Inside Med Admissions 2: Letters of Recommendation

The second episode of Inside Med Admissions focuses on letters of recommendation and is hosted by Dr. Scott Wright, the VP of Academic Advising for Mappd. The panelists for this episode are Dr. Leila Amiri, Assistant Dean for Admissions and Recruitment at the University of Illinois College of Medicine; Kristen Anderson, Director of Admissions at Noorda College of Osteopathic Medicine; and Joel Daboub, Director of Admissions and Records at Dell Medical School.


How do you use and evaluate letters of recommendation?

At both Noorda and the University of Illinois, recommendation letters are reviewed early in the process, along with the primary application and secondaries. The University of Illinois committee evaluates letters as part of the decision to offer an interview invitation or not. A good letter can reveal “intangible aspects” of who the applicant is and augment the applicant’s evaluation. 

Noorda requires letters to be submitted along with the secondary application. Interviewers don’t have access to the letters of recommendation. Still, they have access to a video secondary that students submit to give a more complete picture of who a student is. The interviewer’s feedback, letters of recommendation, and the student’s essays are then given to the admissions committee to make a final decision about whether to offer admission to a student. 

Dell Medical School’s process is somewhat different in that letters are reviewed later in the process. Before the letters are evaluated, the student’s application is screened for whether an interview invitation will be extended, and the interview has been conducted and evaluated. After these steps, the entire packet, including both the letters and the interview feedback, is submitted to the committee to assess the complete form of the application. The letters serve a crucial function in giving context to the rest of the application, and they can highlight certain qualities or add things that would otherwise be missed. 


What makes a good letter?

A good letter shows an understanding of the candidate and can reference personal interactions with the candidate. These show that the writer knows the student well and can accurately comment on their pre-professional qualities and personality. The University of Illinois requires three faculty letters, in which Dr. Amiri likes to see that the student and professor have gotten to know one another. She also wants to see evidence that the student can think critically, analyze information, and pull in outside information when having a discussion with a faculty member. 

A good letter will also reinforce or “prove” qualities that you have already demonstrated in other areas of your application. For example, an anecdote in a letter can show how you specifically live out that quality in a way that’s unique to you and takes it beyond a quality that all applicants possess. A good letter can also contribute to a committee’s understanding of you by discussing something you could not describe in your application. 

When getting a letter from a professor, keep in mind how well they know you and not just how well you did in their class. A letter that only discusses your academic achievement doesn’t tell a committee anything that the rest of your application hasn’t already been made clear. 


How do I get to know my professors well enough that they can write a good letter about me?

Kristen says that students can be honest at the beginning of the class that they hope to ask this professor for a recommendation and that students ask their professor what they can do to make that possible. Even without explicitly mentioning recommendation letters, it’s a good idea to start getting to know your professors early in the semester and to keep up with them once the course is over. Office hours are an excellent way for students to get time with the professor outside of class, and you don’t have to be struggling in the class to use them. You can talk to your professor about the subject matter, their research or make sure you’re doing what you can to stay on top of your coursework. This can be easier in upper-division classes where the population tends to be smaller. It’s also helpful to show that you engage with your learning beyond going to class and then going home. 

Even if you have already graduated, you can get back in touch with professors. Many professors enjoy hearing how former students are doing, and taking time to get to know them again can help them become a great resource for you. Each step of this process requires time, and creating and maintaining relationships with professors is no exception. 


Is it okay to have someone other than your professor or PI write a letter,  like a TA or a postdoc in your lab?

It’s better to have an excellent letter from a TA or graduate student than a letter from the PI or professor that doesn’t reveal anything about the student. Different schools may have other policies on this scenario, so it’s always good to read the school’s website and find out whether they will accept a letter written by someone other than the professor. 

You may also be able to have a TA write a strong letter for you and then have the professor endorse it. There are also times when a composite letter might be written where the professor speaks to your academic achievements, and the TA discusses personal qualities you possess, and then both writers sign the letter. 


What would make a bad letter?

It’s very rare to see a letter where a writer is actively recommending against accepting a student. It’s more common that the letter doesn’t have much substance, and while this doesn’t necessarily hurt the student, it can show that they didn’t make the best choice in who to ask for a letter. If a committee does see what appears to be a negative comment in a letter, they may reach out to the writer for clarification and additional context. Ultimately, someone shouldn’t agree to write a letter for you if they can’t speak positively about you and in sufficient depth, but it’s also good to keep in mind whether this person is the best person to ask. 


How are committee letters evaluated, and what if a student doesn’t have one?

When a student is seeking a committee letter, a premedical committee will have specific requirements for the student, and these requirements will vary between schools. Once the student has completed the requirements, the committee will collectively evaluate the student, usually using set standards or a rubric. It will then submit that letter to schools on the student’s behalf. Committee letters can be especially helpful when the undergraduate institution is known to the medical school; the committee clearly understands what the evaluation says about the student and what was expected of the student.

While some schools may react poorly to a student who doesn’t have a committee letter, despite coming from a school that gives them, today’s panelists would not want this to damage an applicant’s chances. There are many reasons why someone might not have a committee letter, including being a nontraditional student or failing to attend the required advising meetings. Many schools will ask why the student doesn’t have a committee letter, which can help ease any concern that the student or admissions committee may have.

Noorda does require a letter from a premed advising source, but that can be from an advisor or a committee. If neither of those is available or would be beneficial, an additional faculty letter or an employer letter can be used. These can be especially helpful for students who have been in the workforce for a while and whose employers may know them better than their advisors. If you can’t meet some requirements, it’s good to reach out and see if a solution or compromise can be found. 


Do you require physician letters, and if so, why?

Some osteopathic medical schools require a letter from a practicing osteopathic physician. Noorda does require a physician letter, but it can be from an MD or DO. They do like to see that students have had exposure to the osteopathic profession, but it’s entirely possible that they were just able to get to know an MD better. 

Dell Medical School doesn’t require a physician letter, but it can be helpful to read a letter that speaks to your ability to care for patients or make people more comfortable. This letter can come from a physician you worked with as a medical assistant, an EMT supervisor, or an experienced nurse you worked with. It can be anyone who can speak with credibility to your bedside manner. 


What can students do to ensure they have a good letter?

The AAMC publishes guidelines on how to write a good recommendation letter, and it can be good for students to give those to their writers, so they have a clear sense of the expectations and goals. 

Students need at least some faculty letters, but the key is that the writer can speak well about who you are and your value to the school’s community. 

Don’t ask for a letter from an inappropriate source, like a patient. 

Find out what formatting and logistical requirements schools may have for your letters. Do they need to be on letterhead or submitted with specific formatting? You don’t want your application to be held back due to formatting errors in your letter. If there’s an aspect you or the writer cannot fulfill, reach out to the school to find a solution. 


How to Ask For LORs in an Online Class (OldPremeds 247)

More on Committee Letters

The Premed Playbook Guide to The Medical School Application Process




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