. When comparing two evenly matched candidates, schools will be attracted to the one who has expressed a clear desire to attend their program if admitted.
Of course, some schools don’t accept LOIs, while others technically accept LOIs but barely even use them in medical education adcom considerations. In those cases, a letter of intent won’t have a noticeable impact.
According to some adcoms whom the AAMC interviewed, letters of intent should only be sent if you’re sharing something that “adds significant new information to your file.”
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Example letter of intent
Here’s an example to give you a sense of how to craft a professional, well-written letter of intent.
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’ 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 2020.
As indicated in my secondary application, I completed Booth Fundamentals in December 2020. 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 percent 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 the 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 January 2021. 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 healthcare 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 enomura@uchicago.edu if I can answer any questions or provide additional information. Regardless of what you decide, I appreciate your consideration of my application.
Sincerely,
[Signature]
Emika NomuraAAMC ID: 12345678
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Letter of intent vs. letter of interest
Many applicants mistakenly use the terms “letter of intent” and “letter of interest” interchangeably, perhaps because they share the “LOI” acronym.
Purpose: The letter of intent is meant to express your desire to attend a particular school if you’re offered acceptance. On the other hand, a letter of interest simply expresses your interest in attending the school—in other words, you’re not promising anything, but you think you would be a good fit at the school after your interview day went so well.
Binding: While a letter of intent ethically binds you to attend a school if you’re offered admittance, a letter of interest is not binding. However, a letter of interest is also less beneficial, so it’s a trade-off.
Quantity: You should only send one letter of intent. However, you can send letters of interest to wherever you visited during interview season.
Timing: You should only send a letter of intent after your interview. However, a letter of interest can be sent after your secondaries are submitted but before you’ve received an interview invite, especially if it’s been 6-8 weeks and you haven’t heard anything. In this pre-interview letter of interest, you can include major updates that weren’t included in your AMCAS or AACOMAS. You can also send letters of interest after you interview, whether to include updates or just to thank the adcom for their time.
Note: We do not view update letters as a distinct letter type. We encourage students to include updates whenever possible in their letter of intent or letter of interest. Both of these letters should act as update letters in addition to expressing your intent or strong interest in attending your preferred med school.
Below are some things that a good letter of interest should include:
Expression of thanks for considering your application
Emphasis on what you most appreciate about their specific program (make sure you’re not copying and pasting other schools’ unique qualities)
Relevant updates since your last communication
How you will contribute to the school and why you're a good fit
Statement about your continued interest in their program (use clear language so you don’t imply this is a binding letter of intent)
Second expression of thanks to close out your letter
Example letter of interest
Here’s an example of what a letter of interest might look like. Notice how small variations in the interest letter make it significantly different from the intent letter.
Dear Warren Alpert Medical School Admissions Committee Members:
Thank you for considering my application. I remain highly interested in attending Alpert Medical School because of its focus on innovative clinical research and commitment to community service. At this time, I am writing to update you on work I have completed in recent months.
Since submitting my secondary application, I’ve completed Booth Fundamentals in December 2022. Booth Fundamentals is a 6-month certificate program on 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 percent of the cohort—and focused my capstone project on improving public mental health services for children and adolescents.
I also continue to conduct case study analyses on patients with suicidal ideation through my research lab at Northwestern School of Medicine, which has sharpened my research skills and allowed me to understand how individual patients develop life-threatening mental illness. At Alpert Medical School, I would look to take part in the Basic and Translational Research Program and work with professors like Drs. Jennifer Barredo and Sarah Ann Thomas to study the diagnosis and treatment of emotional and substance use disorders and to apply findings to improve care options at the policy level.
In December, I also recruited a group 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 January 2021. 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. Alpert’s curriculum provides a remarkable range of options to continue sharpening my policy skills, especially the integrated coursework on culturally sensitive care.
Ultimately, I view Alpert Medical School as the ideal institution to shape me into the physician scientist and policy expert I hope to become. I am confident that I would grow at Alpert Medical School while contributing to its transformative study environment.
Please contact me via email at enomura@uchicago.edu if I can answer any questions or provide additional information. While I would be honored to meet with you personally if invited for an interview, I appreciate your consideration of my application regardless of what you decide.
Sincerely,
[Signature]
Emika NomuraAAMC ID: 12345678
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What kind of updates warrant a second letter after a letter of intent is sent?
You may send a second letter of intent if more than two months have passed since your initial LOI and if you have meaningful updates to share. Below are some meaningful updates that warrant a second letter:
New coursework completed that fulfills prerequisites
Large increase in GPA
Leadership experiences
Relevant job promotions
Getting research published
Prestigious award
Unless there is a distinct accomplishment or milestone involved, updates involving new clinical, research, or volunteer experience are not typically “significant” enough to warrant a second letter. That said, feel free to include these updates alongside the meaningful ones listed above.
The other scenario in which it would be worth discussing clinical, research, or volunteering updates is if your application was originally lacking in these experiences. If you’ve already racked up hundreds of shadowing or volunteer hours, though, additional hours won’t change how adcoms view your application.
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Frequently asked questions
Is a letter of intent legally binding?
No, a letter of intent is not legally binding. However, LOIs for medical school are—let’s say—ethically binding, which should still matter to you.
If you send multiple schools an LOI telling them all they are your “top choice,” what will you do if more than one school offers you an acceptance? You can only attend one, which means you’ll have to inform the other that you won’t be attending there–and adcoms talk.
Dishonesty before you even set foot in the school shows a lack of integrity. It doesn’t only reflect poorly on you; it also makes anyone who supported you—such as recommendation letter writers—look bad.
The school you chose may rescind its acceptance offer since most offers are conditional on maintaining ethical standards, among other expectations.
If a medical school states that they don’t accept updates or letters of intent, should I send a letter anyway?
No, don’t send an LOI if the school doesn’t accept them. If a med school explicitly requests that you not send them a letter of intent, disregarding these instructions will likely hurt your application, and it certainly won’t give you a leg up.
However, sometimes the language around these kinds of communication can be unclear, so if you’re unsure of what a school’s policy is regarding letters of intent, we recommend that you call their admissions office and ask.
Can I send a letter of intent even if I have no meaningful updates to share?
Yes, you can still send a letter to express your strong desire to attend, even if you don’t have major updates to share. Make sure to demonstrate fit in your letter and communicate any updates that you do have.
That said, a letter of intent will always be strongest when it includes meaningful updates. We do not recommend sending a second letter of intent or interest without major updates to share.
Will a letter of intent guarantee acceptance to your top-choice medical school?
No, a letter of intent doesn’t guarantee admission to your top-choice med school. In many cases, it slightly increases your odds of acceptance, but there are still much more impactful admission considerations, including your MCAT score, BCPM GPA, personal statement, etc.
How long should my letter of interest be?
You should aim to keep your letter within one page or less, 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.
Final thoughts
A letter of intent can make a small positive impact on your med school application, but you can only send one. Make sure you actually want to attend this school above all others before you send them an LOI.
If you want to send update letters to multiple schools, a letter of interest is less binding (and less impactful) but can get your point across all the same.
Whether you need application consulting, personal statement advice, or letter of intent editing, Shemassian Academic Consulting is ready to help you!
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About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. For over 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
