7.4 Letters of Recommendation (Selection, Cultivation, and Management)

Letters of recommendation provide external validation. Your application tells schools who you claim to be. Letters tell schools who others have observed you to be.

A strong letter can tip a borderline candidate toward acceptance. A weak letter, even if technically positive, can raise doubts. A negative letter is devastating.

• Two science faculty letters — From professors in courses where you performed well.
• One non-science faculty letter — Demonstrates breadth.
• Physician letter — From an MD or DO who observed you clinically.
• Other letters — Research mentors, employers, volunteer supervisors.
• Committee letters — Many undergraduate institutions compile faculty evaluations into a single letter.

Check each school's specific requirements.

• Specificity. Strong letters include specific examples, anecdotes, observations.
• Context and comparison. "Among 200+ students I've taught, Marcus ranks in the top 5%."
• Personal knowledge. Writer who actually knows you carries weight.
• Enthusiasm. Lukewarm praise reads as criticism.
• Relevant qualities. Intellectual curiosity, empathy, resilience, communication, professionalism, integrity.

• Generic praise.
• Brief length. Strong letters are 1-2 pages.
• Faint praise. "Adequate," "satisfactory," "among the better students."
• Irrelevant content.
• Obvious template.

• People who know you well. Number one predictor of letter quality.
• People who will say yes enthusiastically. "I'd be happy to" vs. "I suppose I could."
• People who observed you in relevant contexts.
• People who write strong letters. Ask around.

• They don't remember you.
• They seem reluctant.
• They ask you to write the letter.
• They have a reputation for weak letters.

The best letter writers are people you've built relationships with over time.

• Start early. Freshman and sophomore year.
• Attend office hours regularly.
• Participate meaningfully in class.
• Seek mentorship beyond coursework.
• Stay in touch. Occasional check-ins.

• Ask in person when possible. Follow up with email.
• Ask early. At least 6-8 weeks before deadlines.
• Ask the right question. Not "Will you write?" but "Do you feel you know my work well enough to write a strong letter?"
• Explain why you're asking them.
• Be clear about what you need. Deadlines, submission method, specific content.

Provide:

• Full name and contact information
• Deadline and submission instructions
• List of schools you're applying to
• Resume or CV
• Description of your goals and why medicine
• Specific experiences/qualities to address
• Transcript or reminder of performance in their course
• Anything specific you'd like emphasized

• Send materials promptly.
• Track deadlines.
• Send polite reminders. One at 2 weeks out, one at 1 week.
• Confirm receipt.

Example reminder: "Dear Professor Smith, I wanted to follow up regarding my letter of recommendation for medical school. The deadline is October 1st, and I want to ensure you have everything you need. Please let me know if I can provide any additional information. Thank you again for your support."

• Send thank you notes. Handwritten ideal; email acceptable.
• Update them on outcomes.
• Pay it forward.

• Late letter: Follow up politely. Contact schools to explain if needed. Consider backup writer.
• Suspect weak letter: Most schools let you designate which letters go where.
• Not enough writers: Consider gap year employment or post-bacc coursework.

You've prepared your materials. Now comes the final test: the interview.