Directors of Admissions Answers All Your LOR Questions

Session 442

Today, we have a recording of our Inside Med Admissions panel that we did on April 28, 2021. Our goal is to give students a better understanding of what the process is like inside the admissions committee and how things work inside.

In this episode, you’ll learn more about letters of recommendation, why they’re important, and what you can do about them. Sign up for the next session of Inside Med Admissions, happening on May 26. Live at 1pm Eastern where we talk all about secondary applications.

If you’re looking for some help with your application or anything else, go check out Mappd. For more podcast resources to help you with your medical school journey and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[01:25] The MCAT Minute

This section is sponsored by Blueprint MCAT. If you’re taking the test in July, August, or September, go register for your exam now.

If you’re applying this cycle in 2021 to start in 2022, taking the MCAT in July, August and September is an increased risk of schools ignoring your application. They may have already interviewed all of the people or at least invited all of the people they’re going to interview. Or they’re reserving spots for very specific populations the school wants to serve. And so, you have to be careful with later MCAT dates when you are applying.

“The ideal timeframe to take the MCAT for any application cycle is before or at least March or April of the year you are applying.”Click To Tweet

[04:13] An Overview of Today’s Panelists

Dr. Scott Wright is the Host of Inside Med Admissions.

Leila Amiri is the Assistant Dean for Admissions and Recruitment at the University of Illinois College of Medicine. She started as an undergraduate peer advisor in the biology department who worked her way through the ranks into premed advising. Since 2009, Leila has been doing admissions in the medical school arena.

Kristen Anderson is the Director of Admissions at the Noorda College of Osteopathic Medicine. Previously, she worked as a prehealth advisor at a local university for eight years.

Joel Daboub is the Director of Admissions and Records at Dell Medical School. Joel has been involved in college admissions for 31 years. He has served both at the undergraduate level and professional school level. In the last six years, he helped start the selection process for a brand new school.

[08:29] An Overview of How They Use the Letters of Recommendation

Dell Medical School

The letters of recommendation are reviewed during the admissions committee evaluation. At the point of decision, the applicant has been pre-screened for selection for interview. It has been reviewed based on non-cognitive variables to make that choice. The student has then come into the institution, and now virtually interviewed.

Those evaluations have been compiled as well as the entire packet, the application, those recommendations, and interview experience. Evaluations are all sent to the committee for review.

This process allows them to put together other people’s perspective of the applicant. They also observe their behavior at the interview day or through their past behavior application. So it gives them context to the entire application.

University of Illinois College of Medicine

Their letters of recommendation are reviewed as part of the screening process. Leila explains these are intangible parts of their personality that are not accessible by just what they’ve shared with them.

At the screening. stage, they will have comments on the strength of the letter of recommendation and how much additional information it provides.

'What we're looking for is information above and beyond what the candidate has already provided to us by virtue of the personal statement and the experiences.'Click To Tweet

The entire packet goes forward to their committee on admissions for consideration of the interview. At that point, the letters are revisited by the committee on admissions individuals.

When the student comes in for an interview, the interviewers do not have access to the letters. Then they come back into the game again, at the time when they’re deliberating over admissions.

Noorda College of Osteopathic Medicine

The school requires the letters of recommendation to be submitted as part of the supplemental or secondary application, which will be evaluated for meeting the requirements. Then students are invited to complete a virtual interview, although they’re hoping to bring back in-person interviews in the next cycle.

The interviewers don’t have access to the letters of recommendation. They only have access to a video secondary that the applicant submits as part of their supplemental materials and then their personal statement. Then all of the interview feedback along with the letters of recommendation and other application materials, without GPA and MCAT scores, are forwarded on to the admissions committee for evaluation.

[13:10] What Makes a Letter Great

Admissions committees like to see a letter that shows understanding of the candidate, time spent with the candidate, and personal interactions with the candidate. For example, the University of Illinois College of Medicine program requires three faculty letters.

For faculty letters, they like to hear that they’ve had discussions and conversations with the student and that the student is able to think critically. And that they have been able to analyze the information and pull in information from other sources. At the end of the day, they look at the personal relationship that the faculty member has had with the student. This gives them more insight into the individual.

If it’s a personal recommendation such as a volunteering coordinator, for example, they look at the times the individual has gone above and beyond. They also look at the individual experiences they’ve had with the candidate that have set them apart from others.

“This is an introduction to how they would be as a person outside of the carefully curated items that they've submitted to as part of their application.”Click To Tweet

Joel adds who students pick to write the letters tells about the decision making process of the applicant. And so, you want to pick individuals who would be able to speak to certain attributes that you want to highlight.

He gives this analogy of how every applicant is a gemstone with multiple facets. As an applicant, what you want to decide is where you want to shine the light to make a certain facet sparkle.

Dell Medical School does a supplemental letter or fourth letter as well. They want to find voices that could speak about different aspects of who you are, as opposed to one voice or multiple voices speaking about one facet.

[17:37] Utilize Office Hours

From the beginning of the semester, approach professors you may want to ask to write a letter on your behalf. Talk to them about your situation and that you’re planning to apply to medical school and that a letter of recommendation is required as part of that application process.

Ask if they’d be willing to write one as well as what would they need from you this semester and what they feel comfortable writing.

Kristen strongly advises students to utilize office hours to make a connection. Ask questions about the topic of the week or get clarification even if you feel like you have a good grasp on the material. Your goal is to get your face and seen and your name known to them to cultivate that relationship.

“Every professor is going to have office hours even if they have many large classes.”Click To Tweet

[20:49] Letter From a Grad Student

If you’re applying to a school that has stipulations on the type of letter, then it’s up to you to stay in touch with the faculty member. That being said, it would be best for you not to get a perfunctory letter from a chemistry faculty member who’s teaching a class of 270 people, and you’re just one out of the three that got the A.

If the school to which you’re applying requires that the letter be from the PI, it’s okay to ask the postdoc to ask the PI or the faculty member to endorse the letter. They have many letters that have two signatures on them. So the letter is written from the postdoc, or fellow and the faculty member’s or the PI’s signature is on there as well. What’s important is that the letters are from individuals that know you who can write a good letter for you. You don’t want to waste one of those spots of a letter that you have to submit.

“Don't think of this as just a box to check right. There's a reason that we asked for the letters.”Click To Tweet

They have seen composite letters with the faculty instructor’s information at the top of their comments about the student. And then there’s a much more detailed explanation of activities the students engaged in by the teaching assistant or the graduate student.

But they advise it should be someone who knows the applicant best and who can really speak to who they are and how they operate.

[28:46] The Making of a Bad Letter

Some examples of letters why they think are not that great are those wherein they talk about something that had nothing to do about the applicant.

This sends a message to them that this letter writer didn’t really know the applicant. Or they didn’t feel like they had a lot of great things to say about them. Another thing that makes a poor letter is the absence of information.

'As an evaluator, you're looking at what is said and what is not said.'Click To Tweet

All those being said, they concur that they rarely really see bad letters. Generally, students are wise enough to request letters from faculty members and individuals they know will give them a letter of support.

[33:41] Reading Between the Lines

They also have seen letters that give a message of the student being fine, but they’re not great. And they usually do that if they’re not providing examples of what they’re saying. Or if the language they used is neutral and they don’t really seem excited about the student. Now, this could leave the admissions committees wondering about what’s going on here or maybe they just don’t really know the applicant.

Joel adds that they actually caution their committee for speculating unless there’s evidence. You really can’t speculate what it could be. And the question is does it support other past behavior in the application? And if the answer is no, then the letter says they’re fine. And should they find something that’s unclear to them, then they would reach back to that letter writer and ask them to clarify that.

Leila agrees with Joel in that the individual letters rarely ask them to read between the lines. But she feels that the committee letters might have a little bit of “read between the lines.”

'We try not to read between the lines and appreciate it when the language is just clear for us to be able to follow it.'Click To Tweet

[39:08] How They View Committee Letters

What generally happens here is that in some schools, the premed committee produces a letter of summary letter or sometimes it’s just a composite of various comments.

Joel explains that they have a process where the students have to go through certain steps in order to get access to that letter. And so, sometimes you’ll have a candidate who entered the stream the different way to the application process. So they look at the face value of what they provide. And so, they don’t consider it a red flag if for some reason a student didn’t go through the committee process. Maybe they’re non-traditional students. Or maybe there is so much content that they look at in its totality.

'Everybody's got a little bit of a different flavor.'Click To Tweet

Again, there are many different ways that students come to the medical school application process. And even if they are a traditional student, but a student who hasn’t taken advantage of the advising office, and the requirement is that you must meet with them twice a semester to get a letter, then they’re already at a disadvantage. They didn’t have time to go to the office because they had a job or something. So it’s not a red flag for them.

[45:22] Are DO Letters Required?

Kristen explains that Noorda College of Osteopathic Medicine requires a physician letter. They accept a letter from an MD or a DO physician, but they don’t explicitly require a DO letter. Obviously, they would hope that they’ve had some exposure to osteopathic medicine and can speak to that.

For instance, they may have shadowed a DO but didn’t get to know that DO well enough to actually be able to get a letter of recommendation from them. But maybe they worked with an MD as an MA or something like that. And then that physician can provide better insight into who they are as a person and how they might be as a physician, or someone who cares for patients. So they don’t explicitly require the DO letter. They would prefer it but it’s not an absolute requirement.

[47:08] Other Preferences

Joel illustrates that if you have worked, for instance in healthcare, and having somebody you could speak to your acumen for that profession. You worked with the patients, and the patients felt comfortable with you as the physicians.

And that observation could come from a PI or it could come from an employer and a different environment as well. So they don’t really have a checkbox of preference.

'Preference is just something of substantive nature that can tell us more about who you are.'Click To Tweet

Ultimately, the letters need to be insightful, and they need to give additional information they’re looking for.

The AAMC has good guidelines on how to write letters and students could make that available to their letter writers and really get the letters from the individuals that know them best.

The person is putting their name behind the credibility of this individual as an applicant. So when they get a letter from a nurse who has 37 years of experience and talks to them about the bedside manner, they’re not going to worry at all about how the applicant is going to fit into their community.

Additionally, be careful with asking letters from someone who really knows you but then could have some nepotistic bias because that can be problematic. It lessens the effect of the letter. So really think about people you’ve gone out and sought to find out more about who you are who could write about your experience.

[52:49] Final Thoughts

Start looking at the schools that you think you want to apply to and get familiar with their letters of recommendation requirements. Start thinking about who you might be able to fill those requirements and build those relationships now. Start to build them but continue to cultivate and nurture those relationships.

'Who you pick as your letter writer gives us some insight into who you are, but also some of your own self-awareness.'Click To Tweet

If you think about your accomplishments and what you want to highlight, find those individuals who can speak to that. It’s not just one piece of information. It’s really the tapestry of your whole application that they’re looking at and how all that’s interwoven.

Think about what you want to highlight on your application and think about the individuals who can speak to those actions.

Other technical requirements you need to keep in mind for the letter would be things like it should be on letterhead. It needs to have a signature. And so, make sure you have those. If the school has a platform where you can see what’s missing, check that out. If not, email the school to see what the requirements are. If you’ve waived your ability to see the letter, then you really won’t know. You don’t want your application to be held back because of those things.

Finally, request your letters early enough so they get there at the time you’re submitting your supplemental and your application can be completed.