Medical School Letters of Recommendation: The Definitive Guide
/Whom, when, and how to ask for great medical school recommendation letters, including word-for-word scripts
(Note: A version of this article can also be found in our free, 102-page comprehensive guide to medical school applications, Get Into Medical School: 6 Practical Lessons to Stand Out and Earn Your White Coat.)
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Introduction
Similar to writing the AMCAS personal statement, the thought of asking for medical school letters of recommendation (or in AMCAS terms, letters of evaluation) makes most students cringe.
Therefore, it’s not surprising that we receive a ton of questions and concerns about recommendation letters, such as:
“How am I supposed to find three letter writers?!”
“Would it be a good idea to get a letter from Dr. Johnson? I don’t really know her, but she works at Duke Med, loves my mom, and offered to write a letter on my behalf.”
We decided to write a comprehensive guide to medical school recommendation letters to answer all of your questions. If your question isn’t covered, please leave it in the comments section below so we can answer it and add it to the guide, since other students surely share it.
Click on any question below to jump directly to it:
Questions about how many letters of recommendations you need
Questions about whom you should request letters of recommendation from
Timing-related questions about letters of recommendation
Can my letter writers submit letters of recommendation before AMCAS opens?
Does AMCAS require that my recommendation letters be uploaded to verify my application?
Can I add new letters of recommendation after I submit my AMCAS application?
Can I edit or delete letters of recommendation after I submit my AMCAS application?
Questions about how to ask for letters of recommendation
Questions about storing and reusing letters of recommendation
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Questions about whom you should request letters of recommendation from
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Whom should I request letters of recommendation from?
We recommend you compile the following set of six recommendation letters:
Science professor 1 whose class you took for a letter grade
Science professor 2 whose class you took for a letter grade
Non-science professor whose class you took for a letter grade
A professional—preferably a physician—who has observed you providing patient care
Extracurricular observer 1
Extracurricular observer 2
Your two “extracurricular observer” letters could come from anyone who can speak well to your distinguishing activities.
For instance, if you’re a standout researcher, get one of those letters from a principal investigator (PI). If you don’t know your PI well, request a letter from a postdoc with whom you've worked closely, and request that the PI co-sign it.
If, on the other hand, you’re an excellent fundraiser, request a letter from your superior within the organization you were part of or from a high-ranking member of the organization you supported who knows you well.
A good rule of thumb is to ask for a letter from a supervisor from an extracurricular activity that you designated as a ‘Most Meaningful Experience’ in your AMCAS Work and Activities section.
Some letters can do “double duty”—that is, they can check two boxes at once. For instance, if you took a neuroscience course with a professor whose lab you also worked in, a letter from that professor can satisfy one science professor letter and one extracurricular observer letter. Therefore, you don’t necessarily need six distinct letters.
The most important consideration is that you submit outstanding letters. Outstanding letters come from individuals who can speak highly of your skills and qualities and, more importantly, how your merits make you an excellent medical school candidate. Unenthusiastic letters, even if written by a well-known person, are not desirable.
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From whom should I ask for recommendation letters as a non-traditional applicant?
Medical schools want to see recent (i.e., within the last three years) data about your academic achievements. Therefore, if you've been out of school for a while, you should aim to enroll in a few science courses—locally or online—to build relationships with professors.
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Who qualifies as a science professor?
Strictly speaking, medical schools would like to see your science letters come from biology, chemistry, or physics (BCP) professors. While many schools will also accept a science letter from a math, computer science, engineering, or other science professor, other schools won’t. Therefore, you should check directly with your top-choice schools if you intend to submit a science letter from a non-BCP professor.
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Who qualifies as a non-science professor?
Any professor whose field falls outside of biology, chemistry, or physics.
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Do I have to send a letter from a professor in my major?
A very small number of schools require a letter from a professor in your major. Since this isn't necessary for the majority of schools, you probably shouldn't worry about this.
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Do I need to get a letter from a DO physician when applying to DO programs?
Yes, if you’re looking to apply to osteopathic medical schools, make sure to request a letter from a DO physician you’ve shadowed.
DO programs are conscious of the reality that most applicants would prefer to attend an MD program if given the chance. Therefore, they like to see that applicants have demonstrated a specific interest in osteopathic medicine and have made an effort to put this interest into practice.
(Further reading: MD vs DO: The Biggest Differences (And Which is Better))
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What recommendation letters should I avoid?
Generally speaking, you should avoid any letters that are negative, neutral, or slightly positive. In other words, you should avoid a letter from anyone who won’t gush about you.
In addition, you’ll want to avoid sending letters from family members, clergy, or family friends who can’t speak intimately about your professional qualities.
Students routinely ask whether they should get a letter from a family friend who happens to be a well-known physician or faculty member at a school on their list, thinking that their clout will carry significant weight in admissions decisions despite not knowing the applicant professionally. Avoid these letters as well. At best, they’ll be disregarded. At worst, they’ll hurt your application because they’ll be seen as an attempt to gain an unfair advantage.
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Will I be able to see my recommendation letters?
You can, but you shouldn't. In other words, you should always waive your right to read your letters. Otherwise, medical schools won't take your letters seriously.
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Questions about how many letters of recommendation you need
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How many letters of recommendation do I need for medical school?
Schools vary with regard to the number of required recommendation letters, ranging from two to five. Three letters is the most common requirement.
At minimum, most schools will ask you to submit one of the following:
Three individual letters: Two letters from science professors and one letter from a non-science professor. These letters are to be sent directly to AMCAS by individual professors or by your school via a letter packet.
A committee letter: Some schools have a pre-health committee or pre-health advisor who writes a letter representing your school’s evaluation of you. If your school offers the committee letter option, you should take it. Otherwise, medical schools could wonder whether you’re avoiding the committee letter because you’re trying to hide something or were told by the pre-health committee that you’re not a competitive applicant.
Nevertheless, the better question is, “How many letters of recommendation should I get when applying to medical school?” because:
Some schools require that you submit four or five letters.
Many schools optionally allow you to send additional recommendation letters beyond their requirements.
Some letter writers can be flaky and even disappear when you need them most. Therefore, it’s best to have a backup letter.
Our answer to that question is you should gather six letters (see our response to the first question for further details).
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How many letters of recommendation should I send to schools?
We recommend that you send no more than five or six letters to med schools, even if they offer a higher limit on the number of allowed letters.
The quality of your letters and what they collectively say about you are much more important than sending a large number of letters. Negative or even so-so letters can cast a shadow over your other, strong letters, so be thoughtful about which to include or leave out.
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How many recommendation letters can I upload to AMCAS?
AMCAS allows you to upload up to 10 letters of recommendation.
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How many recommendation letters can I upload to AACOMAS?
AACOMAS allows you to upload up to 6 letters of recommendation.
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How many recommendation letters can I upload to TMDSAS?
TMDSAS allows you to upload up to 4 letters of recommendation.
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Can I send different recommendation letters to different schools?
It depends on which application system you’re using. AMCAS allows you to send different recommendation letters to different schools, whereas AACOMAS and TMDSAS do not.
In other words, when applying via AMCAS, you can “overcompile” letters of recommendation and pick and choose individual schools that you’d like to send each letter to. When applying via AACOMAS and TMDSAS, every school you apply to will receive all the letters that you’ve uploaded into that system.
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Can I choose where to send each recommendation letter?
As noted above, only AMCAS allows you to choose individual schools as recommendation letter recipients. Beyond this, you can only select the application system to which you’d like to send each recommendation letter.
For instance, let’s say you’re applying to both MD and DO schools, and you have eight letters, including letters from both MD and DO physicians, stored in a dossier service such as Interfolio. You could then choose the appropriate letters to upload to AMCAS and AACOMAS, bearing in mind both the types of medical schools you’re applying to and the maximum number of letters each system allows.
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Do my recommendation letters have to be addressed to specific medical schools?
No, this is not expected.
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Questions about how to ask for letters of recommendation
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Should I ask for a letter of recommendation in person or via email?
We strongly encourage you to ask for letters from professors in person whenever possible, and definitely if it’s been a while since you’ve been in their class or interacted with them.
Before you ask for a recommendation letter, you should prepare a packet that includes:
A list of your grades, separated by science and non-science courses
Your CV or resume
Your final or near-final personal statement draft
AAMC's guidelines for writing a strong letter of evaluation, including a reminder to write the letter on official letterhead and sign it. You should provide this packet only after a professor or other recommendation letter writer agrees to your request.
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How should I ask for a letter of recommendation in person?
Below are exact email scripts you can use to request a letter in person:
Word-for-word email script when planning to ask someone you know well in person
Dear [Professor’s Name],
I hope this email finds you well. I’m planning on applying to medical school this upcoming summer, and was hoping you’d be willing to offer your perspective on the process since I’ve always valued your guidance. If so, please let me know some days/times that work well for you to meet, and I’ll make sure to accommodate. Thanks for your consideration!
Best,
[Your Name/Last Name]
Word-for-word email script when planning to ask someone in person whom you haven’t seen or spoken with in a while
Dear [Professor’s Name],
I hope this email finds you well. My name is [Name/Last Name], and I was a student in your [Course Number/Title] course during [Semester/year]. I really enjoyed your class because [authentic reason].
I’m planning on applying to medical school this upcoming summer, and was hoping you’d be willing to offer your perspective on the process. If so, please let me know some days/times that work well for you to meet, and I’ll make sure to accommodate. Thanks for your consideration!
Best,
[Your Name/Last Name]
Additional guidance for asking in person
Whenever you meet with a professor to request a letter in person, make sure to let them know why you would value a letter from them, including why you value their perspective and which of your qualities and experiences they can speak to.
Don’t be shy about priming them to do this because it will help their letters corroborate how you describe yourself throughout the rest of your primary and secondary applications.
Once a letter writer agrees to write you a letter, provide the packet mentioned earlier.
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How should I ask for a letter of recommendation by email?
Here is an exact email script you can use to request a letter via email:
Word-for-word email script when planning to ask someone you know well via email
Dear [Professor’s Name],
I hope this email finds you well. I’m planning on applying to medical school this upcoming summer, and was wondering whether you’d feel comfortable writing a strong letter of recommendation. [Authentic sentence describing why you would value a letter from them (e.g., why you value their perspective, which of your qualities they can speak to, etc.)].
If you’re willing to provide a letter, I will provide the following supporting materials: 1) a list of my grades, 2) my CV, 3) a draft of my personal statement, and 4) the AMCAS recommendation letter guidelines. Thanks for your consideration!
Best,
[Your Name/Last Name]
(Note: We have not included a script for requesting a letter via email from a professor who may not remember you because you shouldn't ask them for one.)
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When and how should I remind my letter writers to submit?
Recommendation letter writers often procrastinate on submitting letters on time. Therefore, you should email them using the following email script two to three weeks prior to your primary application submission:
Dear [Professor’s Name],
I hope this email finds you well. I plan on submitting my medical school applications [on date or in # of days/weeks], so I wanted to send a reminder regarding your recommendation letter. Please let me know if there’s any additional information I can provide.
Thanks again for your support!
Best,
[Your Name/Last Name]
Beyond this first reminder email, feel free to send additional reminder emails every one to weeks if you don’t hear back from a letter writer. If you’re unable to get a response via email, call them.
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What should I include in my thank you notes to letter writers?
Once a person submits a letter, you can use the following thank you note script to express appreciation (personalize this however you’d like):
Dear [Professor’s Name],
Thanks again for supporting my medical school applications by offering your perspectives on the process and submitting a recommendation letter. I feel very fortunate to have great mentors like you.
I’ll make sure to update you as the application season progresses!
Best,
[Your Name/Last Name]
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Do you have tips on how to get to know my professors?
Of course! Here they are:
Consistently attend office hours, especially during "off-peak" times, like the beginning of the term.
During office hours, discuss something other than course material (e.g., the professor's research).
Take multiple classes with the same professor.
Invite the professor to coffee or lunch after the term to discuss their work, as well as your career aspirations.
Work as the professor's teaching assistant.
If you're interested in their research, ask to join their lab. Your research involvement will not only improve your relationship with that professor, but will also look great on your application.
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What should I do if I’m asked to write my own recommendation letter?
We’ve covered this topic in depth in a separate guide: How to Write Your Own Letter of Recommendation for Medical School.
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Timing-related questions about letters of recommendation
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When should I request letters of recommendation?
Ideally, you will want to ask for recommendation letters no later than two to three months before you plan on submitting your primary application (i.e., AMCAS). Therefore, if you plan to submit AMCAS in June, you should ask no later than the beginning of May.
Professors receive a ton of recommendation letter requests during the medical school application process. Asking in advance will give your letter writers the time to write a strong letter, and also to prioritize getting yours done before those who asked later.
Finally, your school has a pre-health committee or pre-health advisor who assembles and distributes letters on your behalf. If so, you should follow their suggested timeline for requesting recommendation letters.
(Further reading: The Ideal Medical School Application Timeline)
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When are letters of recommendation due?
You should aim to have your letters sent to programs no later than the date of your secondary application submission (i.e., July at the earliest) because most med schools do not read recommendation letters until the remainder of your materials—primary application, secondary application, fees, MCAT score—have been submitted.
That said, we encourage you to request that recommendation letters be submitted by the end of June to avoid anxiety. That way, even if your writers procrastinate for a week or two, you’ll still have your letters in on time.
It’s important to note that letters of recommendation are rarely used to decide whether or not to send you a secondary application (which most schools send to most applicants anyway). However, they are used to make interview decisions.
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When do medical schools look at letters of recommendation?
As noted above, most medical schools look at letters of recommendation after all of your application materials have been submitted. Therefore, the earliest that your letters will be read is typically July.
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Can my letter writers submit letters of recommendation before AMCAS opens?
No, writers cannot submit before the day AMCAS opens.
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Does AMCAS require that my recommendation letters be uploaded to verify my application?
No, it does not. Your submitted AMCAS application will begin to undergo verification even if your letters of recommendation have not yet arrived.
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Can I add new letters of recommendation after I submit my AMCAS application?
Yes, you can add new letters of recommendation after your AMCAS application has been submitted, so long as you haven’t yet reached the 10-letter maximum. However, if you’ve already submitted your application, you must make sure to resubmit your application after you assign a new letter to ensure that it’s sent.
Even if your application has already been transmitted to a medical school, you can still add and assign new letters to that school as long as it’s before the school’s deadline.
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Can I edit or delete letters of recommendation after I submit my AMCAS application?
No, you cannot delete or personally edit letters of recommendation after your AMCAS application has been submitted. However, your recommenders may upload a new version of a letter they’ve already submitted, so long as they use the same Letter ID number that was assigned to the original letter.
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Questions about storing and reusing letters of recommendation
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Where can I store my letters of recommendation?
You may have two options for storing letters of recommendation that you request ahead of time (e.g., a year or two before your application cycle):
Through your school: Most universities offer to store your recommendation letters, either through the career center, pre-health advising center, or a similar service on campus.
Via an online third-party letter storage service (also called a “dossier service”), such as Interfolio.
Regardless of which option(s) is available to you, you will have to ask your recommenders to send their letters directly to the storage service. As with any other recommendation letter, stored letters must be signed and ideally written on official letterhead. Once you're ready to apply to medical school, you can request that the storage service send your letters to the application system.
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What are the benefits of using Interfolio or another storage service?
As noted above, one reason why med school applicants use Interfolio or other letter storage services is to obtain a fresh, and therefore more enthusiastic, letter of recommendation well in advance of the application cycle.
Storage services also simplify the recommendation process for your letter writers by requiring them to only upload their letter once. Even if you aren’t collecting letters far in advance, you may still find this beneficial if you’re either submitting applications within multiple systems (e.g. both AMCAS and TMDSAS) or you anticipate needing a letter of recommendation again, such as for a scholarship or a future med school application cycle, and don’t want to repeatedly ask your recommenders.
That said, whether or not to store your letters is up to you. It isn’t strictly necessary if you can maintain great relationships with your recommenders.
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Does AMCAS store recommendation letters from one cycle to another?
No, AMCAS does not store recommendation letters from one cycle to another.
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Do I need to submit letters of recommendation as a reapplicant?
Yes, because AMCAS does not store letters of recommendation, you must either resubmit your existing letters or submit new letters of recommendation each time you apply to medical school.
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Can I reuse the same letters of recommendation if I reapply to medical school?
When reapplying to medical school, you can choose to send the same letters from a previous cycle—ideally, with a revised date and, if appropriate, with updates—entirely new letters, or a combination of the two. Even if your letters are stored in Interfolio or a similar service, we encourage you to ask your rec letter writers for a letter with at least an updated date.
(Further reading: Reapplying to Medical School: Every Major Question Answered)
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 nearly 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
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